Is the person acquiring the firearm (Transferee) a FFL?

Yes
No

Transferee's Name and Address (Include trade name, if any) (See instructions 2d)

INDIVIDUAL
TRUST or LEGAL ENTITY

Transferee's Federal Firearms License (If any)

Transferee's Special (Occupational) Tax Status (If any)

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Is the person selling or otherwise disposing of a firearm (Transferor), including applying to transfer a firearm, a FFL?

Yes
No

Transferor's Name and Address (Include trade name, if any) (Executors: see instructions 2k)

Transferor's Federal Firearms License (If any)

Transferor's Special (Occupational) Tax Status (If any)

Description of Firearm (See instructions 2m)

Name and Address of Maker, Manufacturer and/or Importer of Firearm

Law Enforcement Notification (See instructions 2f)

Tired of tracking your customers' CLEO notifications?

Since July 2016, every responsible person must submit a copy of their Form 4/23 to their CLEO. However, did you know that not every field is required on these notifications? Click 'Learn More' to find out how Silencer Shop can help with this tedious requirement, which will reduce stress and save valuable time.

Answer questions 14.a. through 14.h. Answer questions 16 and 17, if applicable. For any "Yes" answer the transferee shall provide details on a separate sheet. (See instructions 7b and definitions)

14a. Are you under indictment or information in any court for a felony, or any other crime, for which the judge could imprison you for more than one year? (See definition 1m)

Yes
No

14b. Have you ever been convicted in any court for a felony, or any other crime, for which the judge could have imprisoned you for more than one year, even if you received a shorter sentence including probation? (See definition 1m)

Yes
No

14c. Are you a fugitive from justice? (See definition 1s)

Yes
No

14d. Are you an unlawful user of, or addicted to, marijuana or any depressant, stimulant, narcotic drug, or any other controlled substance?

Yes
No
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.

14e. Have you ever been adjudicated as a mental defective OR have you ever been committed to a mental institution? (See definitions 1n and 1o)

Yes
No

14f. Have you been discharged from the Armed Forces under dishonorable conditions?

Yes
No

14g. Are you subject to a court order restraining you from harassing, stalking, or threatening your child or an intimate partner or child of such partner? (See definition 1p)

Yes
No

14h. Have you ever been convicted in any court of a misdemeanor crime of domestic violence? (See definition 1q)

Yes
No

16a. Country of Citizenship (Check/List more than one, if applicable. Nationals of the United States may check U.S.A.) (See definition 1r)

Are you a citizen of the United States of America?

Yes
No

16b. Have you ever renounced your United States citizenship?

Yes
No

Are you a citizen of any other country?

Yes
No

Other Country/Countries (specify)?

16c. Are you an alien Illegally or unlawfully in the United States?

Yes
No

16d.1. Are you an alien who has been admitted to the United States under a nonimmigrant visa?

Yes
No

16d.2. If "yes", do you fall within any of the exceptions stated in the instructions? Attach the documentation to the application

Yes
No

17. If you are an alien. record your U.S.-Issued Alien or Admission number (AR#, USCIS#, or 194#):

Provide the full name below for each Responsible Person associated with the applicant trust or legal entity.

Please note that a completed Form 5320.23, National Firearms Act (NFA) Responsible Person Questionnaire, must be submitted with the Form 4 application for each Responsible Person.

ATF E-Form 5320.23 Responsible Persons (None)

    Name and Home Address of Responsible Person

    Law Enforcement Notification (See instructions 5)

    As a responsible person (see definition 4) of the trust or legal entity identified in Item 2 of this form, I am required to provide notification of the proposed making or acquisition and possession of the firearm described in item 4 of this form by providing a copy of the completed form to the chief law enforcement officer (CLEO) in the agency identified below:

    Tired of tracking your customers' CLEO notifications?

    Since July 2016, every responsible person must submit a copy of their Form 4/23 to their CLEO. However, did you know that not every field is required on these notifications? Click 'Learn More' to find out how Silencer Shop can help with this tedious requirement, which will reduce stress and save valuable time.

    Answer questions 6.a. through 6.h. Answer questions 7 and 8, if applicable. For any "Yes" answer the transferee shall provide details on a separate sheet. (See definitions 8-12)

    6a. Are you under indictment or information in any court for a felony, or any other crime, for which the judge could imprison you for more than one year? (See definition 8)

    Yes
    No

    6b. Have you ever been convicted in any court for a felony, or any other crime, for which the judge could have imprisoned you for more than one year, even if you received a shorter sentence including probation? (See definition 8)

    Yes
    No

    6c. Are you a fugitive from justice? (See definition 13)

    Yes
    No

    6d. Are you an unlawful user of, or addicted to, marijuana or any depressant, stimulant, narcotic drug, or any other controlled substance?

    Yes
    No
    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.

    6e. Have you ever been adjudicated as a mental defective OR have you ever been committed to a mental institution? (See definitions 9 and 10)

    Yes
    No

    6f. Have you been discharged from the Armed Forces under dishonorable conditions?

    Yes
    No

    6g. Are you subject to a court order restraining you from harassing, stalking, or threatening your child or an intimate partner or child of such partner? (See definition 11)

    Yes
    No

    6h. Have you ever been convicted in any court of a misdemeanor crime of domestic violence? (See definition 14)

    Yes
    No

    7a. Country of Citizenship (Check/List more than one, if applicable. Nationals of the United States may check U.S.A.) (See definition 12)

    Are you a citizen of the United States of America?

    Yes
    No

    7b. Have you ever renounced your United States citizenship?

    Yes
    No

    Are you a citizen of any other country?

    Yes
    No

    Other Country/Countries (specify)?

    7c. Are you an alien Illegally or unlawfully in the United States?

    Yes
    No

    7d.1. Are you an alien who has been admitted to the United States under a nonimmigrant visa?

    Yes
    No

    7d.2. If "yes", do you fall within any of the exceptions stated in the instructions? Attach the documentation to the application

    Yes
    No

    8. If you are an alien. record your U.S.-Issued Alien or Admission number (AR#, USCIS#, or 194#):