Fillable Application for Federal Firearms License (Bureau of Alcohol, Tobacco, Firearms, and Explosives)

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Application for Federal Firearms License (Bureau of Alcohol, Tobacco, Firearms, and Explosives)

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The Application for Federal Firearms License (Bureau of Alcohol, Tobacco, Firearms, and Explosives) form is 18 pages long and contains:

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  • 219 check-boxes
  • 144 other fields

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U.S. Department of Justice
Bureau of Alcohol, Tobacco, Firearms and Explosives
Application for Federal Firearms License
OMB No. 1140-0018
Part A
2. Licensee Name (Enter name of Owner/Sole Proprietor OR Partnership (include name of each partner) OR Corporation Name OR LLC Name)
3. Trade or Business Name(s), if any
4. EmployerIdenticationNumber
(EIN),ifany(seedenition#17)
6. Business/Activity Address (RFD or Street Number, City, State,
and ZIP Code) (NOTE: This address CANNOT be a P.O. Box.)
7. Mailing Address (ifdierentfromaddressinitem#6)
8. Contact Numbers (Include Area Code)
9. Describethespecicactivityapplicantisengagedinorintendstoengagein,whichrequiresaFederalFirearmsLicense (sale of ammunition
alone does not require a Federal Firearms License).
10. Application is made for a license under 18 U.S.C. Chapter 44 as a: (Place an “X” in the appropriate box(es). Multiple license types may be selected- see
instruction#8.Submitthefeenotednexttothebox(es)withtheapplication.Licensesareissuedfora3-yearperiod.Seeinstruction#5forpaymentinformation).
Type
Description of License Type
Fee
Dealer in Firearms Other than Destructive Devices (Includes: ries,shotguns,pistols,revolvers,gunsmithactivities,and
NationalFirearmsAct(NFA)weapons)(seeinstruction#10)
$200
06
01
Manufacturer of Ammunition for Firearms Other Than Ammunition for Destructive Devices or Armor Piercing Ammunition
(seeinstruction#11)
Manufacturer of Firearms Other than Destructive Devices(seeinstruction#11)
Importer of Firearms Other than Destructive Devices or Ammunition for Firearms Other than Destructive Devices, or
Ammunition Other than Armor Piercing Ammunition(NOTE:Importerofhandgunsandries,seeinstruction#9)
Dealer in Destructive Devices (seeinstruction#10)
Manufacturer of Destructive Devices, Ammunition for Destructive Devices, or Armor Piercing Ammunition(seeinstruction#11)
07
08
09
10
$30
$150
$150
$3000
$3000
5. Name of Countyinwhich
Business/Activity is Located
Business/Activity Phone
Cell Phone
Fax Number
Business Email
Corporation
Collector
(whichcanbeanindividual/partnership/corporationorLLC)
Other (specify)
Importer of Destructive Devices, Ammunition for Destructive Devices, or Armor Piercing Ammunition (seeinstruction#9)
11
$3000
Total Fees
1. Applicant’s Business/Activity is:
11. Method of Payment (Check one)
Name as Printed on Your Credit/Debit Card
Credit/Debit Card Number (No dashes)
Credit/Debit Card
Billing Address:
Visa
Mastercard
American Express
Discover
Address:
City:
State: ZIP Code:
Please complete to ensure payment is credited to the correct application:
IampayingtheapplicationfeeforthefollowingPerson,Corporation,orPartnership:
Total Application Fees:
Signature of Cardholder
IauthorizeATFtochargemyCredit/DebitCardtheaboveamount.Yourcredit/debitcardwillbechargedtheabovestatedamountuponreceiptof
yourapplicationandachargefrom“ATFLicensingFee”willbereectedonyourcredit/debitcardstatement.IntheeventalicenseisNOTissued,
theaboveamountwillbecreditedtothecredit/debitcardnotedabove.
Date
$
Check (Enclosed) Cashier’s Check or Money Order (Enclosed)
PawnbrokerinFirearmsOtherthanDestructiveDevices (Includes: ries,shotguns,pistols,revolvers,gunsmithactivities,
andNationalFirearmsAct(NFA)weapons)(seeinstruction#10)
$200
02
Collector of Curios and Relics (NOTE:Thisisnotalicensetoconductbusiness,seeinstruction#8)
$30
03
IndividualOwner(Sole Proprietor)
Partnership
LLC
Diner’s Club
Expiration Date (MM/YY)
ATF Copy - Page 1
$
ATF
E-Form 7(5310.12)/7CR(5310.16)
Revised April 2019
0
20. Applicant Certication (Please read AND INITIAL each box)
12. Hours of Operation and/or Availability of Business/Activity (pleaseprovideatleastonehourinwhichyoucanbecontactedbyATFpersonnel)
Sun Mon
Tues
Wed
Thu
Fri
Sat
Hour(s):
Please indicate
AM or PM
IF YOU ARE ONLY APPLYING FOR A TYPE 03 (COLLECTOR OF CURIOS AND RELICS) LICENSE, SKIP ITEMS 13-17 AND GO TO ITEM 18.
FOR ALL OTHER LICENSE TYPES, CONTINUE WITH ITEM 13.
13. Was the business obtained from someone else? (If “Yes,”
pleaseprovidethenameofthepreviousbusinessandtheir
FFL Number)
Name of Previous Business
14. Indicate type of business premises
Zoned Commercial:
Zoned Residential:
Store Front
Oce
Rod & Gun Club
SingleFamilyDwelling
Condominium/Apartment
Hotel/Motel
Military Installation (seeinstruction#13-additional
information required)
Other (specify)
Public Housing
Federal Firearms License Number
Owned
Premises
Rented/Leased Premises- provide name, telephone number, and address of the property owner:
Military
Installation
No
Yes
15. Applicant’s business premises is:
Name
Telephone Number (with area code)
Street Address
City, State, and ZIP Code
16. DoyouintendtosellrearmsatGunShowsand/orconductInternetsales? Yes
No
17. DoyouintendtouseyourlicenseONLYtoacquirerearmstoenhanceyourpersonalcollection?
Yes No
a. Thebusiness/activitytobeconductedundertheFederalFirearmsLicenseisnotprohibitedbyStateorlocallawatthepremisesshown
initem6.Thisincludescompliancewithzoningordinances. (Please contact your local zoning department PRIOR TO submitting application)
b. Within30daysaftertheapplicationisapproved,thebusiness/activitywillcomplywiththerequirementsofStateandlocallaw
applicable to the conduct of the business/activity.
c. Business/activitywillnotbeconductedunderthelicenseuntiltherequirementsofStateandlocallawapplicabletothebusiness/activity
have been met.
d. A completed copy of this application has been sent
(mailedordelivered)totheChiefLawEnforcementOcer(CLEO)ofthelocalityin
whichthepremiseslistedinitem6islocated(seeinstruction#4anddenition#1).
