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CALIFORNIA DEPARTMENT OF JUSTICE BUREAU OF FIREARMS

             
       

NOTICE OF NO LONGER IN POSSESSION

       
                 

(Penal Code sec. 12078 subd. (l).)

                 
     

See reverse side for instructions.

       

DOJ/BOF Case No.:

     
                   

Please Type or Print

 

(If applicable)

           

Check appropriate box:

   

AssaultAssaultAssaultAssaultAssault Weapon/.50Weapon/.50Weapon/.50Weapon/.50Weapon/.50 BMGBMGBMGBMGBMG RifleRifleRifleRifleRifle Complete Sections A,C,D,E

 
   

(Check one)

     

Handgun/LongHandgun/LongHandgun/LongHandgun/LongHandgun/Long GunGunGunGunGun Complete Sections A,B,D,E

       

A.

OWNER INFORMATION

                                         

LAST NAME

         

FIRST NAME

               

MIDDLE NAME

   

DATE OF BIRTH

 

RESIDENCE STREETADDRESS

CITY

STATE

ZIP

Mo

Day

Yr

MAILING ADDRESS (If Different)

             

CITY

         

STATE

ZIP

       

CA DL, ID or Military ID#

       

DAYTIME PHONE #

     

Date of Death

County of Death

   

(

)

Is the owner Deceased?

No

Yes

Mo.

Day

Yr.

B.

HANDGUN/LONG GUN INFORMATION

                           

DATE PURCHASED/ACQUIRED

Mo

Day

Yr

SERIAL NUMBER

If Long Gun:

Rifle

MAKE (As stamped on firearm)

MODEL (3032 Tomcat, KP95, 17C, etc.)

CALIBER

Shotgun

If Handgun:

Semiauto

Revolver

FIREARM ORIGIN (U.S., Italy, China, etc.)

Single Shot

Other

BARREL LENGTH

IN.

CM.

MM.

C.

ASSAULT WEAPON/.50 BMG RIFLE INFORMATION - Voluntary cancellation of registration pursuant to 11 CCR 5473.

 

AWR /.50 BMG Registration #

SERIAL NUMBER

MAKE (As stamped on firearm)

MODEL (AK47, AR15, TEC 9, etc.)

CALIBER

D.

DISPOSITION

(See detailed instructions for completing this section on reverse.)

             

Seized by or surrendered to Law Enforcement Agency (LEA) - LEA name and Signature Required:

               

LEA:

Report #:

Date:

 

And/or “Agent” or Representative:

Signature:

         

Date:

                                                       

Reported to LEA as

Lost or

Stolen

       

Report #:

Date:

Sold/Transferred to a licensed firearms dealer:

                                     
   

Name of dealer:

 

Date:

   

Dealer address:

             

Sold/Transferred to a family member or private party:

                                 
   

Name of transferee:

Date of transfer:

   

Address/Phone of transferee:

             
   

Firearms Ownership Record/Operation of Law/Intrafamilial Transfer submitted.

 

Verified Destroyed:

 

Description of destruction method:

Copy of completed form or DOJ acknowledgement letter attached.

Date of destruction:

   

Verification (i.e. insurance claim) attached.

                   
                             

Date residency

No Longer Resident of California:

Name of new state/country of residence:

established:

   

Copy of government-issued identification attached. (from new state/country of residence)

               

Transferred firearms to person/dealer in another state:

                                 

Name of transferee:

Date of transfer:

   

Address of transferee:

             
   

Documentation of sale/transfer attached.

FFL # (if applicable):

Returned to dealer/manufacturer:

                                         
 

Name of dealer/manufacturer:

Date of return:

   

Address of dealer/manufacturer:

         
   

Documentation from manufacturer attached.

                                   

E.

DECLARATION

                                             

I hereby certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct, and that I no longer own or possess the firearm described above.

   

SIGNATURE

                               

DATE

       

BOF 4546 (Rev.02/09)

Instructions for Completing NOTICE OF NO LONGER IN POSSESSION FORM

List Additional Firearms on NLIP Supplemental Page(s) and Attach All Page(s) to this Form

TYPE OF FIREARM

Check the appropriate box(es).

Use one form per firearm. For additional firearm(s), use Supplement form.

SECTION A. OWNER INFORMATION

Enter the requested information. If you are submitting this form for a deceased person, circle “Yes”, state the “date and county of death”. To expedite processing of your request, include a copy of the Death Certificate with this form.

