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STATEOFCAUPORNIA—OFPICEOFADMINISTRAT '=.l,. ~ '~. f ~ i ~ ~ ~ ` tee instructions on For use by Secretary of State only
N~JT'i~~ PUBLICATION/f~~~~L~~'IO~~-~~E~IV9$~-51C3f~ ~'~ ~ `' ~~~ reverse)
STD. 400 (REV. 07-20131
OAL FILE NOTICE FILE NUMBER REGULATORY ACTION NUMBER p EMERGENCY NUMBER
NUMBERS 7. 1 ~ ~ ~ f ~ iJ ~{" 6~For use by Office of Administrative Law (OAS) only
`~ ~~~ ~. ~q
NOTICE ~ REGULATIONS ' _
AGENCY WITH RULEMAKING AUTHORITY AGENCY FILE NUMBER (if any)
Department of Justice (DOJ-17-005
A. PUBLICATION OF NOTICE {Complete for publitation in Notice Register)--- FIRST SECTION AFFECTED 2. REQUESTED PUBLICATION DATE
1. SUBJECT OF NOTICE TITLES)
3. NOTICE TYPE 4. AGENCY CONTACT PERSON TELEPHONE NUMBER I- FAX NUMBER (Optional)
Notice re'Proposed
Re ulator Acton ❑ Other ~
OAL I.JSE ACTION ON PROPOSED NOTICE NOTICE RFGISI FR NUMEIEk Pt1BUCf1itQN DATE
~~'1 ApP~ `~ -5 ~ '—} r~pprnved as ', D1sa Purovea'r rSubrr ~ Modlfieo ~~ wtharawnOt~lL i t ~, _
B. SUBMISSION OF REGULATIONS (Complete when submitting regulations)
1a. SUBJECT OF REGULATIONS) 1b. ALl PREVIOUS RELATED OAL REGULATORY ACTION NUMBERS)
Bullet-Button Assault Weapons
2. SPECIFY CALIFORNIA CODE OF REGUTATiONS TITLE(5) AND SECTION(5} pncluding title 26, if mxics related}
SEC'TIOFd(5) /dFFECTED A~oPr
(List all section numbers) Sections 5470, 5471, 5472, 5474, 5474.1, 5474.2, 5475, 5476, 5477, and 5478
individually. Attach AME"°
additional sheet i~ e~eeded.) Sections 5469 and 5473
TITLES) REPEAL
11
3. 7YPEOPFILING
Regular Rulemaking (Gov. ~ Certificate of Compliance: The agency officer named ❑Emergency Readopt {Gov. ❑Changes Without RegulatoryCode §71346} below certifies that this agency complied with the Code, §11346.1 (h}) Effect teal. Code Regs., title
O Resubmittai of disapproved or provisions of Gov. Code §§7 7346.2-113473 either 1, §100)
withdrawn nonemergency before the emergency regulation was adopted or
Oiling (Gov. Code §§71349,3, within the time period required by staTute. ~ File &Print ~ Print Only
11349.4)
Emergency iGov. Code, ~ Resubmittal of disapproved or withdrawn ❑Other i5pecify)
§11346.1{b)) emergency filing (Gov. Code, §71346.1)
4. ALL BEGINNING AND ENDING DATES OF AVAILABILITY OF MODIFIED REGt1LA710N5.AND/ORMATERIAL ADDEDTOTHE RULEMAKING FILE (Gal, Code Regs. title 7, 444 and Gov. Code 577347.1)
N/A5. EFFECTIVE DATE OF CHANGES (Gov. Code, §4 1.7343.4, 7 7346.1(d); CaI. Code Regs., title 1, §100) -
❑ Effective January 1, April 1, July 1, or ~ Effective on filing with ❑ §100 Changes Without ~ Effective y
October 1 (Gov. Code §11343A(a)) Secretary of State Regulatory Effect other (Specif )
6. CHECK IF THESE REGULATIONS REQUIRE NOTICE TO, OR REVIEW, CONSULTATION, APPROVAL OR CONCURRENCE BY, ANOTHER AGENCY OR E
Department of Finance (Form STD. 399) (SAM §6660) ~ Fair Political Practices Commission ~ State Fire Marshal
Other (Specify)
7. CONTACT PERSON
Jacqueline Dosch 16) 227-5417FAX
$• I certify that the attached copy of the regulation{s)is a true and correct copy
of the regulations) identified on this farm, that the information specified on this form
is true and correct, and that 1 am the head of the agency taking this action,
or a designee of the head of the agency, and am authorized to make this certification.
SIGNA RE OF~A/G~ENCY HEAD OR DEfSIGNEE DATE -~^~
i(~ f ~ ~ f A ~ ~..~. ~ 1. ". ~ _~_ ~ /
AIL ADDRESS (Optlo~a~)
For use by Office of Administrative Law (UAL) only
Sean McCluskie, Chief Deputy Attorney General
California Code of Regulations
Title 11, Division 5
Chapter 39 Assault Weapons and Large-Capacity Magazines
Article Z. r,o~;Yf14'1AN[~ ~~To,.,~,~ TTn~,a +~ T,ao~+;~, n ~r,,,,~,- t~zo.,~,.r~ RegistrationLL VV 1~,FVlil~tl L 1~J ~J 1
Requirement, What Qualifies for Registration, and Definitions
§ 5469. ~~~~ s Registration of Assault Weapons Pursuant to Penal Code Section
30900 b~(1)• Who Must Re ig ster.
..
_ . _ .. .. _ e ... .. ... - - - - - -
_ .~~.
Andperson who from Januar~l 2001 to December 31 2016 inclusive, lawfully possessed an
assault weapon that does not have a fixed magazine as defined in Penal Code section 30515,
including those weapons with an ammunition feedingdevice that can be readily removed from
the firearm with the use of a tool (commonlX referred to as a bullet-button weapon) must register
the firearm before January 1, 2018.
Note: Authority cited: Section ~1~8 30900, Penal Code. Reference: Sections ~ E~}; ~3-5~1 t i l~T:T~T~~KlT~T~L'itl~T_~L~=[t1►1~7lZ~1"Yl~~a~ii7/G~1aT'~v~orTfs~~r~ ~~~urs+~
Page 1 of 15
X5470 Registration of Assault We~ons Pursuant to Penal Code Section 30900(b)(1); Which
We~ons Must be Re ist~L erect•
Department before 3anuary 1, 2018.
(b) A semiautomatic centerfire or rimfire pistol with an aillmunition feeding device that can
be readily removed from the firearm with the use of a tool, commonly referred to as a
bullet-button weapon that has one or more specified features identified in Penal Code
section 30515 is included in the category of firearms that must be registered.
~) A semiautomatic centerfire rifle with an ammunition feeding device that can be readily
removed from the firearm with the use of a tool commonly referred to as a bullet-button
weapon that has one or more specified .features identified in Penal Code section 30515 is
included in the cate~or~of firearms that must be registered.
(d) A semiautomatic shotgun with an ammunition feeding device that can be readily removed
from the firearm with the use of a tool commanl~referred to as abullet-button weapon, is
included in the cate~or~of firearms that must be re ist~ erect•
Note• Authority cited Section 30900 Penal Code Reference: Sections 30515 and 30900, Penal
Code.
§ 5471 Registration of Assault Weapons Pursuant to Penal Code Section 30900(b)(11;
Explanation of Terms Related to Assault Weapon Designation.
The following definitions a~ply to terms used in the identification of assault weapons pursuant to
Penal Code section 30515 and for purposes of Articles 2 and 3 of this Chapter:
~) "Abi1i to accept a detachable magazine" means with respect to a semiautomatic shotgun,
it does not have a fixed ma agL zine•
fib) "Action" means the working mechanism of a semiautomatic firearm, which is the
combination of the receiver or frame and breech bolt together with the other parts of the
mechanism by which a firearm is loaded fired and unloaded.