18. NameofChiefLawEnforcementOcer(CLEO) (Please
print the name of the CLEO to whom a copy of this
applicationwasprovided.Seeinstruction#4anddenition#1.)
19. Address of CLEO (Include Number, Street, City, County, State, and ZIP
Code)
e. Asrequiredby18U.S.C.923(d)(1)(G),Icertifythatsecuregunstorageorsafetydeviceswillbeavailableatanyplaceinwhichrearms
aresoldunderthisFederalFirearmsLicensetopersonswhoarenotlicensees.(Seedenition#4)(IfapplyingforaType03,Collectorof
Curios and Relics License ONLY,write“N/A”insteadofinitialingthiscerticationbox.)
f. PartBofthisapplicationhasbeencompletedandwillbesubmittedforEACH responsible person (RP) (Seedenition#3)
21. Certication:Underthepenaltiesimposedby18U.S.C.924,IdeclarethatIhaveexaminedthisapplicationinitsentiretyandthedocuments
submittedinsupportthereofandtothebestofmyknowledgeandbelief,theyaretrue,correct,andcomplete.Thissignature,whenpresented
byadulyauthorizedrepresentativeoftheU.S.DepartmentofJustice,willconstituteconsentandauthorityfortheappropriateU.S.Department
of Justice representative to examine and obtain copies and abstracts of records and to receive statements and information regarding the
backgroundoftheapplicant.Specically,IherebyauthorizethereleaseofthefollowingdataorrecordstoATF:Militaryinformation/records,
medicalinformation/records,policeandcriminalrecords.ThiscerticationmustbesignedbyaResponsiblePerson(seeinstruction#2anddenition#3).
Print Applicant Name (First, Middle, Last)
Applicant Signature
Date
ATTENTION Chief Law Enforcement Ocer (CLEO): Thisformprovidesnoticationofaperson’sintenttoapplyforaFederalFirearmsLicense(FFL).Itrequires
noactiononyourpart.However,shouldyouhaveinformationthatmaydisqualifythepersonfromobtainingaFederalFirearmsLicense,pleasecontacttheFederal
FirearmsLicensingCentertollfreeat1-866-662-2750.IssuanceofanFFLinnowayguaranteesthebusinessoractivityisnotinviolationofStateand/orlocallaw.
ATF Copy - Page 2
county:
Check Application Status (For ATF Use Only)
Abandoned
WithdrawnApproved Denied
Reason for Denial:
SignatureofLicensingOcial:
Date:
ATF
E-Form 7(5310.12)/7CR(5310.16)
Revised April 2019
1. License or Applicant Name (Fromblock2ofPartA) 2. Federal Firearms License Number (IfbeingaddedtoanexistingFFL)
3. Name of Responsible Person (Last, First, Middle)
4. Aliases (Includegiven,married,maidennames)
6. Social Security Number
5. Position/Title
9. Current Residence Address
10. Telephone Number
(PersonalContact#withAreaCode)
7. Date of Birth (MM/DD/YYYY)
8. Place of Birth (City & State ORforeigncountry)
13. Sex
14. Height 15. Weight 16. Eye Color
Male
Female
17. Hair Color
Feet
Inches
(lbs)
Black
Blue
Brown
Green
Gray
Hazel
Maroon
Multiple
Other
Pink
Bald
Black
Blond
Gray
Brown
Red
Sandy
White
19. Race (Please check one or more boxes)
American Indian or Alaska Native
Black or African American
NativeHawaiianorOtherPacicIslander
Asian
Hispanic or Latino
White
12. Previous Address(es) - Please provide every
addressyouhavehadinthelastveyearsand
dateswhichyoulivedattheaddress(es)(If
additional space is needed attach a separate
sheet.Seeinstruction#1)
Yes
No
20. Have you ever held a Federal Firearms License? (Ifso,pleaseincludeFFL#)
21. Have you ever been a Responsible Person on a Federal Firearms License?(Ifso,pleaseincludeFFL#)
22. HaveyoueverbeenanocerinacorporationholdingaFederalFirearmsLicense?(Ifso,pleaseincludeFFL#)
23. Have you ever been an employee of a Federal Firearms Licensee?
24. Have you ever been denied a Federal Firearms License?
25. Have you ever had a Federal Firearms License revoked?
26. 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denition#10)
27. 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denition#10)
28. Areyouafugitivefromjustice?(Seedenition#11)
29. Are you under 21 years of age?
30. 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.
1. EACH RESPONSIBLE PERSON MUST COMPLETE AND SIGN A SEPARATE QUESTIONNAIRE/ATF Form 7/7CR Part B. In the future,
if you need to add an additional Responsible Person to your FFL, the Responsible Person being added may complete this Part B-Responsible
Person Questionnaire (see instruction #7).
2. IssuanceofyourlicenseoradditionasaResponsiblePersonwillbedelayedifPartBisincompleteorotherwiseimproperlyprepared.
3. IMPORTANT!AllnewresponsiblepersonsmustsubmitaproperlypreparedFD-258(FingerprintCard)withthisquestionnaire.Thengerprints
mustbeclearforaccurateclassicationandtakenbysomeoneproperlyequippedtotakethem.TheFD-258shouldinclude“WVATF1100ATF-FFLC,
MARTINSBURG,WV”intheORIblocktofacilitateprocessingofngerprints.
