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U.S. Department of Justice
Bureau of Alcohol, Tobacco, Firearms and Explosives
Application for Tax Exempt Transfer and
Registration of Firearm
ATF Control Number
Internal Control Number
National Firearms Act Division
Bureau of Alcohol, Tobacco, Firearms and Explosives, 244 Needy Road, Martinsburg, WV 25405
Submit in duplicate to:
1. Type of Transfer: tax exempt
I believe that I am entitled to exemption from
the payment of the Transfer Tax Imposed by
section 5811 (26 U.S.C. Chapter 53) on the
Firearm described herein for the following
reason (See Instruction 2b):
Firearm is unserviceable and is being
transferred as a curio or ornament
Firearm is being transferred to or from
a Government Entity
Firearm is being transferred to a lawful
heir or by operation of law
Other (Specify)
2a. Transferee’s Full Legal Name and Address (Include trade name, if any) (See instruction 2k)
Other Legal Entity
Corporation
Individual
Trust
2b. County/Parish
Government Entity
3a. If Applicable: Decedent’s Name, Address, and Date of Death
3b. Transferor’s Name and Address (Include trade name, if any) (Executors: see instruction 2k)
3e. Number, Street, City, State and Zip Code of Residence (or Firearms Business Premises)
If Different from Item 3a.
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3c. Transferor’s telephone (area code and number) 3d. E-mail address
The above-named and undersigned transferor hereby makes application as required by Section 5812 of the National Firearms Act to transfer and register the firearm described
below to the transferee.
d. Model
4. Description of Firearm (Complete items a through i) (See instruction 2n)
a.
Name and Address of Maker, Manufacturer and/or
Importer of Firearm
b. Type of Firearm (See definitions1c)
c.
Caliber
or
Gauge
e. Barrel:
Length
(Inches)
f. Overall:
g. Serial Number
Additional Description or Data Appearing on Firearm (Attach additional
sheet if necessary)
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h.
i. Has the Firearm been rendered unserviceable as defined in Definition 1m?
(If “Yes,” describe the method by which the firearm has been
Yes
No
rendered unserviceable. Use additional sheets.)
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5. Applicant’s Federal Firearms License (if any) or Explosives License or Permit Number 6. Transferee’s Special (Occupational) Tax Status (If any)
(Give complete 15-digit number) (See instruction 2c)
a. Employer Identification Number
b. Class
2 digits
First 6 digits
5 digits
2 digits
7.
8. Transferor’s Special (Occupational) Tax Status (If any)
Transferor’s Federal Firearms License (If any)
First 6 digits
2 digits
2 digits
a. Employer Identification Number
b. Class
5 digits
Under Penalties of Perjury, I Declare that I have examined this application, and to the best of my knowledge and belief it is true, correct and complete, and that the transfer
of the described firearm to the transferee and receipt and possession of it by the transferee are not prohibited by the provisions of Title 18, United States Code, Chap 44;
Title 26, United States Code Chap 53; or any provisions of State or local law.
9. Signature of Transferor (Or authorized official)
10. Name and Title of Authorized Official (Print or type) 11. Date
The Space Below is for the use of the Bureau of Alcohol, Tobacco, Firearms and Explosives
By Authority of The Director, This Application Has Been Examined, and the Transfer and Registration of the Firearm Described Herein and the Interstate Movement of that
Firearm, When Applicable, to the Transferee are:
Approved (With the following conditions, if any)
Disapproved (For the following reasons)
Date
Signature of Authorized ATF Official
Previous Editions Are Obsolete
ATF Copy
ATF Form 5 (5320.5)
Revised (
)
TRANSFEREE CERTIFICATION (not completed by a Government Entity)
12. Law Enforcement Notification (See instruction 2f)
The transferee is to provide notification of the proposed acquisition and possession of the firearm described on this Form 5 by providing a copy of the completed form to the
chief law enforcement officer in the agency identified below:
Agency or Department Name
Name and Title of Official
Address (Street address or P.O. Box, City, State and Zip Code) to which sent (mailed or delivered)
Information for the Chief Law Enforcement Officer
This form provides notification of the transferee’s intent to acquire and possess a National Firearms Act (NFA) firearm. No action on your part is required. However, should
you have information that may disqualify this person from acquiring or possessing a firearm, please contact the NFA Division at (304) 616-4500 or [email protected]. A “Yes”
answer to items 14.a. through 14.h. or 18.d. or 18.e. could disqualify a person from acquiring or possessing a firearm. Also, ATF will not approve an application if the
transfer or possession of the firearm is in violation of State or local law.
13. Transferee Necessity Statement (Do not complete if the transferee is a government agency) (See instruction 2e)
I,
, have a reasonable necessity to possess the machinegun, short-barreled rifle,
(Name and Title of Transferee)
short-barreled shotgun, or destructive device described on this application for the following reason(s)
and my possession of the device or weapon would be consistent with public safety (18 U.S.C. § 922(b) (4) and 27 CFR § 478.98).
Transferee Questions (complete only when transferee is an individual)
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14. Answer questions 14.a. through 14.h. Answer questions 16, 17, 18, 19 and 20, if applicable. For any “Yes” answer the transferee shall provide details on a separate
sheet. (See instruction 7b and definitions)
Yes
No
a. Are you under indictment or information in any court for a felony, or any other crime, for which the judge
could imprison you for more than one year? (See definition 1n)
b. Have you ever been convicted in any court for a felony, or any other crime, for which the judge could have imprisoned
you for more than one year, even if you received a shorter sentence including probation? (See definition 1n)
c. Are you a fugitive from justice? (See definition 1t)
Are you an unlawful user of, or addicted to, marijuana or any depressant, stimulant, narcotic drug, or any
other controlled substance? Warning: The use or possession of marijuana remains unlawful under
Federal law regardless of whether it has been legalized or decriminalized for medicinal or recreational
purposes in the state where you reside.
Have you ever been adjudicated as a mental defective OR have you ever been committed to a mental
institution? (See definitions 1o and 1p)
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d.
e.
f. Have you been discharged from the Armed Forces under dishonorable conditions?
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2. Photo must have been taken in full face
view without a hat or head covering that
obscures the hair or hairline.
h. Have you ever been convicted in any court of a misdemeanor crime of domestic violence? (See definition 1r)
17a. Ethnicity
Date of Birth:
17b. Race
Hispanic or Latino
Not Hispanic or Latino
Affix a 2” x 2” Photograph here.
No Stapling. Tape Sides of Photo to the
Application.
1. Photo must have been taken within the
last year.
g. Are you subject to a court order restraining you from harassing, stalking, or threatening your child or an
intimate partner or child of such partner? (See definition 1q)
16. Social Security Number: (See Instructions 2h)
15. Photograph
3. On back of photograph print full name,
last 4 of SSN.
American Indian or Alaska Native
Black or African American
Asian
Native Hawaiian or Other Pacific Islander
White
18a. Country of Citizenship: (Check/List more than one, if applicable. Nationals of the United States may check U.S.A.) (See definition 1s)
United States of America
Other Country/Countries (specify):
18b. State of Birth
18c.Country of Birth
Yes
d. Have you ever renounced your United States citizenship?
e. Are you an alien illegally or unlawfully in the United States?
f.1. Are you an alien who has been admitted to the United States under a nonimmigrant visa?
f.2. If “yes”, do you fall within any of the exceptions stated in the instructions? Attach the documentation to the application
N/A
19. If you are an alien, record your U.S.-Issued Alien or Admission number (AR#, USCIS#, or I94#):
20. Have you been issued a Unique Personal Identification Number (UPIN)? (See instructions 2h)
ATF Copy
Yes
No
If yes please provide
ATF Form 5 (5320.5)
Revised ( )
No
CERTIFICATION: Under penalties imposed by 18 U.S.C. § 924 and 26 U.S.C. § 5861, I certify that, upon submission of this form to ATF, a completed copy of this form will be directed
to the chief law enforcement officer (CLEO) shown in item 12, that the statements, as applicable, contained in this certification, and any attached documents in support thereof, are true
and correct to the best of my knowledge and belief. NOTE: See instructions 2.d(2) and 2.d(3) for the items to be completed depending on the type of transferee.