~c~ `Barrel" means the tube usually metal and cylindrical through which a projectile or shot
charge is fired Barrels may have a rifled or smooth bare._
~d) "Barrel length" means the length of the barrel measuxed as follows: Without consideration
Page 2 of 15
of a as or electric steel-seal
temperature (' 1100°F) silver soldering,,_ or blind pinning with the pin head welded over.
Barrels are measured b~inse~tin,~a dowel rod into the barrel until the rod stops a~ainSt
the closed bolt or breech-.face. The rod is then marked at the furthermost end of tie barrel
or permanently attached muzzle device, withdrawn from the barrel, azld measured.
"Bullet" means th~roaectile expelled from a gun. It snot synonymous with a cartrid
Bullets can be of many materials, shapes, weights, and constructions such as sand lea
lead with a jacket of harder metal, round-nosed, flat-nosed, hollow-pointed, et cetera.
"Bullet-button" means a product reauirin~ a tool to remove an ammunition feeding de
bullet-button equipped fizlly functional semiautomatic firearm does not meet the fixed
ma azine definition under Penal Code section 30515(b).
(g,,) "Bare" means the interior of a firearm's barrel excluding the chamber.
hundreds of an inch; 'in Great Britain in thousandths of an inch; in Europe and elsewhere
in millimeters.
(i} "Cartridge" means a complete round of ammunition that consists of a primer, a case,
propellant powder and one or more projectiles.
~j,) "Centerfire" means a cartridge with its primer located in the center of the base of the case.
~k) "Contained in" means that the magazine cannot be released from the firearm while the
action is assembled. For AR-15 style firearms this means the magazine cannot'be
released from the firearm while the Wiper receiver and lower receiver are joined to eg ther.
(1) "Department" means the California Department of Justice.
gym) "Detachable magazine" means any amil~unition feeding device that can be removed
readies from the firearm without disassembly of the firearm action or use of a tool. A
bullet or ammunition cartridge is considered a tool. An ammunition feedin d~ evice
includes any belted or linked ammunition, but :does not include .clips, en<bloe clips, or
striper clips that load cartridges into the magazine.
An AR-15 style firearm that has abullet-button style magazine release with a ma peg t left
on the bullet-button constitutes a detachable magazine. An AR-15 style firearm lackin~a
magazine catch assembly (magazine catch, magazine catch sprin,~ and magazine release
buttons constitutes a detachable magazine. An AK-47 style firearm lacking a magazine
catch assemblesmagazine catch springyand rivetlpinZ constitutes a detachable magazine.
Page 3 of 15
fin) "Disassembly of the firearm action" means the fire control assembly is detached from the
action in such a wav that the action has been :interrupted and will not function. For
example, disassembling the action on a twapart receiver, like that on an AR-15 style
firearm, would require the rear take down pin to be removed, the upper receiver lifted
upwards and awa~from the lower receiver using the front pivot pin as the fulcnun,
be~are the magazine may be removed,
~cteristics associated with that weapon, as listed in Penal Code sectio
(q) "Flare launcher" means a device used to launch signal flares.
(r) "Flash suppressor" means anv device attached to the'end of the barrel, that is designed,
intended, or functions to perceptibly reduce or redirect muzzle flash from the shooter's
field of vision. A hybrid device that has either advertised flash su~pressin~properties or
functionally has flash suppressingproperties would be deemed a flash suppressor. A
device labeled or identified by its manufacturer as a flash hider would be deemed a flash
suppressor.
~) "FMBUS" means a Firearm Manufactured By Unlicensed Subject.
fit) "Forward pistol drip" means a ri that allows for a pistol style grasp forward of the
tiger.
~u) "Frame" means the receiver of a ip stol•
(vim "Grenade launcher" means a device capable of launching a renade.
(w) "Permanently attached to" means .the magazine is welded, epoxied, or riveted into the
magazine well. A firearm with a magazine housed in a sealed magazine well and then
welded, epoxied, or riveted into the sealed magazine well meets the definition of
<permanentl~attached to".
fix) "Overall len~,th of less than 30 inches" with resbect to a centerfire rifle means the rifle has
been measured in the shortestpossible confi oration that the weapon will function/fire
and the measurement is less than 30 inches. Folding and telescoping stocks shall be
collapsed ,prior to measurement. The approved method for measuring the length of the ~ - -
rifle is to measure the firearm from the end of the barrel., or ~ermanently attached muzzle
device if so equipped to that~aart of the stock that is fi rthest from the end of the barrel, or
Page 4 of 15
permanently attached muzzle device (Prior to taking a measurement the owner must also
check anv muzzle devices for'how then are attached to the barrel.}
(y} "Pistol" means anv device designed to be used as a weapon from which a projectile is
expelled by the force of anv explosion or other form of combustion, and that leas a barn
less than 16 inches in length This definition includes AR-15 style pistols with pistol butte:
tubes attached Pistol buffer tubes typically have smooth metal with no wide on the
bottom for rifle stocks to be attached and they sometimes have a .foam pad on the end of
the tube farthest from the receiver.
~z~ "Pistol grip that protrudes conspicuously beneath the action of the weapon" means a grip
____.
and index finer) can be placed beneath or below the top;of the exposed portion oft]
~rig~er while firing This definition includes pistol fps on bullpup firearm designs.
~aa) "Receiver" means the basic unit of a firearm which houses the firing and breech
mechanisms and to which the barrel and stock are assembled.
ebb) "Receiver lower" means the lower part of a two part receiver.
Unlicensed Subjects (FMBUS} began as unfinished receivers.
~ddZ "Receiver upper" means the toyportion of a two part receiver.
ee "Rifle" means a wea on desi ned or redesi ned made ar remade and intended to be fired
from the shoulder and designed or redesigned and made or remade to use the enemy of the
explosive in a fixed cartridge to fire only a single~projectile throu~h~a rifled bore for each
single pull of the trigger.
(ffl "Rimfire" means a rimmed or flamed cartridge with the priming mixture located in
the rim of the case.
~gg.,~ "Second hand rip" means a grip that allows the shooter to drip the pistol with their non-
tri~~er hand The second hand drip often has a grip texture to assist the shooter in weabon
control
~hh) "Semiautomatic" means a firearm functionally able to fire a single cartridge, eject the
empty case and reload the chamber each time the tri~~er is bulled and released. Further,
certain necessary mechanical parts that will allow a firearm to function in a semiautomatic
nature must bedresent far a weapon to be deemed semiautomatic. A weapon clearly
designed to be semiautomatic but lackin~a firingpin bolt carrier gas tube or some other
Page 5 of 15
crucial art of the firearm is not semiautomatic for purposes of Penal Cade sections
30515 30600 30605fa), and 30900.
(1) ~ mechanically whole semiautomatic firearm merely lacking ammunition and aproper magazine is a semiautomatic firearm.
gun lock or firearm safety device is removed, and weapon can he loaded with amagazine and proper ammunition.}
With regards to an AR-15 style firearm if a complete upper receiver and a complete
firearm.
i~Uvu r-~i~-
(ii) "Shogun with a revolving cylinder" means a shogun that holds its ammunition in a
cylinder that acts as a chamber much like a revolver. To meet this definition the shogun's
cylinder must mechanically revolve or rotate each time the weapon is fired. A cylinder
that must be manually rotated by the shooter does not qualify as a revolving cylinder.
(y) "Shroud" means a heat shield that is attached to or partially or comvletely encircles the
barrel allowing the shooter to fire the weapon with one hand and gasp the firearm over
the barrel with the other hand without burning the shooter's hand. A slide that encloses
the barrel is not a shroud.
spigot is what the grenade is attached to prior to the launching of a grenade.
X11) "Stock" means the part of a rifle carbine or shotgun to which the receiver is attached and
which provides a means for holding the weapon to the shoulder. A stock may be fixed,
folding, or telescoping.
(mm} "Stock fixed" means a stock that does not move, fold, or telescope.