4. List any given, married, and maiden names in Item 4, e.g., “Mary Alice (Smith) Jones,” not “Mrs. John Jones.” (If additional space is needed, attach
aseparatesheet.Seeinstruction#1)
For the following questions give full details on a separate sheet for all “Yes” answers(seeinstruction#1)
11. E-mail Address
18. Ethnicity
Yes No
Other
ATF Copy - Page 3
31. HaveyoueverbeenadjudicatedasamentaldefectiveOR have you ever been committed to a mental institution?
(Seedenitions#12and#13)
32. Have you been discharged from the Armed Forces under dishonorable conditions?
33. 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denition#5)
34. Have you ever been convicted in any court of a misdemeanor crime of domestic violence? (Seedenition#7)
Part B - Responsible Person Questionnaire
ATF E-Form 7(5310.12)/7CR(5310.16)
Revised April 2019
Yes No
35. Country of Citizenship: (Check/List more than one, if applicable. Nationals of the United States may check U.S.A.)
36. Have you ever renounced United States citizenship?
37. AreyouanalienillegallyorunlawfullyintheUnitedStates?
40. Under the penalties imposed by 18 U.S.C. § 924 and 1001, I declare that I have examined any related documents submitted in regard to this
questionnaire/ATFForm7/7CRPartB,andtothebestofmyknowledgeandbelief,theyaretrue,correctandcomplete.Thissignature,when
presentedbyadulyauthorizedrepresentativeoftheU.S.DepartmentofJustice,willconstituteconsentandauthorityfortheappropriateU.S.
Department of Justice representative to examine and obtain copies and abstracts of records and to receive statements and information regarding my
background.Specically,IherebyauthorizethereleaseofthefollowingdataorrecordstoATF:Militaryinformation/records,medicalinformation/
records, police and criminal records.
Signature Printed Name Date
Attach a 2” X 2”
Photograph Here
If you are applying for a Type 03
ONLY a photograph is not required
1. Photo must have been taken
withinthelastsixmonths.
2. Photo must have been taken in full
faceviewwithoutahatorhead
covering that obscures the hair or
hairline.
3. On back of photograph print full
name, last 4 of SSN, and business
address.
Print Full Name
EACH RESPONSIBLE PERSON MUST COMPLETE AND SIGN A SEPARATE QUESTIONNAIRE/ATF FORM 7/7CR PART B
If applying for a NEW FFL:
Mailapplication,ngerprintcards,photographs,andapplicationfees,includinga
separate questionnaire/PartBforEACH Responsible Person, to:
Federal Firearms Licensing Center
P.O. Box 6200-20
Portland, OR 97228-6200
If only adding a RP to an existing FFL:
EachReponsiblePersonbeingaddedmustcompleteaseparatequestionnaire/ATFForm7/7CRPartB
andmailit,alongwiththeirfingerprintcardandphotograph,to:ATF,Attn:FFLC,244NeedyRd,
Martinsburg, WV 25405
Type 03 Applicants:
AphotographandngerprintcardarenotrequiredifyouareapplyingforaType03
Collector of Curios and Relics license only.
Questions:
Ifyouhaveanyquestionsrelatingtothisform,pleasecontacttheATFFederalFirearms
LicensingCenterat1-866-662-2750,oryourlocalATFIndustryOperationsOce.
38. a.AreyouanalienwhohasbeenadmittedtotheUnitedStatesunderanonimmigrantvisa?(Seedenition#8)
b. If“yes”,doyoufallwithinanyoftheexceptionsstatedindenition#9?Attachsupportingdocumentationtotheapplication.
39. If you are an alien, record your U.S.-Issued Alien or Admission number(AR#,USCIS#,orI94#):
Paperwork Reduction Act Notice
ThisrequestisinaccordancewiththePaperworkReductionActof1995.Theinformationcollectionisusedtodeterminetheeligibilityoftheapplicant
toengageincertainoperations,todeterminethelocationandextentofoperations,andtodeterminewhethertheoperationswillbeinconformitywith
Federallawsandregulations.Theinformationrequestedisrequiredinordertoobtainorretainabenetandismandatorybystatute(18U.S.C.§923).
Theestimatedaverageburdenassociatedwiththiscollectionofinformationis60minutesperrespondentorrecordkeeper,dependingonindividual
circumstances. Comments concerning the accuracy of this burden estimate and suggestions for reducing this burden should be directed to Reports
ManagementOcer,ResourceManagementSta,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.
ATF Copy - Page 4
N/A
United States of America
Other Country/Countries (specify):
ATF
E-Form 7(5310.12)/7CR(5310.16)
Revised April 2019
Instructions/Denitions for ATF Form 7 (5310.12)/7CR (5310.16)
(Do not return this sheet when submitting your application)
Issuance of your license will be delayed if the fee is not included or incorrect, or if the application is incomplete or otherwise improperly prepared.
Instructions
1. Completion of Application - TYPEorPRINTwithball-pointpen.Anyattachedsheetsshould:
a. beidentiedatthetopofeachpagewithyournameandEmployerIdenticationNumberorSocialSecurityNumber.
b. refertotheitem/question(s)beinganswered.
2. Person Who Signs the Application -ThecerticationinPartA,item#21must be signed by a Responsible Person(seedenition#3).
3. Release of Information -ThisapplicationpackagerequiresyoutoauthorizethereleaseofcertaininformationtoATFsuchasmedicalinformation/
records (seePartA,item#21).Thisinformationisusedtodetermine,forexample,whethertheapplicanthaseverbeenadjudicatedasamental
defective or committed to any mental institution. This information is protected by the Privacy Act of 1974.
4. Chief Law Enforcement Ocer (CLEO) -ApplicantsmustsubmitacopyofthecompletedapplicationtotheChiefLawEnforcementOcer
(CLEO)ofthelocalityinwhichthepremisessoughttobelicensedislocated(seedenition#1).PartA,item#20drequirescerticationthata
completed copy of the application has been sent.
5. Payment - You may pay the application fee by credit/debit card, check, or money order, payable to ATF (seeinstruction#14onthefollowingpage
fortheaddresstosendpaymentandcompletedapplicationpackage). Do not send cash. Postdated checks are not acceptable. Licenses are issued
foraperiodofthreeyears.Norefundofanypartofalicensefeeshallbemadewheretheoperationsofthelicenseare,foranyreason,discontinued
during the period.
6. Fingerprint Cards & Photographs - Thefollowingitemsmustaccompanythisapplication.Failuretosubmittheseitemswilldelayprocessingand
may result in denial of the application. NOTE: AngerprintcardandphotographareNOTrequiredifapplyingforaType03licenseonly.
a. ATF Form 7/7CR Part B, Responsible Person Questionnaire, must be completed and submitted for ALL responsible persons(seedenition#3).
b. Aproperlypreparedngerprintcard(formFD-258)mustbesubmittedforALL responsible persons, unless they have peviously submitted
oneasanRPforanotherFFL.Thengerprintsmustbeclearforaccurateclassicationandtakenbysomeoneproperlyequippedtotakethem.