Date
Signature of Transferee
21. Number of Responsible Persons (see definitions) associated with the transferee trust or legal entity
22. Provide the full name (printed or typed) below for each Responsible Person associated with the applicant trust or legal entity (if there are more
Responsible Persons than can be listed on the form, attach a separate sheet listing the additional Responsible Person(s)). Please note that a completed Form 5320.23,
National Firearms Act (NFA) Responsible Person Questionnaire, must be submitted with the Form 5 application for each Responsible Person.
Full Name
Full Name
Important Information for Currently Registered Firearms
If you are the current registrant of the firearm described on this form, please note the following information.
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Estate Procedures: For procedures regarding the transfer of firearms in an estate resulting from the death of the registrant identified in item 2a, the executor should contact
the NFA Division, Bureau of Alcohol, Tobacco, Firearms and Explosives, 244 Needy Road, Martinsburg, WV 25405.
Change of Address: Unless currently licensed under the Gun Control Act, the registrant shall notify the NFA Division, Bureau of Alcohol, Tobacco, Firearms and
Explosives, 244 Needy Road, Martinsburg, WV 25405, in writing, of any change to the address in item 2a.
Change of Description: The registrant shall notify the NFA Division, Bureau of Alcohol, Tobacco, Firearms and Explosives, 244 Needy Road, Martinsburg, WV 25405, in
writing, of any change to the description of the firearm(s) in item 4.
Interstate Movement: If the firearm identified in item 4 is a machinegun, short-barreled rifle, short-barreled shotgun, or destructive device, the registrant may be
required by 18 U.S.C. § 922(a)(4) to obtain permission from ATF prior to any transportation in interstate or foreign commerce. ATF Form 5320.20 can be used to request this
permission.
Restrictions on Possession: Any restriction (see approval block on face of form) on the possession of the firearm identified in item 4 continues with the further transfer of
the firearm.
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Persons Prohibited from Possessing Firearms: If the registrant becomes prohibited from possessing a firearm, please contact the NFA Division for procedures on how to
dispose of the firearm.
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Proof of Registration: A person possessing a firearm registered as required by the NFA shall retain proof of registration which shall be made available to any ATF officer
upon request.
Paperwork Reduction Act Notice
This form meets the clearance requirements of the Paperwork Reduction Act of 1995. The information you provide is used to apply the tax-exempt transfer of an
unserviceable firearm to anyone other than a Federal firearms licensee who has paid the required special (Occupational) tax to deal in NFA firearms and to or from
government agencies. The data is used to ensure legality of transfer under Federal, State and local law. The furnishing of this information is mandatory (26 U.S.C. § 5812).
The estimated average burden associated with this collection of information is 0.5 hours per respondent or recordkeeper, depending on individual circumstances. Comments
concerning the accuracy of this burden estimate and suggestion for reducing this burden should be addressed to Reports Management Officer, Information Technology
Coordination Staff, Bureau of Alcohol, Tobacco, Firearms and Explosives, Washington, DC 20226.
An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number.
Privacy Act Information
The following information is provided pursuant to Section 3 of the Privacy Act of 1974 (5 U.S.C. § 552(e)(3)):
1. Authority. Solicitation of this information is made pursuant to the National Firearms Act (26 U.S.C. § 5812). Disclosure or this information by the applicant is mandatory for any transfer
without payment of transfer tax as provided in 26 U.S.C. § 5852.
2. Purpose. To verify that the proposed transfer is exempt from transfer tax; to verify that the transfer would not be in violation of law; and to effect registration of the firearm.
3.
Routine Uses. The information will be used by ATF to make the determinations set forth in paragraph 2. In addition, to effect registration of the firearm, information as to the identification
of the firearm, date of registration, and the identification and address of person entitled to possess the firearm will be entered into the National Firearms Registration and Transfer Record. No
information obtained from an application, registration, or records required to be submitted by an individual in order to comply with any provision of the National Firearms Act or regulation
issued thereunder, shall, except in connection with prosecution or other action for furnishing information, be used, directly or indirectly, as evidence against that person in any criminal
proceeding with respect to a violation of law occurring prior to or concurrently with the filing of the application. The information from this application may only be disclosed to Federal
authorities for purposes of prosecution for violation of the National Firearms Act.
4. Effects of not Supplying Information Requested. Failure to supply complete information will delay processing and may cause denial of the application.
ATF Copy
ATF Form 5 (5320.5)
Revised ( )
Definitions/Instructions
imprisonment of two years or less); is a fugitive from justice; is an unlawful user of, or
addicted to, marijuana or any depressant, stimulant, or narcotic drug, or any other
a.
National Firearms Act (NFA). Title 26, United States Code, Chapter
controlled substance; has been adjudicated as a mental defective or has been
53. The implementing regulations are found in Title 27, Code of Federal
committed to a mental institution; has been discharged from the Armed Forces under
Regulations, Part 479.
dishonorable conditions; has renounced his or her U.S. citizenship; is an alien illegally
in the United States or an alien admitted to the United States under a nonimmigrant
b.
Gun Control Act (GCA). Title 18, United States Code, Chapter 44.
visa; or is subject to certain restraining orders. Furthermore, Section 922 (n) prohibits
The implementing regulations are found in Title 27, Code of Federal
the shipment, transportation, or receipt in or affecting interstate commerce of a firearm
Regulations, Part 478.
by one who is under indictment or information for a felony in any Federal, State or
local court, or any other crime, punishable by imprisonment for a term exceeding one year.
c.
Firearm. The term “firearm” means: (1) a shotgun having a barrel or
An information is a formal accusation of a crime verified by a prosecutor.
barrels of less than 18 inches in length; (2) a weapon made from a
shotgun if such weapon as modified has an overall length of less than 26
EXCEPTION: A person who has been convicted of a felony, or any other crime, for
inches or a barrel or barrels of less than 18 inches in length; (3) a rifle
which the judge could have imprisoned the person for more than one year, or who has been
having a barrel or barrels of less than 16 inches in length; (4) a weapon
convicted of a misdemeanor crime of domestic violence, is not prohibited from
made from a rifle if such weapon as modified has an overall length of less
purchasing, receiving, or possessing a firearm if: (1) under the law of the jurisdiction where
than 26 inches or a barrel or barrels of less than 16 inches in length; (5)
the conviction occurred, the person has been pardoned, the conviction has been expunged
any other weapon as defined in 26 U.S.C. § 5845(e); (6) a machinegun;
or set aside, or the person has had their civil rights (the right to vote, sit on a jury, and hold
(7) a muffler or silencer for any firearm whether or not such firearm is
public office) taken away and later restoredAND (2) the person is not prohibited by the law
included within this definition; and (8) a destructive device.
of the jurisdiction where the conviction occurred from receiving or possessing firearms.
Persons subject to this exception should mark “no” in the applicable box.
d.
Person. A partnership, company, association, trust, corporation, including
each responsible person associated with such an entity; including each
o.