~jjjj) tJ lUlilt 1V1U111}.' ll1CiA.l1J Q JI.V~+11 YY1ll411 1.7 lllil~vu itt ~vaaav au.~saay... ..v_ ~.~ ~.+~-.~~ ~~ ~-- »_--- ~•
the stock to be folded next to the receiver to reduce the overall length of the firearm. This
definition includes under folding and over foldin stg~ocks.
boo) "Stock telescoping" means a stock which is shortened or lengthened by allowing one
section to telescope into another~ortion On AR-15 style firearms the buffer tube or
receiver extension acts as the fixed part of the stock on which the telescoping butt stock
slides or telescopes.
Page 6 of 15
magazine.
(qa) "Thumbhole stock" means a stock with a hole that allows the thumb of the trigger hand to
T penetrate into or through the stock while firing.
err) "Threaded barrel cable of accepting, a flash suppTeSsor forward hand~rip or silencer"
means a threaded barrel able to accept a flash suppressor forward hand~p or silencer
and includes a threaded barrel with any one of those features already mounted on it. Some
firearms have "lugs" in lieu of threads on-the end of the barrel. These lugs are used to
attach some versions of silencers For purposes of this definition a lu~~ed barrel is the
same as a threaded barrel
Note• Authoritycited• Section 30900 Penal Code Reference: Sections 3Q515 and 30900, Penal
Code.
Article 3. Assault Weapon Registration
~ 5472 Registration of Assault Weans Pursuant to Penal Code Section 30900Cb)(1); Weapons
That Will Not Be Registered as Assault Weapons.
Via) The Department will not register as an assault weapon a firearm unless it was lawfully
possessed on or before December 31, 20T6.
(b) The Department will not register a firearm that was required to be registered under prior
assault weapon registration laws in effect before January 1 2017 These weapons include
but are not limited to firearms known as "named assault weapons" and are listed in Penal
Code section 30510 and sections 5495 and 5499 of Chapter 40.
~) The Department will not register a firearm as an assault weapon if the firearm is
featureless.
~d} The Department will not register a firearm as an assault weapon if the firearm has a fixed
magazine that holds ten rounds or less.
~e~ The Department will not register a firearm as an assault weapon unless the firearm is fully
assembled and fizliv functional.
Page 7 of 15
(f) The Department will not register as an assault weat~on a firearm manufactured by a
federaliv-licensed manufacturer if the firearm does not have a serial number applied
pursuant to federal law.
~) The Department will not register as an assault weapon a FMBUS if the firearm does not
have a serial number assigned by the De artment and applied by the owner or went
pursuant to section 5474.2.
ion 30900, Penal Code. Reference: Sections_3__0515__and 30900, Penal
_ '~
.. - -.
..
§ .5473. Registration of Assault Weapons Pursuant to Penal Code Section 30900(b)(1); California
Firearms A~blication Reporting_Svstem ("CFARS")• Account Requirements.
~a) Assault weapon registrations must be filed electronicall~usin~ the Department's
California Firearms Application Reportin~S sty em (CFARS~ at the following website:
https://cfars.doica. gov/lo ~in.do.
fib) A CFARS account must be created to use the electronic registration system. To create a
CFARS account assault weapon registrants will be required to agree to the following
Page 8 of 15
conditions of use:
(1) Non-Liability• The Department is not responsible for and will have no liability for any
hardware software - information ar other items or any services provided by any
persons other than the Department Except as maybe required by law in no event
shall either party he liable to the other or an turd party under any theory of liability,
ineludin~ but not limited to~anv contract or tort claim for any cause whatsoever, for
any indirect iilcide~ital special or consequential da~:ia~es including loss of revenue
or profits even if aware of the possibility thereof.
(2) Authorization• I am authorized to use CFARS for the purpose of reporting firearm
information to the Department in order to comply with California firearm laws. and
re~,ulations If I become aware of an unauthorized user obtaining access to my
CFARS account I will notify the Customer Support Center immeciiately at (9161227-
7527 or via email at: firearrns.bureau(a~doj.ca. ov.
(3) Fees• Notwithstanding such notification the Department shall not be liable for
transaction charges fraudulently incurred. It will be the cardholder's responsibility to
ppav an~harges The Department will not provide refunds after the submission of a
transaction.
~plefie to the best of my knowled~
Vic) The followinginformation must be provided by registrants in order to create a CFARS
account:
(1) Full Name
(2) Email Address
(3) Three Security Questions and Answers
{4) Password
Note Authority cited' Section 3Q900 Penal Code Reference: Sections 30515 and 30900, Penal
Code.
5474 Registration of Assault Weapons Pursuant to Penal Code Section 30900(b~(1); Applicant -
and Firearms Information.
Page 9 of 15
Once a CFARS account has been created registrants must-provide the following information:
Via) The registrant's full name address tel~haiie number date of birth sex hei ht~t
eve color hair color military identification number (if applicable), California Driver
License number or California Identification Card number U.S. citizenship status, place of
birth country of citizenship acid alien registration number or I-94, if applicable.
(b1 A description of the firearm that identifies it tmic~uely including but notlirnited to:
firearm type make.~model caliber firearm color barrel length, serial number, all
identification marks firearm countxy of ori~in/manufacturer, the date the firearm was
acquired the name and address of the individual from whom or business from which, the
firearm was acquired.
~c) Clear digital photos of firearms listed on the application One photo shall depict the bullet-
button s le magazine release installed on the firearm. One photo shall depict the firearm
from the end of the barrel to the end of the stock if it is a long gun or the point furthest
from the end of the barrel if it is a pistol The other two photos shall show the left side of
the receiver/frame and right side of the receiver/frame. These locations are typically where
firearms are marked when manufacturing is comt~lete At the discretion of the Department
the last two photos shall be substituted for photos of identification markings at some other
locations on the firearm.
Note• Authority cited• Section 30900 Penal Code Reference: Sections 30515 and 30900, Penal
Code.
Registration of Assault Weapons.
~} If a firearm will be jointly registered one family member must be identified as the primary
registrant The name and relationship of each joint registrant must be provided. Joint
registrants must reside in the same household and share the same address.
fib) All joint registrants must be 18 years of ale by December 31 2017. Joint registrations are
only authorized for the followin f~ amily relationships:
(11 Spouses
~2) Parent to Child
(3~ Child to Parent
~4) Crrand~arent to Grandchild
Page 10 of 15
(5) Grandchild to Grandparent
~6) Domestic Partners
~7) Siblings
~c) Proof of address for each ioint re ist~ rant shall be provided at the time of electronic
submission Acceptable forms o~roof of address are as follows:
~l) Carry Concealed Weapon (CCW) Permit
(21 Curio and Relic (C & R) Federal firearm license with name and address
~3 Utility Bill• Cable electricity ~arba~e ~;as pipeline, propane, alarm/security or
water,bill with purchaser's name on it and dated within three months of application
for registration.
(4} Military permanent duty station orders indicatin~~assi~nment within California;
active duty military spouse ID is not acceptable).
~5) Property Deed• Valid deed or trust for the individual's property or a certificate of title
(6) Resident Hunting License
,~'1) Signed and dated rental agreement/contract or residential lease
~8) Trailer certification of title
(9) DMV Vehicle Registration
X10) Certificate of Eli ig bility as defined in section 4Q31 subdivision (~) of Chapter 3.
Note• Authority cited• Section 30900 Penal Code Reference• Sections 30515, 30900 and 30955,
Penal Code.
5474 2 Registration of Assault Weapons Pursuant to Penal Code Section 30900(b)(1); Firearm
Manufactured By Unlicensed Subject (FMBUSl.
A person seeking assault weapon registration for this type of firearm shall seek a Department
issued serial number at• dojserialnumber(a~dot ca Gov prior to initiating the assault weapon
registration process.
Page 11 of 15
~) ADepartment-provided serial number shall be issued and applied as follows:
(1) The Department shall issue a unictue serial number to the applicant. The serial
number issuance is a se,~,arate process and must be done before .the assault weapon
.application will be accepted by the Department. Applicants seeking; a FMBLIS
:related serial number shall complete a New Serial Number Application, Foxrn BOF
1008 Rev 6!2017 hereb i~orporated by,reference .and submit it to the.
De~a.rtment~rior to the initiation of the registration of this type of firearm.