Tofacilitateprocessingofngerprints,theFD-258shouldlist“WVATF1100ATF-FFLC,MARTINSBURG,WV”intheORIblock.
c. A 2 inch by 2 inch photograph of EACH responsible person. The photograph should be attached to the back of their ATF Form 7/7CRPart B,
ResponsiblePersonQuestionnaire.Pleaseensurethateachphotographisclearlyidentiedonthereversewiththefullnameoftheresponsible
persontowhomthephotographapplies.
7. Adding Additional Responsible Persons - You can use Part B of this application to add a Responsible Person(s) to an existing FFL. If you are only
submittingPartBforthispurpose,sendPartB,alongwiththeResponsiblePerson’sngerprintcardandphotograph,toATF-FFLC,244Needy
Road,Martinsburg,WV25405.OnlysendtothisaddressifyouarejustaddingaResponsiblePerson(s)toanexistinglicense.Sendingan
applicationtoobtainanewFFLtothisaddresswillresultindelaysintheprocessingofyourapplication.
8. License Types -
A Type 03 license issued under 18 U.S.C. Chapter 44:
a. Is NOTalicensetocarry,use,orpossessarearm.
b. Confers NOrightorprivilegetoconductanactivitycontrarytoStateorotherlaw.
c. Willentitleyoutoacquirerearms,classiedascuriosorrelics,ininterstateorforeigncommerce.Youmaydisposeofcuriosandrelicsto
anyperson,nototherwiseprohibitedbytheGunControlActof1968,residingwithinyourState,andtoanyotherFederalrearmslicenseein
anyState.Itmustbeemphasizedthatthecollector’slicensebeingappliedforpertainsexclusivelytorearmsclassiedascuriosandrelics,
and its purpose is to facilitate a personal collection. You may NOT engage in the businessofbuyingandsellinganytypeofrearmwitha
type03license.ApplicantsintendingtoengageintherearmsbusinessshouldapplyforalicenseotherthanaType03,CollectorofCuriosand
Relics, license.
Type 01, 02, 06, 07, 08, 09, 10, and 11 licenses issued under 18 U.S.C. Chapter 44:
a. Are NOTlicensestocarry,use,orpossessarearm.
b. Confer NOrightorprivilegetoconductbusinessoractivitycontrarytoStateorotherlaw.Statelawsorlocallawsorordinancesmayhave
requirementsaectingyourproposedrearmsbusiness.ContactyourStateandlocalauthoritiesforspecicinformationontheirrequirements.
c. Arebusinesslicenses,andwillNOTbeissuedtoanapplicantsolelyintendingtoenhanceapersonalrearmscollection.
d. Are NOT licenses to sell ammunition only.
NOTE: Multiple Licenses - You can apply for more than one license if the business is to be conducted at the same location, by checking more
thanonetypeoflicenseinPartA,item#10.Ifbusinessistobeconductedatmultiplelocations,a separate application and license fee is required
for each business location.
9. Imports - Applicantsintendingtoimportrearmsand/orammunitionmayneedtoregisterwithATFundertheprovisionsoftheArmsExport
Control Act. Contact the Firearms and Explosives Imports Branch at (304) 616-4550 for further information on registration.
ATF
E-Form 7(5310.12)/7CR(5310.16)
Revised April 2019
10. National Firearms Act (NFA)/Special Occupational Tax (SOT) -Applicantsintendingtodealin,import,ormanufactureweaponssubjecttothe
NFA (e.g.,machineguns,short-barreledshotguns,silencers,destructivedevices,etc.)arerequiredtopayaSOT(seedenition#18). Contact the
NFA Branch at (304) 616-4500.
11. Manufacturing - Generally,personsholdingamanufacturer’slicense(FFLType06,07or10)mustregisterasamanufacturerwiththeDepartment
ofStateunlessexemptedbytheDirectorateofDefenseTradeControl(DDTC),regardlessofwhetherthemanufactureractuallyexportsanyofthe
itemsmanufactured.Therefore,applicantsintendingtomanufactureand/orexportdefensearticles,asdenedontheUnitedStatesMunitionsList
(Part121oftheITAR),mayneedtoregisterwithDirectorateofDefenseTradeControls(DDTC).QuestionsshouldbedirectedtotheDDTC
at 202-663-2980 or www.pmddtc.state.gov.
12. Denial of Application - Ifyoudonotqualifyforalicense,youwillbeadvisedinwritingofthereasonsfordenialandyourapplicationfeewillbe
refunded.
13. Military Installation - If“MilitaryInstallation”wasselectedinPartA,item#14asthetypeofbusinesspremises,youmustattachacopyofwritten
authorizationfromtheBaseCommandertoconductarearmsbusinessonthemilitaryinstallation.
14. Where to Send Application - MAKE A COPY OF YOUR COMPLETED APPLICATION FOR YOUR RECORDS, THEN FORWARD
THE APPLICATION WITH FEE, ONE ATF FORM 7/7CR PART B, RESPONSIBLE PERSON QUESTIONNAIRE,
FOR EACH RESPONSIBLE PERSON (WITH PROPERLY IDENTIFIED PHOTO ATTACHED), AND FINGERPRINT CARD(S) TO:
Federal Firearms Licensing Center
P.O. Box 6200-20
Portland, OR 97228-6200
15. Contact Us - Ifyouhaveanyquestionsrelatingtothisapplication,pleasecontacttheATFFederalFirearmsLicensingCenter,244NeedyRoad,
Martinsburg,WV25405,Tollfree1-866-662-2750,oryourlocalATFIndustryOperationsOce.Contactinformationforyourlocalocecanbe
found at WWW.ATF.GOV.
Denitions
1. Chief Law Enforcement Ocer-TheChiefofPolice,Sheri,oranequivalentdesigneeofsuchindividual,ofthelocalityinwhichthepremises
sought to be licensed, is located.
2. Licensed Collector - A collector of curios and relics only and licensed under the provisions of 18 U.S.C. 923. You may not use the license to obtain
rearmsthatarenotclassiedascuriosandrelics.Collectorsarenot licensed to conduct any business.
3. Responsible Person - In addition to a Sole Proprietor, a Responsible Person is, in the case of a Corporation, Partnership, or Association, any
individualpossessing,directlyorindirectly,thepowertodirectorcausethedirectionofthemanagement,policies,andpracticesoftheCorpora-
tion,Partnership,orAssociation,insofarastheypertaintorearms.
