Fillable Collector In-State Acquisition of Curio or Relic Long (California)

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Collector In-State Acquisition of Curio or Relic Long (California)

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CALIFORNIA DEPARTMENT OF JUSTICE
BUREAU OF FIREARMS
Collector In-State Acquisition
of Curio or Relic Long Gun Report
STATE OF CALIFORNIA DEPARTMENT OF JUSTICE
BOF 961 (Rev. 01/2020) PAGE 1 of 4
*Acquired
From:
*Acquired
From:
California Penal Code section 27966.
A total processing fee of $19.00 must accompany this report.
(Instructions on Reverse)
A. Owner Information
*First Name: Middle Name: *Last Name:
Suffix:
Alias First Name (if any):
Alias Middle Name: Alias Last Name:
*Residence Street Address: *City: *State: *Zip Code:
Mailing Address (if different): City: State: Zip Code:
*Date of Birth (mm/dd/yyyy):
Place of Birth (state or country): *Gender: Height: Weight: *Phone No. (include area code):
*COE No.:
*COE Expiration (mm/dd/yyyy):
*U.S.
Citizen?
Yes
No
If no, enter Alien Registration or I-94 No.: *Country of Citizenship:
*FFL Number:
*FFL Expiration Date (mm/dd/yyyy):
Enter your California driver license
(CDL) or California ID (CID) in the ID
number box to the right.
*ID Type (check one)
CDL CID
*ID Number:
B. Long Gun(s) Information (To report additional firearm(s) copy and attach additional applications)
*Make:
*Model: *Caliber: *Firearm Origin: *Barrel Length:
IN.
CM.
*Color: *Date Acquired (mm/dd/yyyy):
*Acquired
From:
Gun Show
Private Party
Family Member (Specify Relationship):
Other
C. Declaration
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. I expressly authorize the Department of
Justice to perform firearms eligibility checks of all relevant state and federal databases, including the Federal Bureau of Investigation's National Instant
Criminal Background Check System. I also understand that if I currently possess or own firearms and the results of this check reveal that I am ineligible
either to lawfully possess or purchase firearms, I must relinquish any and all firearms in my possession.
Signature Date
*All fields marked with an asterisk (*) are mandatory.
*Serial Number:
*Category (select from list on page 3)
*Firearm Type:
Rifle Shotgun
*Firearm Self-Built?
Yes
No
*Did You Obtain A Serial
Number From The DOJ?
*Receiver Only?
No
Yes
No
Yes
*Model: *Caliber: *Firearm Origin: *Barrel Length:
IN.
CM.
*Color: *Date Acquired (mm/dd/yyyy):
*Serial Number:
*Category (select from list on page 3)
*Firearm Type:
*Firearm Self-Built?
*Did You Obtain A Serial
Number From The DOJ?
*Receiver Only?
No
Yes
No
Yes
Yes
No
*Make:
*Model: *Caliber: *Firearm Origin: *Barrel Length:
IN.
CM.
*Color: *Date Acquired (mm/dd/yyyy):
*Firearm Self-Built?
Yes
No
*Did You Obtain A Serial
Number From The DOJ?
*Receiver Only?
No
Yes
No
Yes
Gun Show
Private Party Other
Family Member (Specify Relationship):
Rifle/Shotgun Combo
Rifle/Shotgun Combo
Rifle Shotgun
Rifle/Shotgun Combo
Rifle Shotgun
*Make:
*Serial Number:
*Firearm Type:
Gun Show
Private Party
Family Member (Specify Relationship):
Other
*Category (select from list on page 3)
CALIFORNIA DEPARTMENT OF JUSTICE
BUREAU OF FIREARMS
Collector In-State Acquisition
of Curio or Relic Long Gun Report
STATE OF CALIFORNIA DEPARTMENT OF JUSTICE
BOF 961 (Rev. 01/2020) PAGE 2 of 4
Collector In-State Acquisition of Curio or Relic Long Gun Report Requirements
Federally licensed collectors (FFL type 03) in California who have a current COE may acquire curio or relic long guns from non-licensees
without completing the transfer through a licensed firearms dealer only if he/she completes and submits this report to the California
Department of Justice within thirty (30) days of taking possession of the long gun. Your failure to comply with this reporting
requirement could result in criminal prosecution. (Pen. Code, §§ 27590 & 27966)
The following must be submitted with your application and mailed to the Department of Justice, Bureau of Firearms-C&R, P.O. Box
820200, Sacramento CA 94203-0200:
o $19.00 processing fee (check or money order made payable to the Department of Justice) (Pen. Code, § 28230, (a)(3))
o A copy of your California driver license or identification card. (Cal. Code Reg., tit. 11, § 4045.1)
o If your driver license or identification card has “FEDERAL LIMITS APPLY” on the front, you shall also submit proof of lawful
presence in the United States, in the form of one of the following documents:
(1) Valid, unexpired U.S. passport or passport card.
(2) Certified copy of U.S. birth certificate (issued by a city, county, or state vital statistics office). "Abbreviated" or "Abstract"
certificates are NOT accepted.
(3) Certification of Birth Abroad (FS-545), Certification of Report of Birth (DS-1350) or Consular Report of Birth
Abroad of a Citizen of the United States of America (FS-240), issued by the U.S. Department of State.
(4) Valid, unexpired foreign passport with valid U.S. immigrant visa and approved Record of Arrival/Departure (I-94) form.
(5) Certified copy of birth certificate from a U.S. Territory.
(6) Certificate of Naturalization or U.S. Citizenship.
(7) Valid, unexpired Permanent Resident Card. (Cal. Code Reg., tit. 11, § 4045.1)
o If your name, as it appears on the “FEDERAL LIMITS APPLY” driver license or identification card, differs from the name on
the document(s) above, you shall also submit one of the following certified documents:
(1) An adoption document that contains your legal name as a result of the adoption.