~2) Once the a,~plicant has received a Department issued serial number, the applicant may
number a~pllect m a manner consistent wain ~rus secilon ana Teaera~ zaw. However, a
Federal Firearms Licensee is under no obligation to perform this work. Persons who
have manufacturedtheir- own firearm may also use non-licensed parties to apply the
serial number and other required markings• .however, the owner of the weapon must
not leave the firearm unattended with an unlicensed party in violation of firearms
transfer and/or lending laws. Proof of the serial number being applied to the firearm
sha11 be given to the~Department in the form of one or more digital photoff~raphs of the
newly serialized firearm being submitted in accordance with the photo requirement
noted in section 5474 (c).
3) An unlicensed manufacturer of firearms must legibly and uniquely identify each
firearm manufactured as follows:
{A) By ending c~.stin~ stambin~ (impressing) or otherwise conspicuously
placingor causing to be engraved cast stamp~im_pressed or placed on the
frame or receiver thereof an individual serial number. The serial number must
manufacturer on any other firearm. The engravin c~ astin~, or stamping
{impressin) of the serial number must be to a minimum death of .003 inch
and in a print size no smaller than 1i16 inch; and
(B) By en~ravin~ castin~stampin~(impressin~~) or otherwise conspicuously
1p acin o~ r causin tg o be engraved cast stampedimpressed ar placed on the
frame receiver or barrel thereof certain additional information. This
information must be placed in a manner not susceptible of being readily
obliterated altered or removed. The additional information must include:.......
(i} The model of the firearm if such designation has been made;
Page 12 of 15
(ii) The caliber or gauge of the firearm;
viii) The manufacturer's first and last name as provided to the Department for
re~,istration purposes when applicable; and
Div, The cit~and state~ox recognized abbreviation thereafl where the
manufacturern~ade the firearm.
measurement of height and depth of markings. The depth of all markings required by.. .,, ,
.. , n .t n_1. ---r--- -rah-- ----i_t _~a ~.. a. aL .. .~..,.L,. ,.».
rides The height of serial numbers required by,para~rap~a)~3)(A) of this section
will be measured as the distance between the .latitudinal. ends of the character
..impression bottoms (bases).
~5) The Department shall deny assault weapon re istration applications if it determines
the above described marking regruirements have not been met.
Note' Authoritycited• Section 30900 Penal Code Reference: Sections 30515 and 30900, Penal
Code.
54~ 75 Registration of Assault Weapons Pursuant to Penal Code Section 30900(b)(11; Fees.
~a) The fee to register an assault weapon is $15 O ffer person per transaction. There is no
limit to the number of assault weapons a person can register in a single transaction.
fib} The fee must be paid by debit or credit card at the time the registration is submitted to the
Department for processing If the fee is not paid the registration will not be processed.
~c) A $5 fee is required to obtain a copy of the on ink al re isg tration disposition letter.
Note• Authority cited• Section 30900 Penal Code Reference• Sections 30515 and 3090Q, Penal
Code. ,
$ 5476 Registration of Assault Weapons Pursuant to Penal Code Section 3Q900(b)f 1);
Processing of Applications
~) Applications for assault weapon registration must be received between January 1, 2017,
and December 31 2017 and will be processed in the order in which they are received.
fib) Once the registration has been submitted electronically and fees have been paid, the
Department will inform the applicant via email that the application: has been received
Page 13 of 15
and accepted forprocessin~• is being returned as incomplete and specify what information
is required; or has been rejected.
~c~ If the Department deems an application incomplete and notifies the applicant via email of
the incomplete determination the applicant shall provide the requested information or
documentation within 30 days. If the D~artment does not receive the additional
information or documentation within 30 days the application will be reiected acid the
application fee will not be refunded The abplicant ma~camplete a ne~~ application before
December 31 2017 subject to a new application fee.
(d) Once the Department determines that all necessary information has been received and the
firearm qualifies for registration the firearms eli ig bilit~check shall commence. The
Department will inform the applicant of the results of the check.
(e) If the firearms eli ig, bility check is successful the registrant shall receive an assault weapon
registration disposition letter via U.S. mail.
Note• Authority cited• Section 30900 Penal Code. Reference: Sections 30515, 30900 and 3.0950,
Penal Code.
X5477 Registration of Assault Weapons Pursuant to Penal Code Section 30900(b~(1); Post-
Reg~Lstration Modification of Registered Assault Weapons, Prohibition.
(a} The release mechanism for an ammunition feeding device on an assault weapon registered
pursuant to Penal Code section 30900 subdivision (b)(1}shall not be changed after the
assault weapon is registered A we~on's eli ig bili for registration pursuant to Penal
Code section 30900 subdivision (b)(1) depends in~art on its release mechanism. Any
alteration to the release mechanism converts the assault weapon into a different weapon
from the one that was re ist~ erect•
fib) The prohibition in subdivision {a~does not extend to the repair or like-kind replacement of
the mechanism.
~c This prohibition in subdivision dal does not extend to a firearm that is under~oin~ the
dere_gistration proces pursuant to section 5478 Written confirmation from the
Department that acknowledges the owner's intent to deregister his or her assault weapon
pursuant to section 5478 shall b~roof the dere~istration process has been initiated.
Note Authority cited• Section 30900 Penal Cade Reference: Sections 30515 and_30900, Penal
Cade..
Page 14 of 15
5478. Registration of Assault Weapons Pursuant to-Penal Code Section 30900{b)(1); ~olttntary
Dere istration.
dal The Department will accept voluntary Jere istration requests for zssault weapons that are
nn loner possessed by the~?istrant~in the form of a completed Fornz BOF 4546 "Notice
of No Longer in Possession," (Rev b/2017~ hereby incorporated by reference.
Deregistration requests willalso be accepted for assault weapons, as defined in Penal
Code sectioi130515, that have been modified or reconfi u~~red to rlo longer meet that
definition. Deregistration requests must be in writing, signed, dated, and provide the
toll~win~ information:
~l) Registrant's full name, telephone number, and current address; make, model, and
serial number of the assault weapon; and the Department assault weapon registration
nur~lber (as indicated on the re~7istration confirmation letter provided to the registrant
at the time of registrationl. If tl~e Department assault weapon re~istratioii number is
unknown, the request must be notarized.
~2) If the firearm has been modified or reconfigured to no longer meet the definition of,........i,. _.,,.,.._,.~ ,.~ ................ ri..,.~..,~..,,~i.,. ,.i,.,,:.~., a,._.,,.:~,~ ,.i..~ r...,..,..... ,,.:.,. ,.,,....,.~,
d to the writtel~ dere~istration reauest. Additional
determning~eli~ibility for deregistration.
(3) If the registrant is no longer in possession of the firearm, proof of sale or transfer of
the firearm shall be attached to the written°deregistration request. Acceptable proof
includes receipts from out-of-state gun stores, or law enforcement reports depicting
the seizure and/or destruction of the firearm(s).
(b) Upon determinin eligibility for dere~istration, the Department will delete the assault
weapon registration for the specified firearm(s), and, if the weapon is still. in the possession
of the registrant, will convert the information to a BOF 4542A, "Firearm Qwnershin
Report, (Rev. 6/2017, herebyincorporated by reference.
Automated Firearms System.
~d~ Upon completion of the assault weapon dere~istration, the Department will mail
confirmation of dere~istration and u,~dated firearm ownership information to the re isg trant
at the address provided on the regiuest.
Note: Authority cited: Section 30900, Penal Code. Reference: Sections 30515_and_3.0900, Penal
Code.
Page 15 of 15
STATE OF CAUF6RNIABOF iQOA (Rev. p62017)
Ya
~~~~.
iwM~~C'~~1~~~ ~~I—~~~IVI ~Y~` 7 ~~ aY Liw7 I:.iL:~
~l1REA~J ~~' FIREA~~S
Iew Seri~~ ~ur~ab~r a4pp~~~~fiic~n
D~RRTMENT OF JUSTkC~PAGE 1 of 3
~~
A~piicant information
Last Name: First Name: Middle Name:
Physical Residence Address; City... State: Z4p Code:
Malting Acftire~s (i~ different): Ci#y. Stag: ~'ip Code:
Cate of Birth (mmldc iyyyy)~ Place of Birth {state ~r country): Sex. Phone No, include area code;
U.S. ~^ Yes If no, enter Alien Regist~ati~n Nca. r~r 1-94 too.: Country of Citizenship:Ci#izen?