4. Secure Gun Storage or Safety Device-(A)adevicethat,wheninstalledonarearm,isdesignedtopreventtherearmfrombeingoperated
withoutrstdeactivatingthedevice;(B)adeviceincorporatedintothedesignoftherearmthatisdesignedtopreventtheoperationofthe
rearmbyanyonenothavingaccesstothedevice;or(C)asafe,gunsafe,guncase,lockbox,orotherdevicethatisdesignedtobeorcanbeused
tostorearearmandthatisdesignedtobeunlockedonlybymeansofakey,acombination,orothersimilarmeans.
5. Restraining Order-Under18U.S.C.§922(g)(8),rearmsmaynotbepossessedorreceivedbypersonssubjecttoacourtorderthat:(A)was
issuedafterahearingofwhichthepersonreceivedactualnotice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nding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.
6. Intimate Partner-Withrespecttoaperson,thespouseoftheperson,aformerspouseoftheperson,anindividualwhoisaparentofachildof
theperson,oranindividualwhocohabitatesorhascohabitatedwiththeperson.
7. Misdemeanor Crime of Domestic Violence-AFederal,State,local,ortribaloensethatisamisdemeanorunder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
ATF
E-Form 7(5310.12)/7CR(5310.16)
Revised April 2019
battery),iftheoenseiscommittedbyoneofthedenedparties.(SeeExceptioninthedenition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;or(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.
8. 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.ThedenitiondoesNOT include
permanent resident aliens nor does it apply to nonimmigrant aliens admitted to the United States pursuant to either the Visa Waiver Program or to regulations
otherwiseexemptingthemfromvisarequirements.
9. Exceptions to Prohibition on Aliens Admitted Under a Nonimmigrant Visa - An alien admitted to the United States under a nonimmigrant visa
isnotprohibitedfrompurchasing,receiving,orpossessingarearm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Aairs,whichisvalidand
unexpired;(2)wasadmittedtotheUnitedStatesforlawfulhuntingorsportingpurposes;(3)hasreceivedawaiverfromtheprohibitionfromthe
AttorneyGeneraloftheUnitedStates;(4)isanocial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;(5)isenroutetoorfromanother
countrytowhichthatalienisaccredited;(6)isanocialofaforeigngovernmentoradistinguishedforeignvisitorwhohasbeensodesignatedby
theDepartmentofState;or(7)isaforeignlawenforcementocerofafriendlyforeigngovernmententeringtheUnitedStatesonociallaw
enforcement business.
10. Prohibited Person - Generally,18.U.S.C.§922(g)prohibitstheshipment,transportation,receipt,orpossessioninoraectinginterstatecommerce
ofarearm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 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controlled
substance;hasbeenadjudicatedasamentaldefectiveorhasbeencommittedtoamentalinstitution;hasbeendischargedfromtheArmedForces
under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visa;orissubjecttocertainrestrainingorders.Furthermore,Section922(n)prohibitstheshipment,transportation,
orreceiptinoraectinginterstatecommerceofarearm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.Aninformationisaformalaccusationofacrimeveriedbya
prosecutor.
EXCEPTION: Apersonwhohasbeenconvictedofafelony,oranyothercrime,forwhichthejudgecouldhaveimprisonedthepersonformore
thanoneyear,orwhohasbeenconvictedofamisdemeanorcrimeofdomesticviolence,isnotprohibitedfrompurchasing,receiving,orpossessing
arearmif:(1)underthelawofthejurisdictionwheretheconvictionoccurred,thepersonhasbeenpardoned,theconvictionhasbeenexpungedor
set aside, or the person has had their civil rights (therighttovote,sitonajury,andholdpublicoce)takenawayandlaterrestoredAND(2)the
personisnotprohibitedbythelawofthejurisdictionwheretheconvictionoccurredfromreceivingorpossessingrearms.Personssubjecttothis
exception should mark “no” in the applicable box.
11. Fugitive From Justice - Anypersonwhohased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.
12. Adjudicated as a Mental Defective - Adeterminationbyacourt,board,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himselfortoothers;or(2)lacksthe
mentalcapacitytocontractormanagehisownaairs.Thistermshallinclude:(1)andingofinsanitybyacourtinacriminalcase;and(2)
those persons found incompetent to stand trial or found not guilty by reason of lack of mental responsibility.
13. 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 a commitment to a mental institution involuntarily. The term includes commitment for mental defectiveness or mental
illness. It also includes commitments for other reasons, such as for drug use. The term does not include a person in a mental institution for
observation or a voluntary admission to a mental institution.
EXCEPTION: UndertheNICSImprovementAmendmentsActof2007,apersonwhohasbeenadjudicatedasamentaldefectiveorcommitted
toamentalinstitutioninaStateproceedingisnotprohibitedbytheadjudicationorcommitmentifthepersonhasbeengrantedreliefbythe
adjudicating/committingStatepursuanttoaqualifyingmentalhealthrelieffrom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isnotprohibitedbytheadjudicationor
commitmentifeither:(a)theperson’sadjudication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,supervision,ormonitoringbytheagency;(c)thepersonwasfound
bytheagencytonolongersuerfromthementalhealthconditionthatservedasthebasisoftheinitialadjudication/commitment;(d)the
adjudicationorcommitment,respectively,isbasedsolelyonamedicalndingofdisability,withoutanopportunityforahearingbyacourt,board,
commission,orotherlawfulauthority,andthepersonhasnotbeenadjudicatedasamental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qualiedmentalhealthrelieffrom
disabilities program. Personswhofallwithinoneoftheaboveexceptionsshouldmark“no”intheapplicablebox.Thisexceptiontoanadjudication
or 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 responsibility, or found incompetent to stand trial, in any criminal case or under the Uniform Code of Military Justice.
ATF
E-Form 7(5310.12)/7CR(5310.16)
Revised April 2019
Privacy Act Information
ThefollowinginformationisprovidedpursuanttoSection3ofthePrivacyActof1974(5U.S.C.§552a(e)(3)):
1. Authority: Solicitation of this information is authorized pursuant to 18 U.S.C. § 923(a) of the Gun Control Act of 1968. Disclosure of this
informationismandatoryiftheapplicantwishestoobtainaFederalFirearmsLicense.SystemofRecordNotice(SORN)Justice/ATF-008
Regulatory Enforcement Record System FR Vol. 68 No. 163558 dated January 24, 2003.