Adjudicated as a Mental Defective. A determination by a court, board,
responsible person associated with such an entity; an estate; or an individual.
commission, or other lawful authority that a person, as a result of marked subnormal
intelligence, or mental illness, incompetency, condition, or disease: (1) is a danger to
Section A
himself or to others; or (2) lacks the mental capacity to contract or manage his own
e.
Responsible Person. In the case of an unlicensed entity, including any trust, partnership,
affairs. This term shall include: (1) a finding of insanity by a court in a criminal case;
association, company (including any Limited Liability Company (LLC)), or corporation, any
and (2) those persons found incompetent to stand trial or found not guilty by reason of
individual who possesses, directly or indirectly, the power or authority to direct the
lack of mental responsibility.
management and policies of the trust or entity to receive, possess, ship, transport, deliver,
transfer or otherwise dispose of a firearm for, or on behalf of, the trust or legal entity.
p.
Committed to a Mental Institution. A formal commitment of a person to a mental
institution by a court, board, commission, or other lawful authority. The term includes
Section B
a commitment to a mental institution involuntarily. The term includes commitment
Ttrust: Those persons with the power or authority to direct the management and
for mental defectiveness or mental illness. It also includes commitments for other
policies of the trust includes any person who has the capability to exercise such power
reasons, such as for drug use. The term does not include a person in a mental
and possesses, directly or indirectly, the power or authority under any trust instrument, or
institution for observation or a voluntary admission to a mental institution.
under State law, to receive, possess, ship, transport, deliver, transfer, or otherwise
dispose of a firearm for, or on behalf of the trust. Examples of who may be considered a
EXCEPTION NICS Improvement Amendments Act of 2007: A person who has been
responsible person include settlors/grantors, trustees, partners, members, officers, directors,
adjudicated as a mental defective or committed to a mental institution in a state proceeding
board members, or owners. An example of who may be excluded from this definition of
is not prohibited by the adjudication or commitment if the person has been granted relief
responsible person is the beneficiary of a trust, if the beneficiary does not have the capability
by the adjudicating/committing state pursuant to a qualifying mental health relief from
to exercise the enumerated powers or authorities.
disabilities program. Also, a person who has been adjudicated as a mental defective or
committed to a mental institution by a department or agency of the Federal Government
f. Employer Identification Number (EIN). Required of taxpayer filing
is not prohibited by the adjudication or commitmemt if either (a) the person’s adjudica
special (occupational) tax returns under 27 CFR § 479.35.
tion or commitment was set-aside or expunged by the adjudicating/committing agency;
(b) the person has been fully released or discharged from all mandatory treatment, supervi
g.
Special (Occupational) Tax. Required by the NFA to be paid by a
sion, or monitoring by the agency; (c) the person was found by the agency to no longer
Federal firearms licensee engaged in the business of manufacturing (Class
suffer from the mental health condition that served as the basis of the initial adjudication/
2), importing (Class 1), or dealing (Class 3) in NFA firearms.
commitment; or (d) the adjudication or commitment, respectively, is based solely on a
medical finding of disability, without an opportunity for a hearing by a court, board,
h.
Federal Firearms License. A license issued under the provisions of
commission, or other lawful authority, and the person has not been adjudicated as a mental
the GCA to manufacture, import or deal in firearms.
defective consistent with section 922(g)(4) of title 18, United States code; or (e) the person
was granted relief from the adjudicating/committing agency pursuant to a qualified mental
i.
ATF Officer. An officer or employee of the Bureau of Alcohol, Tobacco,
health relief from disabilities program. Persons who fall within one of the above
Firearms and Explosives (ATF) authorized to perform any function
exceptions should mark “no” in the applicable box. This exception to an adjudication or
relating to the administration of the NFA.
commitment by a Federal department or agency does not apply to any person who was
adjudicated to be not guilty by reason of insanity, or based on a lack of mental responsibil
j.
Transfer. Selling, assigning, pledging, leasing, loaning, giving away, or
ity, or found incompetent to stand trial, in any criminal case or under the Uniform Code of
otherwise disposing of a firearm.
Military Justice.
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1. Definitions
k.
Transferor. The person selling or otherwise disposing of a firearm;
including applying to transfer a firearm.
l.
Transferee. The person acquiring the firearm.
m.
Unserviceable Firearm. One which is incapable of discharging a shot
by means of an explosive and incapable of being readily restored to firing
condition. An acceptable method of rendering most firearms
unserviceable is to fusion weld the chamber closed and fusion weld the
barrel solidly to the frame.
n.
Prohibited Person. Generally, 18 U.S.C. § 922 (g) prohibits the shipment,
transportation, receipt, or possession in or affecting interstate commerce of a firearm
by one who: has been convicted of a misdemeanor crime of domestic violence; has
been convicted of a felony, or any other crime, punishable by imprisonment for a term
exceeding one year (this does not include State misdemeanors punishable by
q.
Restraining Order. Under 18 U.S.C. § 922, firearms may not be sold to
or received by persons subject to a court order that: (A) was issued after a hearing
which the person received actual notice of and had an opportunity to participate in;
(B) restrains such person from harassing, stalking, or threatening an intimate partner or
child of such intimate partner or person, or engaging in other conduct that would place
an intimate partner in reasonable fear of bodily injury to the partner or child; and
(C)(i) includes a finding that such person represents a credible threat to the
physical safety of such intimate partner or child; or (ii) by its terms explicitly prohibits
the use, attempted use, or threatened use of physical force against such intimate partner
or child that would reasonably be expected to cause bodily injury. An “intimate
partner” of a person is: the spouse or former spouse of the person, the parent of a
child of the person, or an individual who cohabitates or has cohabitated with the
person.
ATF Form 5 (5320.5)
Revised ( )
r.
Misdemeanor Crime of Domestic Violence: A Federal, State, local, tribal
offense that is a misdemeanor under the Federal, State, or tribal law and has,
as an element, the use or attempted use of physical force, or the threatened
use of a deadly weapon, committed by a current or former spouse, parent, or
guardian of the victim, by a person with whom the victim shares a child
in common, by a person cohabitating with, or has cohabitated with the
victim as a spouse, parent, or guardian, or by a person similarly situated to a
spouse, parent, or guardian of the victim. The term includes all
misdemeanors that have as an element the use or attempted use of
physical force or the threatened use of a deadly weapon (e.g., assault and
battery), if the offense is committed by one of the defined parties.
(See Exception in the definition of “Prohibited Person”). A person who
has been convicted of a misdemeanor crime of domestic violence also is not
prohibited unless: (1) the person was represented by a lawyer or gave up the
right to a lawyer; (2) if the person was entitled to a jury, was tried by a jury,
or gave up the right to a jury trial. Persons subject to this exception
should mark “no” in the applicable box.
d. Completion of Form.
(1) The transferor shall provide the transferee’s full legal name to include
middle and physical address (no Post office box) in item 2a. If the
transferee is a trust or legal entity, show only the complete name of
the trust or legal entity and do not include any individual names (such
as names of trustees or corporate officials). The address shall be the
location within the particular state where the firearm will be maintained
for a trust or legal entity. In the case of two or more locations for a
legal entity, the address shown shall be the principal place of business
within the particular state (or principal office, in the case of a corporation).
(2) If the transferee is an individual, the entire Form 5 shall be completed
except for items 21 and 22. In addition, the transferee must include
his or her fingerprints on FBI Form FD-258 and his or her photos (see
instruction 2g).
(3) If the transferee is other than an individual, e.g., a trust or legal entity,
such as a corporation, the transferee shall not complete items 14, 15,
16, 17, 18, 19 or 20. All other items must be completed including the
signing of the Transferee Certification statement by the transferee See
2.d.5 for Responsible Person Requirements.