(` Na
inter your California driver license (CL3L), Ifl Type. {check tanej: tt3 ~+lumbei: Handgun SafefyCalifornia ID {CID), or Military 113 {MILj number Cert~cate ~HSC) arrn the iD numt~er bax fo fhe rigtti. !fusing Firearm Safety Certif~c~temilitary identification you must send a copy of CDL ❑ CID ❑ MtLyour permanent duty sfatiatt orders stating y~au
{FSC} t~lo.;
are stafioned in California
Firearm Information - u to three firearms can be fisted on this a Iication. Fcr additional firearms, an additional aP PP — - — ~plication may be attached.
:Date of Manufacture; Make: (Pursuant #0 5474.2, the P~lake ~Vkodel: Ty~ae: Caliber:. Color.: j Barrel Length:Shall Be Your First and Last name}
From ~/Vlhorn Acquired {i# appticable}: Persona9~usiness Address:. City: ~tat~: Zip bode.
City, State, anc~ country of 1Nhere the Addi#ional tdent~cation ~1lark(s}: M~#erial~s):,Firearm was Manufactured:
Date of Manufacture: Make: (Pursuant to 54742, 4he Make Model. Type: {~aliber: Color: Barrel Length: jShall Be Your first and Last Name)
ii
From Whom Acquired (if applicable}: Pe~sonaUBusiness Address: City: State: Zip bode:i
City, State, and Country of ~Nhere the A~ dditional fdent~catian hllark(s): Material{s):Firearm was Manufactured: ~
$TATS OF CAttFpf~N1ABOF iW8 iRev.06t2417)
J Y~:~:L : r~"
Af
~~~~
CALIFC?foA11A E~~~d~F~TME~l' ~F JUSTICEsu~~~►u ~~ ~i~~~~an~~
New serial t~c~~b~r ~,ppli~~ vin
lf`nntin~ratl ~ieEaarm In#nrma#innl
4~N'g>17opig~:.
O¢~ :.♦r t.
M~
tk~
~e',xmK'-'.n.
Date of Manufacture: Make: {Pursuant to _5474.2, the Make Madel: Type: Gabber: Color: Barrel Length:~hafl Be Your First and Last t~4~me)
Froth Whom Acquired {if appfiicable): Personai/Business Address: City: State: Zip Code:
City, State, and Cc~ur~try of Where the Additionalldentifica~ion /lark{s): Material{s):Firearm was Nlanufac~ured:
---~dd6tional ir~fore~atiar~
C~r~ce your Serial ~1un~ber app4icafian has Iaeen processet~, ttze Deparirnent v,~i11 provide your new Department Serial Numbervia US mail.
l{pon receipt of your serial number, you may con#act a Fe~ierai Firearms Licensed f~fanufacturer type t37) to have yourI3epartment issued ser[a1 number applied in a manner consistent with Elie requirement outlined in the Cafifomia Code ~fiP.egulations, tide 11, section 5474,2. However, a Federal Firsarms Lic~ns~e is under no obligation to perform this work. Aperson who has tnanufacture~i #heir own. firearm may also use hart licensed parties to apply the serial number and o#herrequired markings, ~awevsr, the cswner of the weapon .must ~crt gave the firearm unattended with an unlicensed partybecause of firearm transfer andlor lending laws. ~'or assautt weapat~ regis#rations pursuant to Penal Code section 3t3900~bj,proof of the serial number being apptied to the firearm shall be liven to the Department in the form of one or more digi#a1photographs of the newly serialized firearm. Photos shall be subrnit#ed in accordance with the rsgtairements outlined in the.Gafifornia bode ref Regula#ions, title 91, section 5474,2. Please mai! #his applicati~an #o;
Califioia ~3epartment of Jus#ice.Bureau cif Firearms
Firearms Records. Licensing, aa~d Permit SectionP.O.. fox 7603fi7
Sacramen~~, ~R 95816mU367
Declaration
1 declare under penalty of perjury under the laws of fhe State of California fhaf fhe foregoing Is true anci correct
Signature Qate
~F~c~al Use UnIY
Date R~ceiv~ci: tni#ials: Date Processed: lnifiais.
Auth. L~r, Attached Initials: Serial No:
$TATEOFCALTFORN►f1 ~ °~ DEPAF2TA'fENTOF.1USTiCEBOF 7008 t~ev D62{ii7) ~~ ~ ~ 9 FAGE 3 of 3
CALI~t~RNtA, ~EPARTi~E~T OF ~dE~~TlCE,~~ ~t3RE~l1 ~F ~lFZEAFtNfS :~,~
k~~°` e~ry ~e~-i~i t~lur~ab~r Application
~~°~V~~~ Q'~IC~'
~1,~ Req~~reti by civil bode 'l798.~7
~aa(lectio~a ar~~ Use t~f P~rsor~~~ 1e~forrr~atiort: The Division ofi haw Enfiorcement, Bureau ~f firearms inthe Department of Justice collects. the information on this application pursuant to Penal Code sections23910 and 3090D(b)("!}and. Califr~mia Code of Regulations, title 'l1, section X474.2. The Bureau ofFirearms uses this .information to process and assign serial nurnber(s) t~ firearm(s) for. an applicant. Inaddition, any personal i~tfc~rmation collected by state agencies is subject to the limitations in theInformation Practices Act end state policy. The Department of Jus#ice's general privacy policy isavailable at http://oag.~a.g4vlprivacy-~oli~_
Pror~6dir~g Personal Informafieon: All ~ersonai infiormatic~n ~n this ap~licatior~ ~s m~ndat~ry. ~a[lure toprovide the mandatary personal information wi!! result in ~t~ur ~ppiication nc~t being ;processed.
,access to Your Information: You may review the rect~r~#s maintained by fhe Division of Law.Enfiorcement, Bureau of Firearms in the Depart~rrent cif Justice. that ct~ntain your personal in#ormation, aspermitted by the Infi~►rrnation Prac~ic~s ~1ct. See below for contact in#ormation.
°~ossi~le ~}isclt~sure t~f P~rsor~~1 ~r~f~rmata~r~a In t~rd~r to process and assign serial rrumber~s) tofirearms) for an applicant, we may need to share the informati~rt you provide us with any Bureau t~fFirearms representative ar any ~#het person designated by tote A~#orrt+ey General upt~n request. Theinforrr~ation you provide may also k~e ~iscl~sed in the fc~~fowing circumstances:
~ Wi#~ other persons or agencies when necessary to perform heir legal duties, and their use ofyour in#ormation fs compatible and ec~mpties with Mate }aw; such as fQr investigations,iic~nsir~g, certification, or regulatory .purposes;
■ ~~ ~nath~r government agency ~s required by state or #edera! law.
Ganta~t ~r~form~#ion: For questions about phis no#ice car access to your records, you may contact theStaff Services Analyst in the..~ustomer Supper# ~er~t~r at {93Ei) 2~7- 527, via ~rnail atfrearms.bureau~doj-ca-gc~v, or by mail ~t P.O. E3ax ~6i?~&7 Sacramento, GA 958'!6-fl3~7.
STATE DF CALIFORNUs ~% DEPARTMENT OF JUS7'fCE80F d546 (Rev.06124f]) ~h ~ PAGE ~ of4.
CA~IFt9Rl~lA DEPA~RTt~iENT OF JI~S'1~~ .a RLlREAt~ ~F ~I~t~,4f~iV~~ ~~.
~i~ ire cif ~I~ L.on~~r i~ ~' ss~~si r~ ~,(Pen.. Code § 280(i(J)
DOJ/Bd~ Case 1Vo__
Cheek appropriate box: ~ handgun/Long Gun ~ Assault 1NeapoN.50 BMG Rifle(complete sections ft;BA,E} tcomplete sections A,C,D,E)
,~.. ~uvner ~t~f~rmatian
last Name Frst 9~ame Middle Name Date of Birth
Residence Street Address City Sta#e Zip Code.