2. Purpose: To determine the identity and eligibility of the applicant to obtain a Federal Firearms License, the identity and eligibility of all responsible
persons,theownershipofthebusiness,thetypeofrearmsorammunitiontobedealtin,thebusinesshours,andthebusinesshistory.
3. Routine Uses:TheinformationwillbeusedbyATFtomakedeterminationssetforthinparagraph2.Inaddition,informationmaybedisclosed
tootherFederal,State,foreignandlocallawenforcementandregulatoryagencypersonneltoverifyinformationontheapplicationandtoaidin
theperformanceoftheirdutieswithrespecttotheenforcementandregulationofrearmsand/orammunitionwheresuchdisclosureisnot
prohibitedbylaw.TheinformationmayfurtherbedisclosedtotheJusticeDepartmentifitappearsthatthefurnishingoffalseinformationmay
constituteaviolationofFederallaw.Finally,theinformationmaybedisclosedtomembersofthepublicinordertoverifytheinformationonthe
applicationwhensuchdisclosureisnotprohibitedbylaw.
4. Eects of Not Supplying Information Requested:Failuretosupplycompleteinformationwilldelayprocessingandmayresultindenialofthe
application.
14. Gun Control Act (GCA) - Title 18, United States Code, Chapter 44. The implementing regulations are found in Title 27, Code of Federal
Regulations, Part 478.
15. Firearm - Theterm“rearm”means:(A)anyweapon(includingastartergun)whichwillorisdesignedtoormayreadilybeconvertedtoexpel
aprojectilebytheactionofanexplosive;(B)theframeorreceiverofanysuchweapon;(C)anyrearmmuerorrearmsilencer;or(D)any
destructivedevice.Suchtermdoesnotincludeanantiquerearm.
16. Federal Firearms License (FFL) - AlicenseissuedundertheprovisionsoftheGCAtomanufacture,import,ordealinrearms.
17. Employer Identication Number (EIN) - AnEINisalsoknownasaFederalTaxIdenticationNumber,andisusedtoidentifyabusinessentity.
Generally,businessesneedanEIN.FormoreinformationonwhoneedsanEINandhowtoapplyforone,gotowww.IRS.govorreferto27CFR§
179.35.
18. Special (Occupational) Tax (SOT) - RequiredbytheNationalFirermsActtobepaidbyaFederalrearmslicenseeengagedinthebusinessof
importing,manufacturing,ordealinginNFArearms.QuestionsregardingSOTshouldbedirectedtotheATFNFABranchat(304)616-4500.
ATF
E-Form 7(5310.12)/7CR(5310.16)
Revised April 2019
U.S. Department of Justice
Bureau of Alcohol, Tobacco, Firearms and Explosives
Application for Federal Firearms License
OMB No. 1140-0018
Part A
2. Licensee Name (Enter name of Owner/Sole Proprietor OR Partnership (include name of each partner) OR Corporation Name OR LLC Name)
3. Trade or Business Name(s), if any
4. EmployerIdenticationNumber
(EIN),ifany(seedenition#17)
6. Business/Activity Address (RFD or Street Number, City, State,
and ZIP Code) (NOTE: This address CANNOT be a P.O. Box.)
7. Mailing Address (ifdierentfromaddressinitem#6)
8. Contact Numbers (Include Area Code)
9. Describethespecicactivityapplicantisengagedinorintendstoengagein,whichrequiresaFederalFirearmsLicense(saleofammunition
alonedoesnotrequireaFederalFirearmsLicense).
10. Application is made for a license under 18 U.S.C. Chapter 44 as a: (Place an “X” in the appropriate box(es). Multiple license types may be selected- see
instruction#8.Submitthefeenotednexttothebox(es)withtheapplication.Licensesareissuedfora3-yearperiod.Seeinstruction#5forpaymentinformation).
Type
Description of License Type
Fee
Dealer in Firearms Other than Destructive Devices (Includes: ries,shotguns,pistols,revolvers,gunsmithactivities,and
NationalFirearmsAct(NFA)weapons)(seeinstruction#10)
$200
06
01
Manufacturer of Ammunition for Firearms Other Than Ammunition for Destructive Devices or Armor Piercing Ammunition
(seeinstruction#11)
Manufacturer of Firearms Other than Destructive Devices(seeinstruction#11)
Importer of Firearms Other than Destructive Devices or Ammunition for Firearms Other than Destructive Devices, or
Ammunition Other than Armor Piercing Ammunition
(NOTE:Importerofhandgunsandries,seeinstruction#9)
Dealer in Destructive Devices (seeinstruction#10)
Manufacturer of Destructive Devices, Ammunition for Destructive Devices, or Armor Piercing Ammunition(seeinstruction#11)
07
08
09
10
$30
$150
$150
$3000
$3000
5. Name of Countyinwhich
Business/Activity is Located
Business/Activity Phone
Cell Phone
Fax Number
Business Email
Corporation
Collector
(whichcanbeanindividual/partnership/corporationorLLC)
Other (specify)
Importer of Destructive Devices, Ammunition for Destructive Devices, or Armor Piercing Ammunition (seeinstruction#9)
11
$3000
Total Fees
1. Applicant’s Business/Activity is:
11. Method of Payment (Check one)
Name as Printed on Your Credit/Debit Card
Credit/Debit Card Number (No dashes)
Credit/Debit Card
Billing Address:
Visa
Mastercard
American Express
Discover
Address:
City:
State: ZIP Code:
Please complete to ensure payment is credited to the correct application:
IampayingtheapplicationfeeforthefollowingPerson,Corporation,orPartnership:
Total Application Fees:
Signature of Cardholder
IauthorizeATFtochargemyCredit/DebitCardtheaboveamount.Yourcredit/debitcardwillbechargedtheabovestatedamountuponreceiptof
yourapplicationandachargefrom“ATFLicensingFee”willbereectedonyourcredit/debitcardstatement.IntheeventalicenseisNOTissued,
theaboveamountwillbecreditedtothecredit/debitcardnotedabove.