(4) Documentation of entity existence:
a. If the transferee is other than an individual, the transferee must
attach documentation evidencing the existence and validity of
the trust or legal entity, which includes complete and unredacted
copies of partnership agreements, articles of incorporation,
corporate registration, declarations of trust with any trust schedules,
attachments, exhibits, and enclosures.
b. If the transferee entity has had an application approved as a maker
or transferee within the preceding 24 months of the date of filing
this application, and there has been no change to the
documentation evidencing the existence and validity of the entity
previously provided, the trust or legal entity may provide a
certification that the information has not been changed since the
prior approval and shall identify the application for which the
documentation had been submitted form number, serial number, and
date approved.
(5) If the transferee is other than an individual, each responsible person
of the trust or legal entity (see definition1e) must include a completed
ATF Form 5320.23, National Firearms Act (NFA) Responsible Person
Questionnaire, with the submitted Form 5.
(6) Item 4g (serial number) is obscured on the CLEO copy. This field does
not require completion on the CLEO copy.
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s.
Alien Admitted to the United States Under a Nonimmigrant Visa. An
alien admitted to the United States under a nonimmigrant visa includes,
among others, persons visiting the United States temporarily for business
or pleasure, persons studying in the United States who maintain a
residence abroad, and certain temporary foreign workers. These aliens
must answer “yes” to question 16.d.1 and provide the additional
documentation required under question 16.d.2. Permanent resident aliens
and aliens legally admitted to the United States pursuant to either the Visa
Waiver Program or to regulations otherwise exempting them from visa
requirements may answer “no” to this question and are not required to
submit the additional documentation under 16.d.2. An alien admitted to the
United States under a nonimmigrant visa is not prohibited from purchasing,
receiving, or possessing a firearm if the alien: (1) is in possession of a
hunting license or permit lawfully issued by the Federal Government, a
State, or local government, or an Indian tribe federally recognized by the
Bureau of Indian Affairs, which is valid and unexpired; (2) was
admitted to the United States for lawful hunting or sporting purposes; (3)
is an official representative of a foreign government who is accredited to
the United States Government or the Government’s mission to an
international organization having its headquarters in the United States;
(4) is an official representative of a foreign government who is en route to
or from another country to which that alien is accredited; (5) is an official
of a foreign government or a distinguished foreign visitor who has been
so designated by the Department of State; (6) is a foreign law enforcement
officer of a friendly foreign government entering the United States on
official law enforcement business; (7) has received a waiver from the
prohibition from the Attorney General of the United States.
respectively. The complete license number of each shall be entered in items
5 and 7 of the form and, if the licensee is a special (occuptational) taxpayer
under the NFA, the licensee’s employer identification number (EIN) shall be
entered in items 6 and 8 of the form, along with the class of special tax paid.
IMPORTANT NOTE: The business structure of the licensee shall be described
consistently. For example, if the transferor is a sole proprietor, item 3a shall
reflect the FFL information for the sole proprietor business and item 7 shall
reflect the FFL number for that sole proprietor business. Item 8 will reflect the EIN
for the sole proprietor business. If the special tax is paid as a corporation, then it is
not valid for the transaction. Similarly, a corporation name shown in item 3a with
the FFL number and EIN of a sole proprietor will not be valid for the transaction.
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t.
Fugitives from Justice. Any person who has fled from any State to avoid
prosecution for a felony or a misdemeanor, or any person who leaves the
State to avoid giving testimony in any criminal proceeding. The term also
includes any person who knows that misdemeanor or felony charges are
pending against such person and who leaves the State of prosecution.
2. Preparation of Application
a.
Authority. As provided by 26 U.S.C. §§§ 5812, 5852, and 5853, any
person seeking to transfer a firearm exempt from payment of tax must submit,
in duplicate, a separate application on this form for each firearm. The
transferor must furnish all the information called for, except as noted by
instructions within, on this application form. Please note that the form now
contains a 3rd (CLEO) copy of the form for use in compliance with
instruction 2f and item 12 of the form.
b.
Exemptions from Transfer Tax. A registered firearm may be transferred
without payment of the transfer tax if:
(1) it is unserviceable; (See definition 1m)
(2) it is being transferred to or from the United States, or any
department, independent establishment or agency thereof;
(3) it is being transferred to or from any State or possession of the
United States or any political subdivision thereof, or any official
police organization of such government entity; or
(4) it is being transferred to a beneficiary of an estate.
c.
Federal Firearms Licensees. If the transferor or transferee is a Federal
Firearms licensee (FFL) under the GCA, the licensee’s complete name, trade
name (if any), and address shall be entered in items 2a or 3a of this form,
e.
Transferee Necessity Statement. Item 13 must be completed by the
transferee if:
(1)
(2)
(3)
the firearm to be transferred is a machinegun, short-barreled rifle,
short-barreled shotgun, or destructive device;
the transferor is licensed under the GCA to deal in such device or
firearm; and
the transferee is not licensed under the GCA to deal in such device
or firearm.
f.
Law Enforcement Notification. The transferee must provide a copy of
the Form 5 to the chief law enforcement officer (CLEO) who has
jurisdiction over the area of the transferee’s address shown in item 2a of
the Form 5. In addition, if the transferee is other than an individual, a copy
of the Form 5320.23, National Firearms Act (NFA) Responsible Person
Questionnaire, completed by each responsible person must be provided to
their respective chief law enforcement officer. The chief law enforcement
officer is considered to be the Chief of Police; the Sheriff; the Head of the
State Police; or a State or local district attorney or prosecutor.
ATF Form 5(5320.5)
Revised ( )
g.
Photographs and Fingerprints. An individual transferee, except if
licensed as a manufacturer, importer, or dealer under the GCA, must
(1) attach to item 15 of the ATF Form 5, a 2 inch x 2 inch photograph of
the frontal view of the transferee taken within 1 year prior to the date of
the application and (2) submit two properly completed FBI Forms FD-258
(Fingerprint Card with blue lines) with the application. The fingerprints
must be clear for accurate classification and taken by someone properly
equipped to take them.
h.
Social Security Number and UPIN. The Social Security number and
UPIN are not required. However, this informatin assists with the efficient
completion of the NICS background check. Please be aware that refusal
to provide this informatin may result in a delay in the NICS background
check process.
i.
Signatures. All signatures required on ATF Form 5 must be original in
ink on both copies. Exceptions: In the case of eforms or where a variance
has been granted a Digital/Electronic signature may be used.
(1) if the applicant is an individual, the applicant shall sign the form;
(2) if the applicant is the estate of a decedent or the firearm is being
transferred by other operation of law, the executor or administrator of
the estate shall sign the form or, in the case of other operation of law
transfer, the person appointed to dispose of the property shall sign the
form;
(3) if the applicant is a trust or legal entity, a responsible person of the trust
or legal entity shall sign the form;
(4) if the applicant is a Federal firearms licensee, a responsible person of the
Federal firearms licensee must sign the form; or
(5) if the applicant is a government entity, a person who has authority to sign
for the entity shall sign the form.
3.
Approval of Application. Upon approval of an application, the NFA Division
will return the approved copy to the transferor for delivery with the firearm to
the transferee. Since the approval of the application effectuates registration
of the firearm to the transferee, the physical transfer of the firearm must be
completed immediately; however, the transferor must not transfer the firearm
until the application has been approved and received. If the physical transfer
of the firearm cannot be completed immediately, the transferor must contact
the NFA Branch with the specifics.
4. Withdrawal of Application. The transferor may withdraw an application
prior to approval subsequent to a written request directed to the Chief, NFA
Division, 244 Needy Road, Martinsburg, WV 25405.
5.