Mailing Address {if different) City. State Zip Cade
CA DL, 1D, or Military !I~ No. Telephone Rlumber is me owner deceased? Date ~f Death. County ofi ~}eath(" Yes ("' hlo
B. FfanctgunlLong Gun Vn#prorationDate Purchased/Acquired Serial f~lumber it Handgun: ar ~0~,9 gun.
(~ 5em-auto ~"`+ Revolver ~""' Singte Shot ~ Other ~ Rifle {"` Shafgun
Make Sas starr,aed on Firearm} Model (3032 Tamc~t, KP95,17C) Caliber : Fir+~at~n fl~igin (us, ~taty, Cf~ina) ~ ~arrei Length
- - - -~. Assault Weaponl 50 gN1G Rifle Information - vo~s,ntary canc~uation of registration (Cap. code Reg., fit. 11, §5373)AWR/_~0 BMG registration N~. Serial Number Maks {as stamped on Firearm) Model (e_g_, AK47, ~R~~, ~r~c g) Caliber
D. Disposition jsee cietaileci instructions ot~ reverse} -~ ~~
Seized by or surrendered to isw enforcement agency -law enforcement aye~cy name and signature required:
Law enforcement a~ent'y: Repot 1+#0.:
andlor agent or representative: Signature: Date.
~F2eparted to law enforcement as- Lost ~Stoten Repatt hlo.: Date:
QSotd/transferred to a licensed firearms leafier. C3ealer name: p~{~_
Maier address:
Q~otdlks~ansferred to a family member or privets P~~Y~ Tr~nsfer~e name: Transfer da#e_
Transferee address; Trans#wee t+~lephone:
firearms Ownership RecordlOperation of Law/infra fiamilial transfer submitted ~ dopy of compieied form or DLJJ acknowledgement letter atfached
0 Verified desfro ed: Verificafion (i.e_ insurance Maim)Y Destruction method. ~ afkached_ Des#rudion da#e:
~)~kkr longer resident 4f Califomia~ New stateJcourttry ~f residence: ~ date residency established_
~ {yopy of government issued identification attached from new stateitaour~try of residence
Transferred firearms to persoNdealsr in another sate: Transferee name: Transfer date:
Transfe[~e address: Transfe #elephane:
~, ilncurr~entation ofi saleltrar~sfer aitackeci Federal Fir~:arms License No. (if applicc~ble)_
Returned to dealer/manufac#urec Uealerlman~fachuer [game. Return date:
Dsalertmanuf$ctursr address: ~ mer►ta#ion #rom m~nufact~uer attached
~,. Declaration1 de~iar~ under penally of perjury under the laws of the elate of Galifamia the forgoing is true and correct
Signature. Date:
STATE DF CAttFORPIIA ~+ ~ ~ ~ DEFARTPdENT OFJUSTSCEBOF 4546 (Rev, D6CL017} ~"~ PAGE2Df.t
a►ic+e c~~ o ~~n~er ~r~ o~~~~sic~~~mpi~t~c~~ ~nstru~#ions
Type of firearm
Check the appropriate box. Use one #orm per firearm. For additional firearm(s), please use the included supplemental pageand make as many copies as necessary_
section ~4 -owner information
Enter the requested information. If you are submitting this form far a deceased person, check "yes," and (ist the date anccounty of death. To expedite processing of your request, please include a copy of the dea#h certificate with this form.
Seatioc~ ~ -Handgun/Lang Gun inf~acmation
Complete this section if you checl~ed the Handgun/Long Gun box. Do nat complete this section if you checked the AssaultWeapon/.50 BMG Rifle box and entered firearm information in Section C.
Section C -Assault VUeaponl.50 ~i~fG rifle Informs#ior~
Complete this section if the firearm is a registered Assault Weapa~/.5D SMG Rifle. Qo not complete this section if youchecked the Handgun/Long Gun box and entered firearm information in Section B. Completion of Section C will result n thecancellation ~f the registration of the Assault Weapor~1.50 BMG Rifle.
Section D - Disposition
Check the apprapria#e box ana compete the rewired information.• If you check "Seized by or surrendered to law en€orcement agency," an agent or represents#ive from the listed!aw enfo~ceme~t agency must verif}~ and enter-the requested information,. sign, end date this farm.. Attach a copy of apolice report or written confirmation .from the agency.
• #f you check "Reported #o law enforcer'nent" as "Lt~s#" or "Stolen," enter the nurs~ber and crate of the police repast andattach a copy of the report or wriftett cr~nft~natian #rQrn the agency.
• if you check "Sold/transferred to a Licensed firearms dealer:° Iis#the name and address of the licensed ~~lifornia firearms.dealer who conducted the sale ar trans#er, and the date of the sale or transfer.
• ifi you check "Sold/fransferr~d to a'family+ member ar private pa►-ty," fist the name, address and telephone number of theperson who purchased/obtained the firearm and the date of the sale 4r transfer. {fyC7T~: As of 01 /01/ 991, a sale artransfer must be completed through a licensed firearms dealer when nei#her party involved in the sale or transfer of a:firearm has a dealer's license issued pursuant #a Penal Cade section 26700.) The t~epartment of Justice (DOJ) will notprocess this form until and unless D~J re~ei+~es either a Dealer's Record of Sale (documenting a sale of a firearm through a.dealer}, a firearms Ownership Record, an t~peration ~f Lawllnfra-familial Transfer subrr~it#ed by the person who purchased)obtained the firearm (i.e transfers between immediate family members pursuant to Penal Code section 27870) or a DOJacknowledgement fetter to document the sale or transfer. (Pen. Gode, § 27 45)
• If you check "Verged destroyed," list the date artd method of destruction_ You must also attach written veri#ication of thedes#ruction (i.e. copy of an insurance claim for the. destroyed firearm or statement from gunsmith or manufacturer statingthat the firearm was not repairable and could not b~ made ~perablej.
• if you check "No longer a resident ~f California," list the date that you established residency in a state outside of ~alifomiaor country p~at~ide of th~ Uni#ed States. You must also attach a legible cc~~y raf y~aur gov~mmeniissued identification fromthe other state or countr~r.if you check "Transferred firearm out of stale," List the name and address of the person wht~ purchas~dlobtained thefirearm and the date of the sale car #ransf~r, and the name, address, telephone number end, if known, the Federal FirearmsLicense {AFL) number of the firearms dealer{sj who ~:anducted the sale/transfer. You gust atso at#ach any relevant.documentation of the sale or#ransfer, such a~ a sates receipt.
• ~f you check "Returned #o dealer`/manufacturer,"fist ttte name and address of the mant,~acturer. ~'ou must also attachclocumentatian showing #hat the dealerlmanufacturer received the firQarm from you and did not redeliver it to you.
E~ae~ ~ - CDeclarator~ _
You must read, sign end da#e the deciarafion.
PlOTE: 'the ~OJ may not be able to disassocia#e you from the 1is~e~1 firear€n(s) withou#adequate supportingdocumentation {i.e, police repot-ts, dearer transfer informafiion, details c~# tr~ns~er #o privy#e Party).
Mail completed notice of No Longer in Pos~e~sion and codes of any rec~uir~d documents to:Depar#rnent of JusticeBureau of firearmsP.t~. Box 82{32,OD
Sacrarr~ento, CA 9423-€320For questions, please visit the Bureau csf Firearms website of www.oa~c .ca.go~~rearms
STAlE OF CA~1F0}~NIA
B~F 4546 fRev fl6t2017j
Supplement Page.. _
~~~
LPW 1..1 ~'t.i dl E~6 ~l'4, ~~~Pi~~IViC~ 9 'V~ dV~7 d ~1~.~
~lJ6zE~iU ~F ~IFtEARiVfS
a►~e ~~ IVo 1~~nger ~n o~~~ss~~~
~~~~~~~~~~ ~~~~ DQJBOF -Case No_:
,DEFART'MENT OF JUSi7CEPAGE 3 at 4
N+va
Check appropriate box: ~ handgun/Long Gun ~ Assault Weapon/.50 BMG Rifle(complete sections A,B4O,E) (complete sections A,C,~,E?