Date
$
Check (Enclosed) Cashier’s Check or Money Order (Enclosed)
PawnbrokerinFirearmsOtherthanDestructiveDevices (Includes: ries,shotguns,pistols,revolvers,gunsmithactivities,
andNationalFirearmsAct(NFA)weapons)(seeinstruction#10)
$200
02
Collector of Curios and Relics (NOTE:Thisisnotalicensetoconductbusiness,seeinstruction#8)
$30
03
IndividualOwner(Sole Proprietor)
Partnership
LLC
Expiration Date (MM/YY)
CLEO Copy - Page 1
$
ATF E-Form 7(5310.12)/7CR(5310.16)
Revised April 2019
0
20. Applicant Certication (Please read AND INITIAL each box)
12. Hours of Operation and/or Availability of Business/Activity (pleaseprovideatleastonehourinwhichyoucanbecontactedbyATFpersonnel)
Sun Mon
Tues
Wed
Thu
Fri
Sat
Hour(s):
Please indicate
AM or PM
IF YOU ARE ONLY APPLYING FOR A TYPE 03 (COLLECTOR OF CURIOS AND RELICS) LICENSE, SKIP ITEMS 13-17 AND GO TO ITEM 18.
FOR ALL OTHER LICENSE TYPES, CONTINUE WITH ITEM 13.
13. Was the business obtained from someone else? (If “Yes,”
pleaseprovidethenameofthepreviousbusinessandtheir
FFL Number)
Name of Previous Business
14. Indicate type of business premises
Zoned Commercial:
Zoned Residential:
Store Front
Oce
Rod & Gun Club
SingleFamilyDwelling
Condominium/Apartment
Hotel/Motel
Military Installation (seeinstruction#13-additional
information required)
Other (specify)
Public Housing
Federal Firearms License Number
Owned
Premises
Rented/Leased Premises- provide name, telephone number, and address of the property owner:
Military
Installation
No
Yes
15. Applicant’s business premises is:
Name
Telephone Number (with area code)
Street Address
City, State, and ZIP Code
16. DoyouintendtosellrearmsatGunShowsand/orconductInternetsales? Yes
No
17. DoyouintendtouseyourlicenseONLYtoacquirerearmstoenhanceyourpersonalcollection?
Yes No
a. Thebusiness/activitytobeconductedundertheFederalFirearmsLicenseisnotprohibitedbyStateorlocallawatthepremisesshown
initem6.Thisincludescompliancewithzoningordinances. (Please contact your local zoning department PRIOR TO submitting application)
b. Within30daysaftertheapplicationisapproved,thebusiness/activitywillcomplywiththerequirementsofStateandlocallaw
applicable to the conduct of the business/activity.
c. Business/activitywillnotbeconductedunderthelicenseuntiltherequirementsofStateandlocallawapplicabletothebusiness/activity
have been met.
d. A completed copy of this application has been sent
(mailedordelivered)totheChiefLawEnforcementOcer(CLEO)ofthelocalityin
whichthepremiseslistedinitem6islocated(seeinstruction#4anddenition#1).
18. NameofChiefLawEnforcementOcer(CLEO) (Please
print the name of the CLEO to whom a copy of this
applicationwasprovided.Seeinstruction#4anddenition#1.)
19. Address of CLEO (Include Number, Street, City, County, State, and ZIP
Code)
e. Asrequiredby18U.S.C.923(d)(1)(G),Icertifythatsecuregunstorageorsafetydeviceswillbeavailableatanyplaceinwhichrearms
aresoldunderthisFederalFirearmsLicensetopersonswhoarenotlicensees.(Seedenition#4)(IfapplyingforaType03,Collectorof
Curios and Relics License ONLY,write“N/A”insteadofinitialingthiscerticationbox.)
f. PartBofthisapplicationhasbeencompletedandwillbesubmittedforEACH responsible person (RP) (Seedenition#3)
21. Certication:Underthepenaltiesimposedby18U.S.C.924,IdeclarethatIhaveexaminedthisapplicationinitsentiretyandthedocuments
submittedinsupportthereofandtothebestofmyknowledgeandbelief,theyaretrue,correct,andcomplete.Thissignature,whenpresented
byadulyauthorizedrepresentativeoftheU.S.DepartmentofJustice,willconstituteconsentandauthorityfortheappropriateU.S.Department
of Justice representative to examine and obtain copies and abstracts of records and to receive statements and information regarding the
backgroundoftheapplicant.Specically,IherebyauthorizethereleaseofthefollowingdataorrecordstoATF:Militaryinformation/records,
medicalinformation/records,policeandcriminalrecords.ThiscerticationmustbesignedbyaResponsiblePerson(seeinstruction#2anddenition#3).
Print Applicant Name (First, Middle, Last)
Applicant Signature
Date
ATTENTION Chief Law Enforcement Ocer (CLEO): Thisformprovidesnoticationofaperson’sintenttoapplyforaFederalFirearmsLicense(FFL).Itrequires
noactiononyourpart.However,shouldyouhaveinformationthatmaydisqualifythepersonfromobtainingaFederalFirearmsLicense,pleasecontacttheFederal
FirearmsLicensingCentertollfreeat1-866-662-2750.IssuanceofanFFLinnowayguaranteesthebusinessoractivityisnotinviolationofStateand/orlocallaw.
CLEO Copy - Page 2
county:
Check Application Status (For ATF Use Only)
Abandoned
WithdrawnApproved Denied
Reason for Denial:
SignatureofLicensingOcial:
Date:
ATF E-Form 7(5310.12)/7CR(5310.16)
Revised April 2019
1. License or Applicant Name (Fromblock2ofPartA) 2. Federal Firearms License Number (IfbeingaddedtoanexistingFFL)
3. Name of Responsible Person (Last, First, Middle)
4. Aliases (Includegiven,married,maidennames)
6. Social Security Number
5. Position/Title
9. Current Residence Address
10. Telephone Number
(PersonalContact#withAreaCode)
7. Date of Birth (MM/DD/YYYY)
8. Place of Birth (City & State ORforeigncountry)
13. Sex
14. Height 15. Weight 16. Eye Color
Male
Female
17. Hair Color
Feet
Inches
(lbs)
Black
Blue
Brown
Green
Gray
Hazel
Maroon
Multiple
Other
Pink
Bald
Black
Blond
Gray
Brown
Red
Sandy
White
19. Race (Please check one or more boxes)
American Indian or Alaska Native
Black or African American
NativeHawaiianorOtherPacicIslander
Asian
Hispanic or Latino
White
12. Previous Address(es) - Please provide every
addressyouhavehadinthelastveyearsand
dateswhichyoulivedattheaddress(es)(If
additional space is needed attach a separate
sheet.Seeinstruction#1)
Yes
No
20. Have you ever held a Federal Firearms License? (Ifso,pleaseincludeFFL#)
21. Have you ever been a Responsible Person on a Federal Firearms License?(Ifso,pleaseincludeFFL#)
22. HaveyoueverbeenanocerinacorporationholdingaFederalFirearmsLicense?(Ifso,pleaseincludeFFL#)
23. Have you ever been an employee of a Federal Firearms Licensee?
24. Have you ever been denied a Federal Firearms License?
25. Have you ever had a Federal Firearms License revoked?
26. 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denition#10)
27. 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denition#10)
28. Areyouafugitivefromjustice?(Seedenition#11)
29. Are you under 21 years of age?
30. 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.