Cancellation of Approved Application. The transferor may cancel an
approved application only if the physical transfer of the firearm has not been
completed. The transferor must return the approved application with a written
request directed to the Chief, NFA Division, 244 Needy Road, Martinsburg, WV
25405 for cancellation, citing the need and that the physical transfer of the
firearm did not take place.
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note item 4g. to “see attached list of xxx serial numbers.” Any attachment
must be referenced to the ATF Form 5. (7) If there are differences
between the description of the firearm on the form in comparison to the
physical description of the firearm or in the markings on the firearm,
including the serial number, contact the NFA Division in regard to these
differences. (8) Item 4i. Answer “Yes” or “No”.
o.
State or Local Permit. If a State or local permit or license is required
for the transferee prior to acquisition of the firearm, a copy of the permit
must be included with the application. If the transferee is a trust or legal
entity, when the State of residence for any responsible person requires a
State or local permit or license, a copy of the permit or license must be
submitted with Form 5320.23, National Firearms Act (NFA) Responsible
Person Questionnaire.
j.
Photocopies, Computer Generated Versions, or Downloaded
Version. The form may be copied or downloaded (for example, from the
ATF website (www.atf.gov)). The form does not have to be printed front
to back.
R
k.
Estates, Trusts, and Other Transfers by Operation of Law. When a firearm
is being transferred from an estate by bequest or intestate succession (see 27 CFR §
479.90a), or by other operation of law to a beneficiary or other authorized recipient,
ATF Form 5 is used to effect the transfer. The executor, trustee, or other person
appointed to dispose of property shall provide documentation of the legal status of the
person entitled to receive property, and shall identify that person in item 2a.
In the case of an estate, item 3e shall be completed to reflect the decedent’s
information. If the transfer is to someone other than to a person identified under
operation of law, the transfer is subject to transfer tax and ATF Form 4 shall be used.
D
l.
Submission. The transferor shall submit 2 forms (ATF Copy 1 and Copy 2
(Registrant)) to the NFA Division at the address on the face of the form. All
items on the form are to be completed except as noted in the instructions and
any attachment included with the submission. The applicant shall direct the
3rd copy (CLEO) complete copy of the form to the chief law enforcement
officer as provided in instruction 2f and item 12.
m.
Submission by Facsimile Transmission. ATF Form 5 may also be
submitted (in situations where the application is not accompanied by
fingerprints and photographs) for approval by facsimile transmission to
(304) 616-4501 provided that the transferor has filed an affidavit with
the NFA Division as provided by ATF Industry Circular 89-6.
n.
Description of Firearm and Markings. (1) Item 4a. please provide
the name and address of the maker, manufacturer or importer of the fire-
arm. If there are additional makers, manufacturers, or importers, include
this information in item 4h or on a separate sheet of paper. (2) Item 4b
the types of NFA firearm are listed in definition 1c. (3) Item 4c. specify
one caliber or gauge. If there are additional calibers associated with the
description of the firearm, include this information in item 4h or on a
separate piece of paper. (4) Item 4d. show the model designation (if
any). (5) Item 4e. and 4f. specify the barrel and overall lengths as
applicable. If there are additional barrel and overall lengths associated
with the description of the firearm, include this information in item 4h or
on a separate sheet of paper. (6) Item 4g. (a) enter the serial number of
the firearm. (b) When more than one firearm of the same description is
being transferred and the serial numbers are in a consecutive series, the
transferor may enter the beginning and ending serial numbers of the
range. When more than one firearm of the same description is being
transferred but the serial numbers are nonconsecutive, the transferor may
6. Disapproval of Application. If the application is disapproved, the NFA
Division will note the reason for disapproval on the application and return one
copy of the ATF Form 5 to the transferor.
7. Reasons for Disapproval. 26 U.S.C. § 5812 provides that applications shall
be denied if the transfer, receipt, or possession of the firearm would place the
transferee in violation of law.
a.
Violation of Law. Applications shall be denied if the receipt or possession
of the firearm would place the person receiving or possessing the firearm
in violation of law.
b. Persons Prohibited from Receiving a Firearm. The application will be
disapproved if the transferee is a person prohibited from receiving a
firearm. For information regarding persons prohibited from receiving a
firearm, refer to definitions 1n through 1s.
8.
Status Inquiries and Questions. Information relating to the NFA and other
firearms laws is available at the ATF Internet website at www.atf.gov. Any
inquiry relating to the status of an application to transfer an NFA firearm or
about procedures in general should be directed to the NFA Division at (304)
616-4500. Please be aware that any dissemination by ATF of information
relating to the application to register an NFA firearm must conform with the
restrictions in 26 U.S.C. § 6103.
9. Penalties. Any person who violates or fails to comply with any of the
requirements of the NFA shall, upon conviction, be fined not more than
$10,000 or be imprisoned for not more than 10 years, or both. Any firearm
involved in a violation of the NFA shall be subject to seizure and forfeiture.
It is unlawful for any person to make or cause the making of a false entry on
any application or record required by the NFA knowing such entry to be
false.
10. Compliance with the Gun Control Act. Persons must also comply with all
relevant portions of the GCA.
ATF Form 5(5320.5)
Revised (
)
OMB No. 1140-0015 (xx/xx/xxxx)
U.S. Department of Justice
Bureau of Alcohol, Tobacco, Firearms and Explosives
Application for Tax Exempt Transfer and
Registration of Firearm
ATF Control Number
Internal Control Number
National Firearms Act Division
Bureau of Alcohol, Tobacco, Firearms and Explosives, 244 Needy Road, Martinsburg, WV 25405
Submit in duplicate to:
1. Type of Transfer: tax exempt
I believe that I am entitled to exemption from
the payment of the Transfer Tax Imposed by
section 5811 (26 U.S.C. Chapter 53) on the
Firearm described herein for the following
reason (See Instruction 2b):
Firearm is unserviceable and is being
transferred as a curio or ornament
Firearm is being transferred to or from
a Government Entity
Firearm is being transferred to a lawful
heir or by operation of law
Other (Specify)
2a. Transferee’s Full Legal Name and Address (Include trade name, if any) (See instruction 2k)
Other Legal Entity
Corporation
Individual
Trust
2b. County/Parish
Government Entity
3a. If Applicable: Decedent’s Name, Address, and Date of Death
3b. Transferor’s Name and Address (Include trade name, if any) (Executors: see instruction 2k)
3e. Number, Street, City, State and Zip Code of Residence (or Firearms Business Premises)
If Different from Item 3a.
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3c. Transferor’s telephone (area code and number) 3d. E-mail address
The above-named and undersigned transferor hereby makes application as required by Section 5812 of the National Firearms Act to transfer and register the firearm described
below to the transferee.
d. Model
4. Description of Firearm (Complete items a through i) (See instruction 2n)
a. Name and Address of Maker, Manufacturer and/or
Importer of Firearm
b. Type of Firearm (See definitions1c)
c. Caliber
or
Gauge
e. Barrel:
Length
(Inches)
f. Overall:
g. Serial Number
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h. Additional Description or Data Appearing on Firearm (Attach additional
sheet if necessary)
i. Has the Firearm been rendered unserviceable as defined in Definition 1m?
(If “Yes,” describe the method by which the firearm has been
Yes
No
rendered unserviceable. Use additional sheets.)