A. ~O~nrner Information ~.~~
.Las# Name First Name Middle Name Date of Birth
Residence Strut Address. pity Sta#e Zip Code.
Mailing Address {if different) City State. Zip. bode
~A DL, ID, or Military 1D i~lo. Telephone [~lurrtbe~' Isiheownerdeceased? ~~te of Death County of I}eath} (` Yes {~`, ~,#o
~. HandgunlLong dun Information ~
Date Purchased/Acquired Seria3 Number ~~►~andyun_ ir~ang ~u~,_
('` Set~isuto ~'. Revolver ~` Single Shot (' Other ~ Rifle ~'' Shotgun
Make (as stamped on firearm) M~idE1(3t132 Tomcat, KP9b,17G) caliber Firearm Origin (us, itaty, China) Barrel Length
C. Assaultlt~eapon/.50 BIVfG Rifle lnforrtzation Voluntary ~a~cellation of registration (Cal. Code Reg., tit. 11, §5473)
AWR/.5Q B(ViG Registration No. Serial dumber Make (as stamped on~irearm> Model ~e_9_, AKa~, a~t~~, ~~c 9) Caliber
D. Disposition (see cietai~ed insfructions on reverse)Q Seized by or surrendered to law enforcement agency -law enforcement agency r~arne end sig[~atuce required.
Law enforcement agency:. Re~rt No.
and/or agent or representative. Sagnatt~re: date:
QReported to law enforcement as. QLost QStolen }~e~Sort No__ Date:
Sold/trans(erred #o ~ licensed firearms dea[ec i)eater name. Date.
Dealer address.
~So1d/transferred to a family member or private party. Transferee names Transferdate:
Transferee address_ Transferee telsphotie:
[J Frearms Ownership Record/Operation of LawAntra familial tr~nsFer sabmitteci ~ Copy ofi comple#~d form os ~7flJ ackncwvledgement letter attached
Verificgtion (i.e_ ir~suranc~ claim}QVerified destroyed: D~estructian method: D attached I3estructicin date:
tdo longer resident of California: Nevr statelctwcrtr~+ of residence: t7ate residency establ~hed:
SPY of c~ovemmeni issued identification attached from new skatetcr~untry of residence
~Transfemed firearms to personfdealer in another state: Transferee name: 'transfer date.
TransFeree address. Trar►sferee telephor~e.
L)oct~mer ta~tican of sale/trans#er atkached Q federal Firearms license No_ j'rf applicable}.
~Retur[~ed #o dealerlmanufacturer Deaterlmenufacturernatrre: R$turn date:
[}eal~r/manufachirer address. [~ Dacumerrtaf'wn from manttfac#urer attached
E. declaration
1 declare under penalty of perjury under the laves ~f :the. State of California t~►e forgoing is #sue and corr+~ct.
Signature. Qate:
STATE. OF CALIFORNIA IPSs~~°~" - DFPARTMEIVTOFJUSTtCE
BOF A546 (ftev_ O6R017) B~ S PAGE a of 4
~LiFU~C~iA D~P~E~T~lENT 4~F JL~S"i'ICEBtJREAI~ OF F6~E~l~l1~S Ems'"r~, .~~.
Ida ire cif tV~ L~n~+~r in ~~►ss~~s~or~ a~'~..~
r~~~ ~G
As Requ[red #~y ~iv,~ Code. ~ 1798.'1 7
~cal9ectior~ and #3se of Personal lrtf~cmati+an. The ~3ivision cif Law enforcement, Bureau of Firearms inthe Department of Justice c~11~c#s'the information o~ this nc►tics pursuant fio Penal Code section 2$~D(~.The Bureau of Firearms uses this information #c~ record a na#ice that a person. is no longer in possessic~r~of a firearm. in ad~iitic~n, any personal infQrm~tic~n collected by state. agencies is subject to the limitationsin the information Practices Act and state policy. T ae ae~ar#ment of Justice's genera( privacy pfllicy isavaiiabfe at http_llt~ag_ca.c~~vlprivaay-pc~lic~.
P~ovidis~g Personal nforma~~ian: All persc►nal nformatifln on #leis notice is mandatory, failure ~oprovide the mandatory personal information will r~sutt in your notice nod being processed.
Access to Your lnform~ti~r~: You may r~vie~ty the records maintained by the Division of LawEnfiorcement, bureau +~f Firearms in ~e Dep~rt~nent of J~stic~ ghat contain your.personal inforrnatic~n, aspermitted by the In#armation Prat#ices Act. fee below for contact information.
P~~~ible Di~clo~ure cif Personal nfc~ tn~t€a~. in order to rect~rd a notice tha# ~ person is no loner irepossession of a firearm, we may need t~ share the infiormatifln yc~u provide us with any Bureau. ofFirearms r+eprese~tative or any ~tt~tter person designat~~i by the Attorney General upon request. Thyinformation ~o~ provide rr~ay also be dise~osed in the follt~wir~g circumstances:
~ With other persons flr agencies vrh~ necessary to ~rfc~rm their legal duties, and their use ofinforms#icon is compatible and cc►mpiies with state I~aw, such as #or investiga~ic~ns, licensing,certification, or reg~4~tary purposes;
■ "~o anath~r ~overnm`ent agency as ~egired by state. or fe~~ral law,
Cmntact lr~fs~rrna#ion: For ~uestic~ns about ~~is notice +ar access to your records, yc~u nay contact theStaff Services Rraaly~t in the Customer Sup~aor~ ~e~ter at X91 ~) 227-~5~7, via err~a~l at~ir~arms.bureauCc7dc j.~a.g~v, ~r by mail at P.~'3. Box 8202~fl, Sacramento, ~A 94203-0200.
STATE OF CAttFORNIABOF 4542A {Rsv_ 062D1?)
~':~:e
~,~'~
~/"'~~~~iJ F''l~~►'9 ~~i'"~~~Alll~~ 9 ~~ ~tJ ~7~~~~
~l1F~E~4IJ ~F F9R~ARTviS
i~-~arm ~~nership ~pt~rtCalifornia Penal Code section 28000
A pt~caessing fee of $19,00 musf accompany this ~pplica#ion.llnstructior~s on Dane 2)
•a'~' •
~t~g RT7gqy
Fr.
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~:.~, .°Fnd:
A. Avuner Information
Last Name: first Name: Middle Name.
Alias Last Name (if any). Atlas First. Name: Alias Middle Name:
~2esidence Stree# Address: City Stale: dip Code:
Mailing Address ~~f different): City: ~tafe_ lap Code:
mate of Birth (mm/c~dlyyyy): Place of Birfh {stag or coun#syj: Sex: Phone Na_ include area code)
~:S ~' Yes If no, enter Alien.Registration No. car ~-94 Nca.; Country of Citizenship.
~tQen? t ' No
Enter your Cakfomra drivetlicense {CDL), California 1L1 Its Type (check onej_ !t} Number_ ryandgun Safety Certificaie(CID), ar Iv,'ilitary ID (fv11LJ nvmberin the 1D number box to
(HSC) or Firearm Safetythe nghf_ ~f using military ~dentifica€ion you must send a
Certificate (FSC} No..copy of your permanent duty station orders staffing you CDL [~ Ctd ~I [Vileare stationed in Calftomia.
~. Fireae~rn(s) lnfor►nation i"To report additional rirearm(s) copy and aiiach additional applications)---- --- -------
Firearm Type. Category: select from fist an page 2) 5enal Number.
