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Original ATF Form

Original ATF Form

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Xerxes Wilson
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377K views6 pages

Original ATF Form

Original ATF Form

Uploaded by

Xerxes Wilson
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
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Case 1:23-cr-00061-MN-—Document 157-1 Filed-05/20/24 Page 5 of 14 PagelD #: 2554 US. Department of Justice OM We 140-0020 Bureau of Alcohol, Tobacco, Fireacms and Explosives Firearms Traieaction Record fed by Federal or State fn, The information you provide willie Salles arm, Certain violations of the Gua Contra Act 18 USC. 921 Transaction Sexal 0,000 fine | Number (any determine whether you are prohibited fromt receiving cf. seq. are punishable by up to 10 year ment nadir up toa Definitions on this form. Prepare in original only atthe Heensed premises (*“eense premises" includes business temporarily conducted from a qualfing gun shove or exe in the same Statin which the licensed premises is under 18 U.S.C. 922(¢). All entries must be handwritten in nk. “PLEASE Section A- Must Be Completed Personally By TramsfereTiuyer PRINT” | 70" sie the intial. Ino milena or name, record "NMN™) Buyers Full Nome (Tegal name contains an initial only, record Last Name Inctading suis (ex, Jr Sr: TH) | Psst Nm Milile Neme BIiOEN Zob ERI HUNTER 7, Curent Site oF Ridenee wal AEN (US. Postal abbreviations are uceeptable: Cannot be a post wflice box) — Winingter_\noulsHe |peliagor Uf. Cy eo ing “OR | Foreign Come tye tat y waaiigod Set —— OA 7. mg 72 Instructions for Question 9) ely, ele ome or maar race TAK Weal 1 an TAK st Be were.) — Hispanic or Latin [J American indian or Alaska Naive [] Black or Aican American Sei ‘Not Hispanic or Launo |=] asian verte TlTowina questions hy checTing or marking Wes" or "won Te Bons toe are you The act tanafereeTbuyer o” The Tears) Tas on is Tens?” Warming Vow are are acquiring the frearmis) on behalf of another person. Ifyou are not the actual the firearms) to you. Exception: If you are picking up a repaired frearm(s) for another And may proceed to question I.b. (See lnsoretions for Question 1.2) buyer, the licensee cannot transfer are not required to answer 1.2 i Are you under indictment or information in any court for felony, or any ether erime Tor which the judge could Imprison you Tor ‘more than one yea? (See Insructions for Question Il:b) Have you ever been convicied in any cour of a felony, or any othe erime Tor which te jaye could have hmpriboned you for more than one year even i you received a shorter sentence including probation? (See Intretions for Question 1 Are yous fugitive from justice? (See Instructions for Quewtion 11d) Ave you ar wala aera oracle, marijuana or aay apse, Mian rca Ure. OF wy vibe Te wR ijuana remains unlawful under Federal law regardless of whether it has been legalized or tal defective OR ‘Warning: The use or possession o 7 Have you ever been adjudicated as am for Question If) you ever b ited tow mental inslition? (See Taatuction ged from the Armed Forces under dishonorable conditions? ig. Have you beea dsch i. Are you abject oa sont order restraining you fom haraising, ealking, or threnening your child or an lle partner or child of (Gee Instructions for Question Ith (See Insirctions for Question 11) i, Tlave you ever been convicted in any court of « misdemeanor erime of do United States of America (U.S.A) _[_] Other Country/Countties (Specify) 12. Have you ever renounced your United States citizenship? Ifyou ae an lien, reurd your U.S-Issued Alien or Admission number (48%, USCIS or 1941 “Transferee/Buyer