1. EACH RESPONSIBLE PERSON MUST COMPLETE AND SIGN A SEPARATE QUESTIONNAIRE/ATF Form 7/7CR Part B. In the future,
if you need to add an additional Responsible Person to your FFL, the Responsible Person being added may complete this Part B-Responsible
Person Questionnaire (see instruction #7).
2. IssuanceofyourlicenseoradditionasaResponsiblePersonwillbedelayedifPartBisincompleteorotherwiseimproperlyprepared.
3. IMPORTANT!AllnewresponsiblepersonsmustsubmitaproperlypreparedFD-258(FingerprintCard)withthisquestionnaire.Thengerprints
mustbeclearforaccurateclassicationandtakenbysomeoneproperlyequippedtotakethem.TheFD-258shouldinclude“WVATF1100ATF-FFLC,
MARTINSBURG,WV”intheORIblocktofacilitateprocessingofngerprints.
4. List any given, married, and maiden names in Item 4, e.g., “Mary Alice (Smith) Jones,” not “Mrs. John Jones.” (If additional space is needed, attach
aseparatesheet.Seeinstruction#1)
For the following questions give full details on a separate sheet for all “Yes” answers(seeinstruction#1)
11. E-mail Address
18. Ethnicity
Yes No
Other
CLEO Copy - Page 3
31. HaveyoueverbeenadjudicatedasamentaldefectiveOR have you ever been committed to a mental institution?
(Seedenitions#12and#13)
32. Have you been discharged from the Armed Forces under dishonorable conditions?
33. 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denition#5)
34. Have you ever been convicted in any court of a misdemeanor crime of domestic violence? (Seedenition#7)
Part B - Responsible Person Questionnaire
ATF
E-Form 7(5310.12)/7CR(5310.16)
Revised April 2019
Yes No
35. Country of Citizenship: (Check/List more than one, if applicable. Nationals of the United States may check U.S.A.)
36. Have you ever renounced United States citizenship?
37. AreyouanalienillegallyorunlawfullyintheUnitedStates?
40. Under the penalties imposed by 18 U.S.C. § 924 and 1001, I declare that I have examined any related documents submitted in regard to this
questionnaire/ATFForm7/7CRPartB,andtothebestofmyknowledgeandbelief,theyaretrue,correctandcomplete.Thissignature,when
presentedbyadulyauthorizedrepresentativeoftheU.S.DepartmentofJustice,willconstituteconsentandauthorityfortheappropriateU.S.
Department of Justice representative to examine and obtain copies and abstracts of records and to receive statements and information regarding my
background.Specically,IherebyauthorizethereleaseofthefollowingdataorrecordstoATF:Militaryinformation/records,medicalinformation/
records, police and criminal records.
Signature Printed Name Date
Attach a 2” X 2”
Photograph Here
If you are applying for a Type 03
ONLY a photograph is not required
1. Photo must have been taken
withinthelastsixmonths.
2. Photo must have been taken in full
faceviewwithoutahatorhead
covering that obscures the hair or
hairline.
3. On back of photograph print full
name, last 4 of SSN, and business
address.
Print Full Name
EACH RESPONSIBLE PERSON MUST COMPLETE AND SIGN A SEPARATE QUESTIONNAIRE/ATF FORM 7/7CR PART B
If applying for a NEW FFL:
Mailapplication,ngerprintcards,photographs,andapplicationfees,includinga
separate questionnaire/PartBforEACH Responsible Person, to:
Federal Firearms Licensing Center
P.O. Box 6200-20
Portland, OR 97228-6200
If only adding a RP to an existing FFL:
EachReponsiblePersonbeingaddedmustcompleteaseparatequestionnaire/ATFForm7/7CRPartB
andmailit,alongwiththeirfingerprintcardandphotograph,to:ATF,Attn:FFLC,244NeedyRd,
Martinsburg, WV 25405
Type 03 Applicants:
AphotographandngerprintcardarenotrequiredifyouareapplyingforaType03
Collector of Curios and Relics license only.
Questions:
Ifyouhaveanyquestionsrelatingtothisform,pleasecontacttheATFFederalFirearms
LicensingCenterat1-866-662-2750,oryourlocalATFIndustryOperationsOce.
38. a.AreyouanalienwhohasbeenadmittedtotheUnitedStatesunderanonimmigrantvisa?(Seedenition#8)
b. If“yes”,doyoufallwithinanyoftheexceptionsstatedindenition#9?Attachsupportingdocumentationtotheapplication.
39. If you are an alien, record your U.S.-Issued Alien or Admission number(AR#,USCIS#,orI94#):
Paperwork Reduction Act Notice
ThisrequestisinaccordancewiththePaperworkReductionActof1995.Theinformationcollectionisusedtodeterminetheeligibilityoftheapplicant
toengageincertainoperations,todeterminethelocationandextentofoperations,andtodeterminewhethertheoperationswillbeinconformitywith
Federallawsandregulations.Theinformationrequestedisrequiredinordertoobtainorretainabenetandismandatorybystatute(18U.S.C.§923).
Theestimatedaverageburdenassociatedwiththiscollectionofinformationis60minutesperrespondentorrecordkeeper,dependingonindividual
circumstances. Comments concerning the accuracy of this burden estimate and suggestions for reducing this burden should be directed to Reports
ManagementOcer,ResourceManagementSta,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.
CLEO Copy - Page 4
N/A
United States of America
Other Country/Countries (specify):
ATF
E-Form 7(5310.12)/7CR(5310.16)
Revised April 2019
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Application for Federal Firearms License (Bureau of Alcohol, Tobacco, Firearms, and Explosives)

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Completed 19 July 2020

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