D
5. Applicant’s Federal Firearms License (if any) or Explosives License or Permit Number 6. Transferee’s Special (Occupational) Tax Status (If any)
(Give complete 15-digit number) (See instruction 2c)
a. Employer Identification Number
b. Class
2 digits
First 6 digits
5 digits
2 digits
8. Transferor’s Special (Occupational) Tax Status (If any)
7. Transferor’s Federal Firearms License (If any)
First 6 digits
2 digits
2 digits
a. Employer Identification Number
b. Class
5 digits
Under Penalties of Perjury, I Declare that I have examined this application, and to the best of my knowledge and belief it is true, correct and complete, and that the transfer
of the described firearm to the transferee and receipt and possession of it by the transferee are not prohibited by the provisions of Title 18, United States Code, Chap 44;
Title 26, United States Code Chap 53; or any provisions of State or local law.
9. Signature of Transferor (Or authorized official)
10. Name and Title of Authorized Official (Print or type) 11. Date
The Space Below is for the use of the Bureau of Alcohol, Tobacco, Firearms and Explosives
By Authority of The Director, This Application Has Been Examined, and the Transfer and Registration of the Firearm Described Herein and the Interstate Movement of that
Firearm, When Applicable, to the Transferee are:
Approved (With the following conditions, if any)
Disapproved (For the following reasons)
Date
Signature of Authorized ATF Official
Previous Editions Are Obsolete
ATF Copy 2 - To Be Returned to Registrant
ATF Form 5 (5320.5)
Revised (
)
TRANSFEREE CERTIFICATION (not completed by a Government Entity)
12. Law Enforcement Notification (See instruction 2f)
The transferee is to provide notification of the proposed acquisition and possession of the firearm described on this Form 5 by providing a copy of the completed form to the
chief law enforcement officer in the agency identified below:
Agency or Department Name
Name and Title of Official
Address (Street address or P.O. Box, City, State and Zip Code) to which sent (mailed or delivered)
Information for the Chief Law Enforcement Officer
This form provides notification of the transferee’s intent to acquire and possess a National Firearms Act (NFA) firearm. No action on your part is required. However, should
you have information that may disqualify this person from acquiring or possessing a firearm, please contact the NFA Division at (304) 616-4500 or [email protected]. A “Yes”
answer to items 14.a. through 14.h. or 18.d. or 18.e. could disqualify a person from acquiring or possessing a firearm. Also, ATF will not approve an application if the
transfer or possession of the firearm is in violation of State or local law.
13. Transferee Necessity Statement (Do not complete if the transferee is a government agency) (See instruction 2e)
I,
, have a reasonable necessity to possess the machinegun, short-barreled rifle,
(Name and Title of Transferee)
short-barreled shotgun, or destructive device described on this application for the following reason(s)
and my possession of the device or weapon would be consistent with public safety (18 U.S.C. § 922(b) (4) and 27 CFR § 478.98).
Transferee Questions (complete only when transferee is an individual)
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14. Answer questions 14.a. through 14.h. Answer questions 16, 17, 18, 19 and 20, if applicable. For any “Yes” answer the transferee shall provide details on a separate
sheet. (See instruction 7b and definitions)
Yes
No
a. Are you under indictment or information in any court for a felony, or any other crime, for which the judge
could imprison you for more than one year? (See definition 1n)
b. Have you ever been convicted in any court for a felony, or any other crime, for which the judge could have imprisoned
you for more than one year, even if you received a shorter sentence including probation? (See definition 1n)
c. Are you a fugitive from justice? (See definition 1t)
Are you an unlawful user of, or addicted to, marijuana or any depressant, stimulant, narcotic drug, or any
other controlled substance? Warning: The use or possession of marijuana remains unlawful under
Federal law regardless of whether it has been legalized or decriminalized for medicinal or recreational
purposes in the state where you reside.
Have you ever been adjudicated as a mental defective OR have you ever been committed to a mental
institution? (See definitions 1o and 1p)
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d.
e.
f. Have you been discharged from the Armed Forces under dishonorable conditions?
D
2. Photo must have been taken in full face
view without a hat or head covering that
obscures the hair or hairline.
h. Have you ever been convicted in any court of a misdemeanor crime of domestic violence? (See definition 1r)
Date of Birth:
17b. Race
Hispanic or Latino
Not Hispanic or Latino
Affix a 2” x 2” Photograph here.
No Stapling. Tape Sides of Photo to the
Application.
1. Photo must have been taken within the
last year.
g. Are you subject to a court order restraining you from harassing, stalking, or threatening your child or an
intimate partner or child of such partner? (See definition 1q)
17a. Ethnicity
15. Photograph
3. On back of photograph print full name,
last 4 of SSN, and business address.
American Indian or Alaska Native
Black or African American
Asian
Native Hawaiian or Other Pacific Islander
White
18a. Country of Citizenship: (Check/List more than one, if applicable. Nationals of the United States may check U.S.A.) (See definition 1s)
United States of America
Other Country/Countries (specify):
18b. State of Birth
18c.Country of Birth
Yes
d. Have you ever renounced your United States citizenship?
e. Are you an alien illegally or unlawfully in the United States?
f.1. Are you an alien who has been admitted to the United States under a nonimmigrant visa?
f.2. If “yes”, do you fall within any of the exceptions stated in the instructions? Attach the documentation to the application
N/A
19. If you are an alien, record your U.S.-Issued Alien or Admission number (AR#, USCIS#, or I94#):
20. Have you been issued a Unique Personal Identification Number (UPIN)? (See instructions 2h)
Yes
ATF Copy 2 - To Be Returned to Registrant
No
If yes please provide
ATF Form 5 (5320.5)
Revised ( )
No
CERTIFICATION: Under penalties imposed by 18 U.S.C. § 924 and 26 U.S.C. § 5861, I certify that, upon submission of this form to ATF, a completed copy of this form will be directed
to the chief law enforcement officer (CLEO) shown in item 12, that the statements, as applicable, contained in this certification, and any attached documents in support thereof, are true
and correct to the best of my knowledge and belief. NOTE: See instructions 2.d(2) and 2.d(3) for the items to be completed depending on the type of transferee.
Date
Signature of Transferee
21. Number of Responsible Persons (see definitions) associated with the transferee trust or legal entity
22. Provide the full name (printed or typed) below for each Responsible Person associated with the applicant trust or legal entity (if there are more
Responsible Persons than can be listed on the form, attach a separate sheet listing the additional Responsible Person(s)). Please note that a completed Form 5320.23,
National Firearms Act (NFA) Responsible Person Questionnaire, must be submitted with the Form 5 application for each Responsible Person.
Full Name
Full Name
Important Information for Currently Registered Firearms
If you are the current registrant of the firearm described on this form, please note the following information.
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Estate Procedures: For procedures regarding the transfer of firearms in an estate resulting from the death of the registrant identified in item 2a, the executor should contact
the NFA Division, Bureau of Alcohol, Tobacco, Firearms and Explosives, 244 Needy Road, Martinsburg, WV 25405.
Change of Address: Unless currently licensed under the Gun Control Act, the registrant shall notify the NFA Division, Bureau of Alcohol, Tobacco, Firearms and Explosives, 244 Needy Road, Martinsburg, WV 25405, in writing, of any change to the address in item 2a.
Change of Description: The registrant shall notify the NFA Division, Bureau of Alcohol, Tobacco, Firearms and Explosives, 244 Needy Road, Martinsburg, WV 25405, in
writing, of any change to the description of the firearm(s) in item 4.
Interstate Movement: If the firearm identified in item 4 is a machinegun, short-barreled rifle, short-barreled shotgun, or destructive device, the registrant may be
required by 18 U.S.C. § 922(a)(4) to obtain permission from ATF prior to any transportation in interstate or foreign commerce. ATF Form 5320.20 can be used to request this
permission.
Restrictions on Possession: Any restriction (see approval block on face of form) on the possession of the firearm identified in item 4 continues with the further transfer of
the firearm.