Continue fo Next Page TF Fama STAPLE IF PAG OME SEPARATED eve Ona 26 StarQuest_000004 Page | of Case 1:23-cr-00061-MN Document 157-1 Filed 05/20/24 Page 6 of 14 PagelD-#:2555 wai Tn Sedo A ve tre, corre and compet, Ihave read and understand the Noes, instructions and Detilins on ATF Form, Tam wot the actual ransfereefbuyer isa crime punishable as a flony under Federal lw and Aero lt Stat anor loa! on Tandesta tha persen who answers yes to any of he questions 1b. through (Landon 12, OB) ie ceastinaea trom pociming or recvng a ficarm, Tundertand that person who answers “yes to question 124i probilid rom resin eer Srenray nics he person anewers"ye” fo qusin 12.42 nd provides the documentation equrd in 18 nh undersind at hing rae sal or rien stereo exhibiting nny fac or misrepresented ientfention with respect o his transaction = crime puns Mace ders yand muy also alae Satan clam. urther understand hatte repttie purchase of earn ie Parpse of aT frllveiboed and prot without Feral ents iense isa violation of Federal aw. (Sec Insructions for Question 14) 16, Type of firearms apply): |W If wansfers at a qualifying gun show or event inggua [Lore Gun [| Othe rer hms Dame Neitesor See tnsructions or Ores ge) “Ba Idenifation (eg, Virginia Driver's Tense (VA BL) or other valid governmenissved phovo {ssuing Authority and Type of Identification Number on Identification Hs fe | Ieee (Question 18.6) Teeny that ny (4873, understand that anvwering "yes" to question Its jee Inatrctions for Question 1B.) [Expiration Date of Idetification (ifony) -aawered "VES TREE. he Woeleoraclor ust record the ype of IAT Form 473, (See Instructions for Question 18) {He Beeepion to he Nonimmigrant Allen Tie wanster Dentmeaaton showing te exception to the probit and attach copy tts Sone 19:30, or 21 Must Be Competed Por To THE Transfer OF The Firearms) (See Tahuctions for Question 19 29a 21 ae eiaiyers Mantyinginfotion in Sooo A was [ 19. Fie ICS or State waneaion number (Zonided wae =| transmit to NICS or the appropriate State agency | Mens [Dy | Yor fon - ; ; IPDS, ‘ [ig f | AE 1 appropriate State | 19.4. The OB TT NICS or the 19s, The response inally (Bs) pre appropeiate State agency: wore Prosced ] Delred [L Prsced ide) [F] Oven ret OD Fr ficrmt) may turontondon | | FL ese Moe) eee te aw pert (opin) ———— Canceled —*" toptionad | canesied (ate) = " _ : [Er] Noein was provided within business day, Bc (imps apace cn wasnt te lowing spose was sive rom NICS rte appropiate SE SHY on (dat), Co Proce ] Denied} Ceneeled TFET. Employee Completing NICS check. (Opriomal) T9.E The name and Brady identification number of the NICS examines. (Optional) ‘ian) Pano io NICS check war roqureT SABE TH the NEA frearm(s), as reflected on the approved NFA application. TPA] NeNIGS check was required because the ronsercTiyet has @ TTT Seittxempio to NICS. (See Isrcton for Question 21) Issuing State and Petit Type Date of Issuance (amy) id permit Trows the State where the transfert to take place, which qualifies Expiration Date (any) Pe Number (any) = — Becton C= Wit He Compe Personally By Transercel Baye Ff akc vanaf of he Froarn() takes place on a diferent day from the dace thatthe transfereetbuye signed Section A, the tansfeve/buyer must Seation © immediately prio othe transfer ofthe frearm(s). (See nstructivns for Question 22 and25;)__ Teerlify that my answers to the questions in Section A ofthis form are sill complete. Fares gnats Twansferor/SeTier Continwe to Next Pane STAPLE IF PAGES BECOME SEPARATED. | | StarQuest_000005 | Page 20f6 Case 1:23-cr-00061-MN Document 157-1 Filed 05/20/24 Page 7 of 14 PagelD #: 2556 ‘Section D= Must te Completed By Transforor [Seller Even If The Firearms) h Not