For the attention of The Chief Constable.

Dear Sir / Madam

I am sending this in accordance with the requirement of the Firearms Act to notify you of the sale or transfer of the firearm(s) shown below. I would be grateful if you could pass the details on to your Firearms Licensing Department. Thank You.


Full Name: ________________________________________________________________________

Address: __________________________________________________________________________

Certificate No: ____________________________________ Date: ____________________________

Complete as appropriate

(a) ACQUISITION OF A FIREARM (b) SALE/DISPOSAL OF A FIREARM
Type: _______________________________________
(bolt action, under lever, semi-automatic etc)

Calibre: ______________________________________

Make: _______________________________________

Serial No: ____________________________________
________________________________________

Name: _______________________________________

Address: _____________________________________

________________________________________

________________________________________ Certificate No: _______________________________
who has completed Table 1 of my certificate.

Signed: ______________________________________

Type: ________________________________________
(bolt action, under lever, semi-automatic etc)

Calibre: _______________________________________

Make: ________________________________________

Serial No: ______________________________________
________________________________________

Name: ________________________________________

Address: ______________________________________

________________________________________

________________________________________
Certificate No: _________________________________
I have completed Table 1 of their certificate.

Signed: _______________________________________