{~ Handgun (`': Rifile ~` Shotgun
AAake_ Model: Caliber Firearm ~?rigir~: ~arr~( Lengfh: ~'' IN_
j~' C11+1-
Cofor gate Arquireci {mmlddlyyyy}: Acciuiresi From_ (' Firearms healer {"` family Member ~sFecitY ~zetationsr~ip?:
(^' Private ParEy {"" Gun Show.. ~" Other:
Firearm Type: Category: (select #rom list on page 2) Serial Number
('~ Handgun ~' Rule t" Shotgun
Make ~ Modems I ~~Caliber Frearm O~igm_ Barrel Length_ (~ ~N_
_— _~— ~ ~ ~' CM.
Color Date Acquired {mm/dd/yyyy) Acquired From. (` ~q~eanns Dealer '~ Family Member ~Specity ~teiationsnip} _ __
E {`~ Pnv~te Par#y ~~ Gun Shaw C~ Othr~_
Frearm 3ype_ Ca#egory. (select from lisi an page 2) Serial Number,
~ Handgun ~ Rifle ~' Shotgun
Make,: Model: Catibec Freann Origin: Barrel Length: ~" l~I.
(~"~ GM.
Color. I}ate Acquired {mmlddtyyyy): Acquired F m: ~"` Fresrms Dealer ~'~"; family Member ~speciry Relationship):
("; t'ri~ate Pariy (":Gun Shouv t'~' Other:
~eciaratiorr;dare under- penalty of perjury under fhe Jaws of fhe State of California That the foregoing is L'[te and carreci. 1 expressly authorize tfie Depatinaent of~rce #c~ perform firearms eligibility checks of ail relevant stag anc! federa/ databases, including the Federal Bureau of tnyesfigatian`s Nafionat Instant
ninal Background Check System. !also understand that if l currently possess or own firearms and the resut~s of this check reveal that t am ineligiblerer to7a~vf[r/fy possess ~r purshese firearms, I must reli~tquish any artd aU firearms in my possession.
Sigraaturs Date
$TATS DF CALIFORNIA 4 ~EPAftTMEMT~F:,1llSTiCEB4F4542~.iRev a5t2U173 ~` PA6E2of3
Firearm OwnershiQ Report S~bmEssinn Re_,#c uirementsPursuant to Penal Code section 28230, subdivis[c~n ~a)(3), you must submit this application along vaith a $'t9.D0 processingfee (check or money order made payable to the Departmenf of Justice) to;
Deparatrnent of Justice$ureau of Firearms ~ JeOR
P.O. f ox 820200Sacratnenta, C~4 94203-02U~
~'Iease note, incomple#e applica#'runs or applications submitted without the proper fees wilt be rearmed without processing. Ifreporting more than three firearms, attach additional copies of this form as needed. A firearms eligibility check will beconducted to determine whether you are lav,+fuily eligible to possess firearms. Once apprc►ved, yota will receive a confirmationnotice of your ~irearrns t~wnership R~por[.
This form may nat be used fo report ownership of assault weapons definer! in Penal Code.s~ctions 3{~5~{} through ~(3~30. liis the responsibility ofi the applicant to determine if the ([rearm -being reported is an assault weap+an. A list c~fi assautt weaponsis available on the Bureau of Firearms website at www.oag.c~:~ov/firearms.
Part ,4. Owner informationinter the information as requested_ Only one appticar~t perform, ~f you are using a military dumber far identification, Yot~ must.submit a copy of your permanent duty station orders indicating you are stationed in Califflrnia.
Part B. Firearm ]nformafionFor each firearm, you must provide the ident cation info~mafion requested. i'lease refer tc~ your frearm owner's mama(, the.firearms manufacturer's wet~site, or the examples below to assist you in providing the required in#ortnatton:
■ Firearm. Type: Handgun, Rifle, car Shotgun
: Ca#egory: Bolt Action, Lever Action, Pump Action, Revolter, Semi-Automatic, fir Single Shat
■ Serial Number l~sual(y located on the frame caf a handgun, r~r ~e receiver of a long gun. Maybe all numericgar a combination of alpha and numeric characters.;(~.g., ~876~,'US54321G)
■ Make 'the manufacturer of ti~~ firQarrt~. (e.g., Remington, Vt(inches#er, Gloc#~, ~rr~ith ~& Vllesso~)
■ Model The rnodei name ofi the firearm.. ~e-9., 870 Express, Mode( 70, ~17C, 29-'Ifl)
■ Caliber The caliber of the firearm. {e,g., ~ 2 gauge, .3fl8 ~Ninches#er, ~ m, .44 Magnum)
a Firearm f3rigin The country cif t~rigin ~#the fireai~r~_ {e.g., United S#ales, Russia, China, italy~
■ Barrel Length Etter the #carrel length as stated either in your owner's manu~i, manufacturer's website, ormeasure the ~Sarrel length by clos'sng the action of the firearm and inserting a wooden da~rreldown the k~acrel until it steps. N'fark the doweFw'~#t► a pen at the muzzle. Remove-the dowelantl measure the distance laetween the inserted end of the d€~vre1 anc! the den mark.
Part C C?sclara~innYou must"sign and date the declaration on #his application_
~r~r~ o~ cnu~oarai~a ~ ~ S
~EnrraE~ ; aF ~t,s~ ~~ESCE 45dZA (£tev. OC~2077} PACE 3 of 3
.~..*- rte:, c~~~F~~~r~ ~E~~~Tr~~r~T c~~ ~~~-ricE
,~, ;:~ ~.t~`~~ ~ir~~r t~wnership .ept~:r~ ~~ ~.,
r~v~~~ ~V~►~i~~s R~c~uired by Civil ~~~le ~ '178."17
Cctllec#ion and Use of ~*ersonai Inforrx~ation. The Divis~fln Qf ~~~~ ~€~fiorcer~rent ire ih~ Departrr~e~t e~fJustice collects the information requested on this form as auth~rizeci by Penal Grade section 2~~~0. Tiedivision ofi Law Enforcement uses this informatirn to establish firearm ownership_ In addition, anypersona! information calle~~ecf by state agencies is subject to the limitations in the Information Practi~e~Act and state policy. The Dep~rtrn~n3 afi Justice's general privacy ~o(icy is available atttp:floac~ ca_ o~lprivacy-policy.
Providing Persc~na~ Infarmat can. AID tl~e pe►-sanal inform Lion requested i the f+~rm ~a~t tie provided.if you fail to provide an~r of the required persorta~ information, the unprocessed report ~r~i1 fie r~t~rnet~ toy~~a #or compEetion artc~ r~s~ebrniss~~.
cces~ to Your 1n#orm~tion. Yo►~ may reviev~ tie records mainta[ned by the ~~aisic~ cif LawEnforcement in the Department of Justice tha# contain your personal i ft~r ~tit~ r, ~s perrnitt~d by theIn#c~~mation Practices Act_ See below for contact information_
Pass bl~ Disclosure ~fi Pe~rsor~a4 )~farmatio~. Ire order #~ ensure y~ are nc~t prohibited ~r~cf establishfirearm ownership, w may n~e~! to share the ~r~fc~r atic~n you give gas with erg#iti~s ~s ~uthori~ed ire Per~~l
Code section 11:1(35. Tt~e inf~rrnatiar~ you pr~avicle may also be d~scfc~se+~ ire tt~e follc~v~~n~ ~ircumsta ces:
Vtlith other persons ~r ~ge~cies when necessary eta perForm their let~~l duties, ~r~cf tl~e~r tas~ ofi}roar infarm~tian is compatible and. cQmpli~s with state law, such as fir inv~s#igafiic~ns or forEicensiri~, certific~tian, t~t~ regufatflryr pur~ose~;'
T€~ ~nc~~er goverr~m~r~t agency as required by ~~ate t~~ f~d~r~l l~ww
~c~nt~Ct tr~fo~~n~tiar~. Far questions boat this notice or access tc~ your rect~rds, you may cc~nta~t the
staff services Analys# ire ~h~ Customer Sup~c~~t Center ~t ~~9 6} 227-7 27; via ~rnail atfirearms.#~~rea~dcr~.ca.q ov or by rnaiE at ~.Q. Bc~~ 8~~32~0, ~~a~rarner~t~, ~/~ ~42C}3-C~~~C}_
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