Transferred i PE anutaeturer and importer (lf ny) (fe] Model Tr 77 7 Serial Number Type (See fnsiructioms| Caliber or ‘Jor Question 27). | Gauge ‘manufacturer and importer are differen, ‘he FFL must include both) NCoeT- (Up Designated) eka MASS [Se | 2 3 « REMINDER -y the Civ of Busines Complete ATF Porm 33104 Far Matpe Paras of Handguns Win § Consecutive Bivins Days |B Toul Niner of Firearms Tawstered (Please handarite by printing &. zero, ae 00, twa, of, Do mot mae mameritn) ONE I. For Use by Licensee (See Tnverucrions for Question 37 ) BO. Check Tany part of is ranean 8 pawn vedempion [Lire Number(s) From Question 2¢ Above 32 Cheek iis transaction i [L] See trntions for Question 32) 33. TradeTeorprate name aol addres of wansfero/eler wal Feral Firearm License Number (Whi conta of Test ft Hrs an as five digi Of FEL Number XAXXQCOX,) (Han stamp may be used.) SIALQUEST SHGOTERS & SURVIVAL SUPPLY 3704 CONCORD MIKE: WILMINGTON, DE 19s03 8-51-003-01-9E-00996 "The Person Transferving The Fireara(a) Must Complete Questions 3-37 For Denia/Cancelled Transactions the Person Who Completed Section B Must Complete Quest 1534-36, erty that (1) Thave read and understand the Notices, Instructions, and Definitions on this ATF Form 4473; (2) the information recorded in Sections Band Ds {rues correc and complet; sn (3) this entire transaction record as been completed at my licensed buses premises icensed premises incl bine {senporarty conducted som a quabtying gun show or eveot inthe same Statin which the lensed prem located) unless this transaction has ne the Fequirements of 18 USC, 922). Unles this transaction ha been dene or cancelled further certify on the bass of (1 ) the transferee buyer's responses in Section A (and Section Cif ppliabl) (2) my verteation ofthe identification recorded in question 18 (and my rvercatin tthe Geof ansen Secon C sna cumple) st 3) State o loa nw applicable the treacms husiness— itis my bel that ci not unlawful for mito sel deliver, ransport or otherwise lisa ofthe fre) sted on this form to the pers dente in Section A, 34, ThansferorsiSeller’s Name (Please prino)3s, Transferor'Selier's Signature Heel a AT Onel I ['6. TransferorSellers Tite 7. Date Transfened Sal 12 Gordan T Cleveland NOTICES, INSTRUCTIONS, AND DEFINITIONS eepoxe of the Form: he information sd certfeation o this form are esigned so that person Keene ander 18 USC. 923 may dstnnve hele ‘nay avy sll er dlvera rear the person deified in Seti A, ae {o ler the rarters/tuyerof cern estitons on te fect and pose ‘of freams. The tnsfrovselkr af rear ms tcrmine he lawless of the amsoeton and minan proper records ofthe raeactionConsaquenty the leonferoie mat be fiat nae rotons of 18 US. 9E Ss tad ‘he regulations in 27 CFR Parts 478 aod 49, n detenniaing te whines of thesale or delivery oF re or sbxgur wo. reident of another Site the transfers i resimed to know the applicable Ste las aol pulsed ordinances in bathe nserver Sat nd the ransleres'yers Sule, See ATF Publication 580.5 Soe Lans und Fublshed Ontiance,) General, ATE Form £473 must be snp a th Heemed sings prs whe rear i tansered oversbe-sunter, Feder lw, 8 U.S.C. S23), stows aliensed importer manure, o dee ola rear to noni ese who dos not apc in persona the icene' busines premises ly i the tanafreebuyer ces cetain requirements. These equrements re se. Aonhin ection 92(¢.27 CFR 47R96D), and ATF Procedure 2019-2, ‘Aner the wantere/cehas completed the cans ization, he mst ‘nak the complete, original ATE Form 473 which nce he Note, i= ‘ra Invoucions and Definitions), ad ay supporting dosimens gor ober Servanent records. Such Forms 4473 must be tained fart Ine 90 youre ant Ilr tha peod maybe smiied to AT. Flim he ooo oy de © dposition, phabsical fy name of purchaser). ornare oy rama ‘serie! meter) og aslo the transferor srs empl Forms ‘473 ae fled inthe sme rm Page 3 0f6 FORMS 4473 FOR DENIEDICANCEL LED TRANSFERS MUST BE RETAINS ‘We nsf of firearm i denedeaeled by NICS, oF foray cher ese ‘he tanfer ino competed alex NICS check i nated the Hien ns in {he ATF Form 4473 ir hse recon frat est § yrs Forms 4473 with epee, to which wal delivery. or traf tt eke pace shal be ep resin In alphabetical (y name of tense) or chronology ete of rare cerifcaton) ce. We tasers the transfer dicover that an ATF Foon 73 incomplete o improperly completed ater he ren has bee tse an the transferee rte ransferetbayer wishes o cont he enn) ot sn) ptcopy the incur or and make aly weeeary alos oF ‘vision tothe photocepy. The steerer show nly make changes Sections Band D. The tansereyer sha C. Whoever made the charges should inital and at the changes. The eon Photocopy should be alached to the rigial Forn-4873 aad tan as pt ef Ue (analerar sles penn wads Exporttion of Pirearms: The Ste o Comers: Depasimens may rie 8 freams export oobtin ens roe exoort. Warulng Any penen ho cx ‘ots rear witout proper suhertzation mey be ied not mere $1 000 00) snr ipso for note th 20 yeas. Sex 22 USC. 277M). Section A "ha wanaferenyw mat poranally vate kn at buyer ‘omplted by anti parson, excting the tata ‘han the ramsroeer ms then sig a witnesses 0 nawrs and sigraturtetiction i ison 1 str an esety cv ithe ame! radar wis he answers other ik the sgn) may Be “Two pers ihr tons bayer eve Oa 6 StarQuest_000006 Case 1:23-cr-00061-MN Document 157-1 Filed 05/20/24 Page 8 of 14 PagelD #2557 = Wher the vans of rear ex coportion company, asacaion, atnership, or other such busines ent, an ocr authorized 1 act on hal the busines mst cmplte Seti Ao the fo wither pera Infra, sign Section A and aah 8 wren Matementexesed ur Penal perry, ting’ (A) the ream i bing ged fer the se of ad Wilbe the pope ht bene nity and (fc mame and ues fa bse emi ‘Question 1. ihe ransereebayer's ame in question ies the ans Fister must pit the nesforce'buyers mate abows Ie mn writen hy he tamer Question 2, Current Rendence Adress: Arr route (RR) may be acepd [woided tc tntscebuye fiver in Stator local whee i canada Keg vesience ables. County and Parish sr one andthe sans. Lite tamsinetuver its mabe ofthe Armed Frees om aie dy ier Sta of resfence ithe Stalin which ier permanent dly sign ond Ir the service member is aegurng itera ia a Sate where hier permanent shy ation is oe, br resis nu difret Stat he wasfereebayer tus liar th her permet dey ation nhs and Nir psec ores response o question 2. 1F the ansferee/buyer has owe Stes of eae, he tranafrerayer soul st hier cure residence adress in espns 9 gestion 26 ifthe onsfroeuper ix purchasing feu while stavine trite ws hme State X fhe ould at the ein Sate a ‘ejponse question 2. Question 9. Unique Personal Meatification Number (UPIN): Fer antec buyer approved to have infoiationsintaine abt then FE NICS ‘Voluntary Appeal Fil, NICS wl roe them with a UPIN, which he rns ferefuer should ecd in question 9. The Hcemee should rove te UPIN ‘wes conducting background checks toogh the NICS or he Sate POC, ‘Question 10. and 10. oder! wgultins (27 CER A7A.