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Persons Prohibited from Possessing Firearms: If the registrant becomes prohibited from possessing a firearm, please contact the NFA Division for procedures on how to
dispose of the firearm.
D
Proof of Registration: A person possessing a firearm registered as required by the NFA shall retain proof of registration which shall be made available to any ATF officer
upon request.
Paperwork Reduction Act Notice
This form meets the clearance requirements of the Paperwork Reduction Act of 1995. The information you provide is used to apply the tax-exempt transfer of an
unserviceable firearm to anyone other than a Federal firearms licensee who has paid the required special (Occupational) tax to deal in NFA firearms and to or from
government agencies. The data is used to ensure legality of transfer under Federal, State and local law. The furnishing of this information is mandatory (26 U.S.C. § 5812).
The estimated average burden associated with this collection of information is 0.5 hours per respondent or recordkeeper, depending on individual circumstances. Comments
concerning the accuracy of this burden estimate and suggestion for reducing this burden should be addressed to Reports Management Officer, Information Technology
Coordination Staff, Bureau of Alcohol, Tobacco, Firearms and Explosives, Washington, DC 20226.
An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number.
Privacy Act Information
The following information is provided pursuant to Section 3 of the Privacy Act of 1974 (5 U.S.C. § 552(e)(3)):
1. Authority. Solicitation of this information is made pursuant to the National Firearms Act (26 U.S.C. § 5812). Disclosure or this information by the applicant is mandatory for any transfer
without payment of transfer tax as provided in 26 U.S.C. § 5852.
2. Purpose. To verify that the proposed transfer is exempt from transfer tax; to verify that the transfer would not be in violation of law; and to effect registration of the firearm.
3.
Routine Uses. The information will be used by ATF to make the determinations set forth in paragraph 2. In addition, to effect registration of the firearm, information as to the identification
of the firearm, date of registration, and the identification and address of person entitled to possess the firearm will be entered into the National Firearms Registration and Transfer Record. No
information obtained from an application, registration, or records required to be submitted by an individual in order to comply with any provision of the National Firearms Act or regulation
issued thereunder, shall, except in connection with prosecution or other action for furnishing information, be used, directly or indirectly, as evidence against that person in any criminal
proceeding with respect to a violation of law occurring prior to or concurrently with the filing of the application. The information from this application may only be disclosed to Federal
authorities for purposes of prosecution for violation of the National Firearms Act.
4. Effects of not Supplying Information Requested. Failure to supply complete information will delay processing and may cause denial of the application.
ATF Copy 2 - To Be Returned Registrant
ATF Form 5 (5320.5)
Revised ( )
OMB No. 1140-0015 (xx/xx/xxxx)
U.S. Department of Justice
Bureau of Alcohol, Tobacco, Firearms and Explosives
Application for Tax Exempt Transfer and
Registration of Firearm
ATF Control Number
Internal Control Number
National Firearms Act Division
Bureau of Alcohol, Tobacco, Firearms and Explosives, 244 Needy Road, Martinsburg, WV 25405
Submit in duplicate to:
1. Type of Transfer: tax exempt
I believe that I am entitled to exemption from
the payment of the Transfer Tax Imposed by
section 5811 (26 U.S.C. Chapter 53) on the
Firearm described herein for the following
reason (See Instruction 2b):
Firearm is unserviceable and is being
transferred as a curio or ornament
Firearm is being transferred to or from
a Government Entity
Firearm is being transferred to a lawful
heir or by operation of law
Other (Specify)
2a. Transferee’s Full Legal Name and Address (Include trade name, if any) (See instruction 2k)
Other Legal Entity
Corporation
Individual
Trust
2b. County/Parish
Government Entity
3a. If Applicable: Decedent’s Name, Address, and Date of Death
3b. Transferor’s Name and Address (Include trade name, if any) (Executors: see instruction 2k)
3e. Number, Street, City, State and Zip Code of Residence (or Firearms Business Premises)
If Different from Item 3a.
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3c. Transferor’s telephone (area code and number) 3d. E-mail address
The above-named and undersigned transferor hereby makes application as required by Section 5812 of the National Firearms Act to transfer and register the firearm described
below to the transferee.
d. Model
4. Description of Firearm (Complete items a through i) (See instruction 2n)
a. Name and Address of Maker, Manufacturer and/or
Importer of Firearm
b. Type of Firearm (See definitions1c)
R
h. Additional Description or Data Appearing on Firearm (Attach additional
sheet if necessary)
c. Caliber
or
Gauge
e. Barrel:
Length
(Inches)
f. Overall:
i. Has the Firearm been rendered unserviceable as defined in Definition 1m?
(If “Yes,” describe the method by which the firearm has been
Yes
No
rendered unserviceable. Use additional sheets.)
D
5. Applicant’s Federal Firearms License (if any) or Explosives License or Permit Number 6. Transferee’s Special (Occupational) Tax Status (If any)
(Give complete 15-digit number) (See instruction 2c)
a. Employer Identification Number
b. Class
2 digits
First 6 digits
5 digits
2 digits
8. Transferor’s Special (Occupational) Tax Status (If any)
7. Transferor’s Federal Firearms License (If any)
First 6 digits
2 digits
2 digits
a. Employer Identification Number
b. Class
5 digits
Under Penalties of Perjury, I Declare that I have examined this application, and to the best of my knowledge and belief it is true, correct and complete, and that the transfer
of the described firearm to the transferee and receipt and possession of it by the transferee are not prohibited by the provisions of Title 18, United States Code, Chap 44;
Title 26, United States Code Chap 53; or any provisions of State or local law.
9. Signature of Transferor (Or authorized official)
10. Name and Title of Authorized Official (Print or type) 11. Date
The Space Below is for the use of the Bureau of Alcohol, Tobacco, Firearms and Explosives
By Authority of The Director, This Application Has Been Examined, and the Transfer and Registration of the Firearm Described Herein and the Interstate Movement of that
Firearm, When Applicable, to the Transferee are:
Approved (With the following conditions, if any)
Disapproved (For the following reasons)
Date
Signature of Authorized ATF Official
Previous Editions Are Obsolete
CLEO Copy
ATF Form 5 (5320.5)
Revised (
)
TRANSFEREE CERTIFICATION (not completed by a Government Entity)
12. Law Enforcement Notification (See instruction 2f)
The transferee is to provide notification of the proposed acquisition and possession of the firearm described on this Form 5 by providing a copy of the completed form to the
chief law enforcement officer in the agency identified below:
Agency or Department Name
Name and Title of Official
Address (Street address or P.O. Box, City, State and Zip Code) to which sent (mailed or delivered)
Information for the Chief Law Enforcement Officer
This form provides notification of the transferee’s intent to acquire and possess a National Firearms Act (NFA) firearm. No action on your part is required. However, should
you have information that may disqualify this person from acquiring or possessing a firearm, please contact the NFA Division at (304) 616-4500 or [email protected]. A “Yes”
answer to items 14.a. through 14.h. or 18.d. or 18.e. could disqualify a person from acquiring or possessing a firearm. Also, ATF will not approve an application if the
transfer or possession of the firearm is in violation of State or local law.
13. Transferee Necessity Statement (Do not complete if the transferee is a government agency) (See instruction 2e)
I,
, have a reasonable necessity to possess the machinegun, short-barreled rifle,
(Name and Title of Transferee)
short-barreled shotgun, or destructive device described on this application for the following reason(s)
and my possession of the device or weapon would be consistent with public safety (18 U.S.C. § 922(b) (4) and 27 CFR § 478.98).