(2) A name change document that contains your legal name both before and, as a result of, the name change.
(3) A marriage certificate.
(4) A dissolution of marriage document that contains your legal name as a result of the court action.
(5) A certificate, declaration or registration document verifying the formation of a domestic partnership.
(6) A dissolution of domestic partnership document that contains your legal name as a result of the court action. (Cal. Code
Reg., tit. 11, § 4045.1)
Complete all required information. Incomplete reports submitted without the proper fees and documentation will be returned without
processing. If reporting more than three firearms, attach additional copies of this report as needed. A firearms eligibility check will be
conducted to determine whether you are lawfully eligible to possess firearms. Once approved, you will receive a confirmation notice of your
Collector In-State Acquisition of Curio or Relic Long Gun Report.
This report may not be used to report ownership of assault weapons defined in Penal Code sections 30510 through 30530. It is the
responsibility of the applicant to determine if the firearm being reported is an assault weapon. A list of assault weapons is available on the
Bureau of Firearms website at www.oag.ca.gov/firearms
.
CALIFORNIA DEPARTMENT OF JUSTICE
BUREAU OF FIREARMS
Collector In-State Acquisition
of Curio or Relic Long Gun Report
STATE OF CALIFORNIA DEPARTMENT OF JUSTICE
BOF 961 (Rev. 01/2020) PAGE 3 of 4
Part A. Owner Information
Enter the information as requested. Only one applicant per report.
Part B. Firearm Information
For each long gun, you must provide the identification information requested. Please refer to your long gun owner's
manual, the long gun manufacturer's website, or the examples below to assist you in providing the required information:
o Long Gun Type Rifle, Shotgun, Rifle/Shotgun Combo
o Category Bolt Action, Lever Action, Pump Action, Semi-Automatic, Single Shot, Carbine, Over and
Under, Double Barrel
o Serial Number Usually located on the frame of a handgun, or the receiver of a long gun. May be all numeric
or a combination of alpha and numeric characters. (e.g., 98765; US54321 G)
o Make The manufacturer of the firearm. (e.g., Remington, Winchester, Glock, Smith & Wesson)
o Model The model name of the firearm. (e.g., 870 Express, Model 70, 17C, 29-10)
o Caliber The caliber of the firearm. (e.g., 12 gauge, .308 Winchester, 9 mm, .44 Magnum)
o Firearm Origin The country of origin of the firearm. (e.g., United States, Russia, China, Italy)
o Barrel Length Enter the barrel length as stated either in your owner's manual, manufacturer's website, or
measure the barrel length by closing the action of the firearm and inserting a wooden dowel
down the barrel until it stops. Mark the dowel with a pen at the muzzle. Remove the dowel
and measure the distance between the inserted end of the dowel and the pen mark.
o Date Acquired The date you, the person submitting this report, took possession of the firearm.
Part C. Declaration
You must sign and date the declaration on this report.
CALIFORNIA DEPARTMENT OF JUSTICE
BUREAU OF FIREARMS
Collector In-State Acquisition
of Curio or Relic Long Gun Report
STATE OF CALIFORNIA DEPARTMENT OF JUSTICE
BOF 961 (Rev. 01/2020) PAGE 4 of 4
Collection and Use of Personal Information. The Division of Law Enforcement in the Department of
Justice collects the information requested on this report as authorized by Penal Code section 27966,
subdivision (f). The Division of Law Enforcement uses this information to record the acquisition of a
curio or relic long gun by a licensed collector. In addition, any personal information collected by state
agencies is subject to the limitations in the Information Practices Act and state policy. The Department
of Justice's general privacy policy is available at https://oag.ca.gov/privacy-policy.
Providing Personal Information. All the personal information requested in the report must be
provided. If you fail to provide any of the required personal information, the unprocessed report will be
returned to you for completion and resubmission.
Access to Your Information. You may review the records maintained by the Division of Law
Enforcement in the Department of Justice that contain your personal information, as permitted by the
Information Practices Act. See below for contact information.
Possible Disclosure of Personal Information. In order to ensure you are not prohibited from owning a
firearm and to record the acquisition of a curio or relic long gun as a licensed collector, we may need to
share the information you provide us with entities as authorized in Penal Code section 11105. The
information you provide may also be disclosed in the following circumstances:
■ With other persons or agencies when necessary to perform their legal duties, and their use of
your information is compatible and complies with state law, such as for investigations or for
licensing, certification, or regulatory purposes;
■ To another government agency as required by state or federal law.
Contact Information. For questions about this notice or access to your records, you may contact the
Staff Services Analyst in the Customer Support Center at (916) 210-2300, via email at
firearms.bureau@doj.ca.gov, or by mail at P.O. Box 820200 Sacramento, CA 94203-0200.
Privacy Notice
As Required by Civil Code § 1798.17
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Completed 11 October 2020

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