(246)) eguice Fo andlor Site POC make or rule ot potential matches during the bnckpond check process ont can assist wih crininal nvestiga ams, Pron 0 Ofhce of ‘Management und Beds (OMB), fective January 12003 all Fl ansncis xing collection of race and chet infomation on ndminisratve forme ‘and records, ete eed wo cle his infrmation a standrd ferme, (See {62 FR S72) The anand OMI Forma consists of Wo eatgories foe dia on ‘iii: “gpnie or Latino" nd “Not apace Lai and Be categorics, Toedusontace: America Indian or Alaska Native, Asin, Black or Alan ‘American, Native Hawavian ot Other Pcie Islnd, and Whe Ethic ees 3 peson'shetitage. Peta of Cuban, Mexican, Perio Rica, South o Cental America, ther Spanish clr oii, recs ‘of rot se considered Mipano Latin. Race one a mo of the following responses must he seletd (1) American Ind o Aloka Note person bavi vii nan of the rghit popes ‘of Nosh and South Aerie inching Cental Aerie), and wh mains {iba afin a eorityaachiment (2) Aan A pts ineny ofthe oigial peoples ofthe Far Eat, Southeast Asi o sbconinent inclding, fo example, Cambodia, Cina, nda Jpn, Kone, ‘Malai, Pakistan, th Pilppne Ilana, Tindal Vic: (3) Ble or ‘Arcam American” A peron having origins ie ano te Black ail eroupe of ‘Alias (4) Native Hawn of Other Pacific sande -A pion having origins inany of he vigil peoples of Hawai, Guan, Sane, o othr Pace an snd (3) White-A person having orgs in any the orga peoples of Eo, the Middle East, o Noth Alien. Any her ace o ety a oc tal ‘within those ints, pleage cle ihe eset cession, Question Hn, Actua Transferee/Buyer: For purposes oF this fan pean the actual vanserceuyerifhosh is purchasing the carn for hinherelt ‘orcaherise acquiring th fica fo hier. (eden he reorm fiom pan, rein fom consignment, Jar ae ime. Apso ‘ako the aca wansereouye if honk lpitimtely purchasing Ie rear ‘bond fe gi fora ha party. Agi i ot Bona fie ano ron ofeed ernrrethe pores completing tin form rveer mervietoh or brs uf rae ‘Scie th rear Yr hirer, ihe ar paaon i prohibed By lw fom ‘xr possesting He rear, ACTUAL TRANSFEREF/BUYER EXAMPLES: Me Sih aks Me Jones foperche’ wear fr Mr Seth (he mer sere he prfiine). Me ‘Sih gives Mr Jones the movey fre ica, Mt Jones NOV TIN Poge 40f 6 ACTUAL TRANSFEREE/BUYER oh arm and mst asset “NOM to ‘vestinn TL. The Kase may ot raster the Bar oe Jon. However Ife Thrown ps the caren wth i ow noney io get he, lack nea it (thn sericea tong ing of ne prove by Me Blak, Mc Brows he | ‘cual tansfre/buyer othe ean ad shook answer “VES™ v9 qin However, the ranferosler may not tae # firearm any pera ene hows locas resonable ene wo bie ie proied Uk 18 US. 9248), (8) (x EXCEPTION: Ifs pesmi picking up a epired freanns or ane pxson, habe isa equied to answe . and way proce to question 1. ‘Question 1..-12. Gencaly, 18 U.S.C, 9224) hibies he ship, tsps tio, roe ov passesian in aletnginrtte earmerce afar by ane ‘who: has beer convzted of flonyin ay Federal, Stat r lca cor, of any ‘therein, pone by impriscnment fora er exceeding one yer hs does tnt inched Sete misemcenare punishable by imprimment of ve years ol), ‘Su fgitve om jase an unlawful ue of oF ated, maria ox ny ‘posers ahocan or mete dost ey re wereld ectetne han Eeam djtieaet as ntl detetive obs bon onic wena ition; has bee discharged fram the Armed Forces under dishonorable cnn, subject © Cera vesting es: convicted ofa misdemeanor crime of Jones voice tnder Pedra, Stator Tia! law; hus enauneed hive US. een san len legally in he United Stes or n alien ante to he United States nde noni migra’ vis, Further, secton 922(n) prohibits the ship, asporation, oF ‘ecsipt no atetiogintrantesormroe Of fw by ne wh nde indi ‘Men or nformatin To fon in ny Fedral Stat ral ert. or ay Ot Crime, paishabley impisonment fra tr exceeding on yea. A infeoation i 2 Fume accsain oF axime verified by a puget ‘Amma of the Anno Fores must answer yes" Ibo Hh. feaged with ‘anoles tht was ter fered o General Court Mat at which the mer ‘er was cmc. DSchrged "under Ushonrabl conn mean separation from the Armed Force resuling fom a dishonorable iscarge Gk ad {gst by 2 Genera Courant, Tha tern does nt nude ay her discharge fr septic rom he Ate Vance | EXCEPTION: & person who bas been evict of felony. orany athe cme, for Which the judge euld have imprisoned the person fr more than yeu wk fim been anv ofa nisdcmeanor rime of domestic viene, s00tpohibied | ‘om prchasing.eceivng or possssing «rar if: (1 ur th nw ofthe juris ‘ikon where te conviction oeured, he penn has teen pnd th onviton tas bee expunged octane, rte pron ha had thi il gh the righ vo esr aun aed ol pubic aie ae away and ltrs, AND (2) the | Peron aot roid bythe In of th juridicion whet ie coniton occured. | ‘hom resving or pesesing rears. Pesons abject ohn exception, o who ‘soz oli rom dsbiies under 18 U.S.C 925(0 should answer" othe applicable quot | (Question 1h. Payhive fom Justi: Any pion mh Rl fm ny State to void peneclion for Keny 3 mieresnor or any pean wh eves the ‘Stato 2d giving ein inn ermal procttng, The en so inches any person who knows that misdemeanor oe fy chats ae nendie eta such sun an who leave the Sale of procaion. ‘Question ILE Adjuicated as a Mental Detetve: A datenioation by & cou, ‘oan, commision, er ter awl authonty that peton as sul oF marked Simona intelligence, e mental illness, incinpetone "ange isl oo es ¢ (2) lack he etal capacity seni gehen alfa. Tas et al nce: (1) = Ging of rai by meer in ‘imi eae; (2) done pros Found incomipcn to and ilo fod ily by eezon of ek of wel responsi, ‘Committed 194 Metal Institution: A formal commitment oF pronto mental instation bya cout har comission, eit wil authority. Ths erm includes» comesionen 13 mena nstiation involntny, hte inludes con ‘nine for menial deatvaess open ves. Habe chan cme Or ther eosons. such as fo gus. The tem does wo inelde person neni Jnitxam fr ehseration or 3 voluntary admission a mental sian. EXCEPTION: Unde the NICS Inprovamen Amendment Act of 207 person ‘who has Been adjudicated m8 mentl detest o commited oa meal stiaion Ina Sate proceedings no protiited by the audition comin ‘ATF Fae 479(3008) StarQuest_000007 ng Case 1:23-cr-00061-MN Document 157-1 Filed 05/20/24 Page 9 of 14 PagelD #: 2558 Uke pron ha been granted eli bythe aucaingeommiting Slate prsint toa caaliying mental hea reli from disses program. Alb, «person ho as bees alice ax etl deci ene he te lin by adoartment or agency of Federal Crvemmen tpi By _djct or coment ith: (the person's judieton or ei: ent was staid expel y the aidan covmiting agen (the ‘ema is teen fly ema or acon! rom a anny ses, erision, or iin by he agency (6) the person wos ow by the agency {Gn lenge ule en she metal helt cond hat served the as the ital adda oF) the aaicaton oe coment, ‘espostively ists snely on aed finding of Gaby witht ay oppor tay fora her bye, ae, com isi, te el uh sh the person as ct bor audited ma dete esac with ton S22(eK) of ie 1, Une Sats Cv, () Oe pera wan ponte el tho ajudicatingleonuiingopney prs! Wo ali metal Aclh it Feom dias proyra. Persons wh fll witha one ofthe ab ec ton should answer “no to questi ILL. Thisexceton lo a aioicton ‘eeomatimen by 3 Federal epanient or agency doer at apy tomy prin ‘who was adit te not uly by reason of samy based ko ‘ment eapoasibliy c ondieompstnt 9 stad any eran a tteder the Unies Cre of Miliary oie Question 1h. Qualilying Restraining Orders: Under I8S.C. 92, fan snag not he nl avery pai sujet to cou oer ae (A) we ised afer a hearing which he pon recived actus wate of and iad a ‘portunity to prticpte in (8) retin such porn fom tarsi, tain, ot theatening nina pai eld of S4B intial pains or pt, ‘or engaging other condut sl wold place an a male parte In reaabhe Fear of boty inary othe print or chil and (CX) inl a finding tat such person sees were veal the pyscal sls of wich lite tuto orci (3) hy tenes explcily pros the we, temple ve, heaton use