Transferee Questions (complete only when transferee is an individual)
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14. Answer questions 14.a. through 14.h. Answer questions 16, 17, 18, 19 and 20, if applicable. For any “Yes” answer the transferee shall provide details on a separate
sheet. (See instruction 7b and definitions)
Yes
No
a. Are you under indictment or information in any court for a felony, or any other crime, for which the judge
could imprison you for more than one year? (See definition 1n)
b. Have you ever been convicted in any court for a felony, or any other crime, for which the judge could have imprisoned
you for more than one year, even if you received a shorter sentence including probation? (See definition 1n)
c. Are you a fugitive from justice? (See definition 1t)
Are you an unlawful user of, or addicted to, marijuana or any depressant, stimulant, narcotic drug, or any
other controlled substance? Warning: The use or possession of marijuana remains unlawful under
Federal law regardless of whether it has been legalized or decriminalized for medicinal or recreational
purposes in the state where you reside.
Have you ever been adjudicated as a mental defective OR have you ever been committed to a mental
institution? (See definitions 1o and 1p)
R
d.
e.
f. Have you been discharged from the Armed Forces under dishonorable conditions?
D
2. Photo must have been taken in full face
view without a hat or head covering that
obscures the hair or hairline.
h. Have you ever been convicted in any court of a misdemeanor crime of domestic violence? (See definition 1r)
Date of Birth:
17b. Race
Hispanic or Latino
Not Hispanic or Latino
Affix a 2” x 2” Photograph here.
No Stapling. Tape Sides of Photo to the
Application.
1. Photo must have been taken within the
last year.
g. Are you subject to a court order restraining you from harassing, stalking, or threatening your child or an
intimate partner or child of such partner? (See definition 1q)
17a. Ethnicity
15. Photograph
3. On back of photograph print full name,
last 4 of SSN, and business address.
American Indian or Alaska Native
Black or African American
Asian
Native Hawaiian or Other Pacific Islander
White
18a. Country of Citizenship: (Check/List more than one, if applicable. Nationals of the United States may check U.S.A.) (See definition 1s)
United States of America
Other Country/Countries (specify):
18b. State of Birth
18c.Country of Birth
Yes
d. Have you ever renounced your United States citizenship?
e. Are you an alien illegally or unlawfully in the United States?
f.1. Are you an alien who has been admitted to the United States under a nonimmigrant visa?
f.2. If “yes”, do you fall within any of the exceptions stated in the instructions? Attach the documentation to the application
N/A
19. If you are an alien, record your U.S.-Issued Alien or Admission number (AR#, USCIS#, or I94#):
20. Have you been issued a Unique Personal Identification Number (UPIN)? (See instructions 2h)
CLEO Copy
Yes
No
If yes please provide
ATF Form 5 (5320.5)
Revised ( )
No
CERTIFICATION: Under penalties imposed by 18 U.S.C. § 924 and 26 U.S.C. § 5861, I certify that, upon submission of this form to ATF, a completed copy of this form will be directed
to the chief law enforcement officer (CLEO) shown in item 12, that the statements, as applicable, contained in this certification, and any attached documents in support thereof, are true
and correct to the best of my knowledge and belief. NOTE: See instructions 2.d(2) and 2.d(3) for the items to be completed depending on the type of transferee.
Date
Signature of Transferee
21. Number of Responsible Persons (see definitions) associated with the transferee trust or legal entity
22. Provide the full name (printed or typed) below for each Responsible Person associated with the applicant trust or legal entity (if there are more
Responsible Persons than can be listed on the form, attach a separate sheet listing the additional Responsible Person(s)). Please note that a completed Form 5320.23,
National Firearms Act (NFA) Responsible Person Questionnaire, must be submitted with the Form 5 application for each Responsible Person.
Full Name
Full Name
Important Information for Currently Registered Firearms
If you are the current registrant of the firearm described on this form, please note the following information.
AF
T
Estate Procedures: For procedures regarding the transfer of firearms in an estate resulting from the death of the registrant identified in item 2a, the executor should contact
the NFA Division, Bureau of Alcohol, Tobacco, Firearms and Explosives, 244 Needy Road, Martinsburg, WV 25405.
Change of Address: Unless currently licensed under the Gun Control Act, the registrant shall notify the NFA Division, Bureau of Alcohol, Tobacco, Firearms and Explosives, 244 Needy Road, Martinsburg, WV 25405, in writing, of any change to the address in item 2a.
Change of Description: The registrant shall notify the NFA Division, Bureau of Alcohol, Tobacco, Firearms and Explosives, 244 Needy Road, Martinsburg, WV 25405, in
writing, of any change to the description of the firearm(s) in item 4.
Interstate Movement: If the firearm identified in item 4 is a machinegun, short-barreled rifle, short-barreled shotgun, or destructive device, the registrant may be
required by 18 U.S.C. § 922(a)(4) to obtain permission from ATF prior to any transportation in interstate or foreign commerce. ATF Form 5320.20 can be used to request this
permission.
Restrictions on Possession: Any restriction (see approval block on face of form) on the possession of the firearm identified in item 4 continues with the further transfer of
the firearm.
R
Persons Prohibited from Possessing Firearms: If the registrant becomes prohibited from possessing a firearm, please contact the NFA Division for procedures on how to
dispose of the firearm.
D
Proof of Registration: A person possessing a firearm registered as required by the NFA shall retain proof of registration which shall be made available to any ATF officer
upon request.
Paperwork Reduction Act Notice
This form meets the clearance requirements of the Paperwork Reduction Act of 1995. The information you provide is used to apply the tax-exempt transfer of an
unserviceable firearm to anyone other than a Federal firearms licensee who has paid the required special (Occupational) tax to deal in NFA firearms and to or from
government agencies. The data is used to ensure legality of transfer under Federal, State and local law. The furnishing of this information is mandatory (26 U.S.C. § 5812).
The estimated average burden associated with this collection of information is 0.5 hours per respondent or recordkeeper, depending on individual circumstances. Comments
concerning the accuracy of this burden estimate and suggestion for reducing this burden should be addressed to Reports Management Officer, Information Technology
Coordination Staff, Bureau of Alcohol, Tobacco, Firearms and Explosives, Washington, DC 20226.
An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number.
Privacy Act Information
The following information is provided pursuant to Section 3 of the Privacy Act of 1974 (5 U.S.C. § 552(e)(3)):
1. Authority. Solicitation of this information is made pursuant to the National Firearms Act (26 U.S.C. § 5812). Disclosure or this information by the applicant is mandatory for any transfer
without payment of transfer tax as provided in 26 U.S.C. § 5852.
2. Purpose. To verify that the proposed transfer is exempt from transfer tax; to verify that the transfer would not be in violation of law; and to effect registration of the firearm.
3.
Routine Uses. The information will be used by ATF to make the determinations set forth in paragraph 2. In addition, to effect registration of the firearm, information as to the identification
of the firearm, date of registration, and the identification and address of person entitled to possess the firearm will be entered into the National Firearms Registration and Transfer Record. No
information obtained from an application, registration, or records required to be submitted by an individual in order to comply with any provision of the National Firearms Act or regulation
issued thereunder, shall, except in connection with prosecution or other action for furnishing information, be used, directly or indirectly, as evidence against that person in any criminal
proceeding with respect to a violation of law occurring prior to or concurrently with the filing of the application. The information from this application may only be disclosed to Federal
authorities for purposes of prosecution for violation of the National Firearms Act.
4. Effects of not Supplying Information Requested. Failure to supply complete information will delay processing and may cause denial of the application.
CLEO Copy
ATF Form 5 (5320.5)
Revised ( )
File Type | application/pdf |
File Modified | 2019-06-28 |
File Created | 2019-06-28 |