of pgs! ce saint we ite porno rei ha would reasonably be expected case boil injury. AN “inrste pre” prion ithe speuseo* fone spouse of te petsn, te paren oF a eld he peso, ran nual wh Cont Oh cate eh pet, Li Miudemeanor Crime of Domestic Velece: A Fede, Sia, 1 ofene thet fa mnlemeor under Fee, Sa wa law and has, an hema th 88 amped use of piysical fre, or he t= ‘hed reo deadly weap commit by acre or finn pe, pot, ‘organi oF the itn by per wih won The vii share hid ‘comms. y 8 penon who cohabiting with eh calcd wil ih ii {381 spose part or gual, By 9 peso simi sia 9 soe, orator guardian of the sti. The cov nto ll msde that have {son lenin the we or aerped use of physi! Fore rte tiene ea 2 daly weapon ex esl ea bat), the oes commit by ene of "he defined partis. (See Execs ta ILD. 12.) A prs whalas be cone ‘eked a misdemeanor eine of domestic violence lois ot potbied vte les: (1) he psson was rorsened bya lawyer or gave wp height 3 we, or) fhe person was ete toa jury, was red bya jury. or ave pth gh {oe jury. Porone wb this xcepion shoud aneter me™ o T Qveston 12.4, Lrmigraton States: A aen adit othe Unk Sas ‘er 9 nonienigan vin nc, wmong ters, sans ving he Ure Stats temporarily or bases pleasure pens syn the Uni Ses ‘who mina a residene brad, and etain tmporary Toeign works. "These Alcs ust answer “yet this question and povide he anal documenta Yin required under question I. Permanent ions and ans legally mie othe Unit Sites prion to her he Via Walver Program oo regulations othawise exempting Ucn fom visa rere may answer no {othis question ad are not required ta suber the ional dscuenton| ‘mnder question iB. 13, UScised Alien Number or Admission Number: US-issuat admission amber maybe found ante following U.S. Dspotnet oF Home Sour docsments: Legal Resident Car or Employment Author tion Cal (ARB ¢ USCISHAcial/Deparare Recor Fon 194,08 Fm TA, (1388), Additional inormation an be abi fom weap go you ae 8 Under 8 US.C.922(aK 1) itt ular 8 pets to engage snes of dealing i Grearms witont a iets. A pera ix ese in th busines of dealing i rex i ee devotes ie, stetan, ar labor ealing in frcams 28 regalar eure of deo busines wilh he pica Pays 5 066 objativ of Hiveiboed ae prasi heugh she repetitive paras and esa Firearms Alcon io quire oF a person who eal makes oecasional les, ‘tcunges or purchanc of trav the eahoncaen o's person elition oF Tora hob. of wi sll ll or pat hier pera elton of feewems. Section 8 ‘Question 16. Type af Firearms): “Othe” lero Fane, reser andor fren hat ae nether handgas pr fog puns ifs shotgun) el sree hewn itl ip tht eet sa slo Maina! Fears At (NEA) Frese, cdg silencer, ta ame tev mony be nde nlm (tg it i it {frames recive no handgun oe log gun. Hower, rm rosin Sul "fcur by dein an mjot the me GCA Tinton kay ot Face, Soe Seton 921(0}3)U}- ection 522(0K!) sakes i wl Ieease te any ean eter han a shlyun Orie ony psn we th ge ‘of 2 Since fame cor nese fora fsa, eld oe that an only be mse ino tog gn, Tear terse 3 shag i,” eavo! be anor tomyone om the age nf 21, norcan these Oren be trated one wh ota rodent the Ste wher the nae to ake place. Ale oe that mle sales forms ae ot eqaited for frames oF reseiven of ay fans © pst arin ‘hoigurs snc hey ae al“ Fever” unde Section S23) 3A ‘Question 17. Qualising Gun Show or Events As defined 27 CFR 7K 100, 3 ‘gu show or ove i incon sponsor hy any nana, Site oF eal npn Hon, deve ote elton compute se or ther sprting we of fe ‘or ona ation o asain that sponsor tion deve Wo th leon ‘ompeliive ws, a eter sporti use a rear inthe comma Question 1a. Mentieatin: Befove#lcesee ay sll or ever rm Aentienne, the bese mat each the Wen, plac of ween, od age {ne vanserbuye. The wasereuyer must provi ad governmancsued ‘toto eenineton document the amterosels tt cna the onl buyers ame, siden aes, and date of birth A evr’ sa an ie Fein ear ased by a Slate in place of cense i sceepble. Soil Seay ‘ard are l crplbl erste a ald, do bith, phsograph is shown thecardh. A combination f government issued dociments maybe provided. See nsrutions fer question 18, Supplemental Documentation. ue traaftcouyer ix member ofthe Armed Force on ative day aging a Fase inthe Sine where hve peemanent doy ston is leew, bt else hae 2 sive’ iene ou another Sia the Waser shoul st che woe yer allay ication card wl eich rdet shoring where biter por nan duty tan oct in espns to quesin 8a, Tecenes may ap ‘lesiranie PCS oder a exblih esidency, Question 18. Supplemental Domentation: Licenses nay dcx combina ‘in of aid governed document to sally the Menfeaion doce rouirerint a th law. The equted val govecr men scl poo lente ‘in acumen arg te nae, photog nd =o ot ansere yer ‘may be supplemented by ater li, government med dome! sowing ie tenafre buyers residence ess. This spplematl dacurestin abl Neeson in quetion 1ih wih heetng mb and ip deletion presoted. For example he wanlecetber bas wo Slay skew od is {ing tuy chin in Ste Xs he ry provide adver oe fh he ‘nom, date ob ent pore ised by State Y snl another govern ‘ed docoment fc a tat docuner rom Stat X show ng hi vudenee ‘ates, A valid electonie dame rom 3 government webs ay Be ed ‘ippereataldocumenaion provide cna he (anafrse'haye's nae nl Question U8 ble Documentation: An alin ited wo the United Slats unde nonin ‘visa ml profbied fom purchasing. eciving, posing «ea I Ue le (1) isin possession os hung license or permit awl sted bythe Federal ‘Gwstnat a Stato ol gover, or Indian be Feral recogni bythe Dore of en Aa ish een ep 2) nel the Tied Soe or etl ing sing pura () boil x anor ion th probation fro the Allarncy General ote United States (9) cial ‘ejresetative oF fvegn goverment who is aczredited to the Unie States Gove ‘mentor ie Goverment mnt a interno eran ving 4 417 (3000) Case ’3-cr-00061-MN Document 157-1 headgunterin the Ue Snes (5) an oil epesetatve of a ven ‘government who is fou 16 fom other cout 1 which ht lene creed (6) is oficial of sign aovoranen oF stings eign ‘str wh has ban sa designated by the Depart! a Slats or (7) 8 Trign Tew enforcement oar fa indy frign governmenc cueing he Unit Stats on oli aw enkxcemcnt Bases. ‘Question 19. NICS BACKGROUND CHECKS! 1X USC. 9220) rites tha rior to raeerting any Brean oan unless ern ees pert, ‘manicure dealer mt icone the Natio Instant Cra Back {round Check System (NICS), NICS will vise Diente wheter estan finds ay information thal the pushes prot by hw fom poses ‘receiving aren, For purposes of this fer, contacts NICS ile Seats ‘snes deigatd an poo contact ("oe POC) We codet NICS checks Forthe Federal Govenmel reasonable nus 1 lee ta the ansercTer fpr om recet~ Ingo ponsrsing Freon, inloing iE the asterenhuyer anes" o «question 11.2; the ranferetuyeranswets "yes to ay question 11.8. IL tr 12h 12 fe tanseoeyer hs snawercd"yes” 0 queson 12, an nswered “noo question [22 ore tnstresbayereanot ove ti documentation requ by questions Na, bof €. WARNING: Any pson ‘es tanelere sa ony parte else knwo as esol cause 1 believe i pried from reeiving or ponte fice vides the leven ‘tthe tansforrsler tat complied wid the Fea chron check requiemens ‘Ath time that NICS i contacted, the Hicnsce mus con question 192. = 19. the dae of eon. the NICS or Sere) ransotion nme a a (Ge) reagan proved by NICS or he Sua. The coe nay roel Ue ‘il he rear maybe rns othe wansere/byer so known ashe Missing Disposition Infrmatan (MDI) de) 19's tal NICS provide or

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