SECTION B. HANDGUN/LONG GUN INFORMATION

Complete this section if you checked the Handgun/Long Gun box. Do not complete this section if you checked the Assault Weapon/.50 BMG Rifle box and entered firearm information in SECTION C.

SECTION C. ASSAULT WEAPON/.50 BMG RIFLE INFORMATION

Complete this section if the firearm is a registered Assault Weapon/.50 BMG Rifle. Do not complete this section if you checked the Handgun/Long Gun box and entered firearm information in SECTION B. Completion of SECTION C will result in the cancellation of the registration of the Assault Weapon/.50 BMG Rifle.

SECTION D. DISPOSITION

Check the appropriate box and complete the required information. Enter the date of disposition.

• If you checked the Seized by or Surrendered to Law Enforcement Agency box, an agent or representative from the law enforcement

agency must verify and enter the requested information and sign this form.

Attach a copy of a police report or written confirmation from

the agency.

If you checked the Reported to LEA as Lost or Stolen boxes, enter the number and date of the police report and attach a copy of the report or written confirmation from the agency.

• If you checked the Sold/Transferred to a Licensed Firearms Dealer box, list the name and address of the licensed California

firearms dealer who conducted the sale or transfer, and the date of the sale or transfer.

If you checked the Sold/Transferred to a Family Member or Private Party box, list the name and address of the person who purchased/obtained the firearm and the date of the sale or transfer. DOJ will not process this form until and unless DOJ receives either a Dealer’s Record of Sale (documenting a sale or the firearm to a dealer), a Firearms Ownership Record, an Operation of Law/ Intrafamilial Transfer submitted by the person who purchased/obtained the firearm (i.e. transfers between immediate family members pursuant to Penal Code section 12078, subd. (c)(1)), or a DOJ acknowledgement letter to document the sale or transfer. (NOTE: As of 01/01/1991, a sale or transfer must be completed through a licensed firearms dealer when neither party involved in the sale or transfer of a firearm has a dealer’s license issued pursuant to Penal Code (PC) Section 12071.) (PC Section 12072(d).)

If you checked the Verified Destroyed box, list the date and method of destruction. You must also attach written verification of the destruction (i.e. copy of an insurance claim for the destroyed firearm, or statement from gunsmith or manufacturer stating that the firearm was not repairable and could not be made operable).

If you checked the No Longer a Resident of California box, list the date that you established residency in a state outside of California, or country outside of the United States. You must also attach a legible copy of your government-issued identification from the other state or country.

• If you checked the Transferred Firearm Out of State box, list the name and address of the person who purchased/

obtained the firearm and the date of the sale or transfer, and the name, address, telephone number and, if known, the FFL# of the firrearms dealer(s) who conducted the sale/transfer. You must also attach any relevant documentation of the sale or transfer, such as a sales receipt.

• If you checked the Returned to Dealer/Manufacturer box, list the name, address, and telephone number of the manufacturer. You

must also attach documentation showing that the dealer/manufacturer received the firearm from you and did not redeliver it to you.

SECTION E. DECLARATION

You must read, sign and date the declaration.

NOTE: The Department of Justice may not be able to disassociate you from the listed firearm(s) without adequate supporting documentation (i.e., police reports, dealer transfer information, details of transfer to private party).

MAIL COMPLETED NOTICE OF NO LONGER IN POSSESSION AND COPIES OF ANY REQUIRED DOCUMENTS TO:

Department of Justice Bureau of Firearms P.O. Box 820200 Sacramento, CA 94203-0200 For Questions: www.ag.ca.gov/firearms

BOF 4546 (Rev.02/09)

               

CALIFORNIA DEPARTMENT OF JUSTICE BUREAU OF FIREARMS

                 
               

NLIP Supplemental Page

                 
                 

(Penal Code sec. 12078 subd. (l).)

                   
                 

DOJ/BOF Case No.:

       

Check appropriate box:

   

Please Type or Print

 

(If applicable)

             
     

Handgun/LongHandgun/LongHandgun/LongHandgun/LongHandgun/Long GunGunGunGunGun Complete Sections A,B,D,E

       

AssaultAssaultAssaultAssaultAssault Weapon/.50Weapon/.50Weapon/.50Weapon/.50Weapon/.50 BMGBMGBMGBMGBMG RifleRifleRifleRifleRifle Complete Sections A,C,D,E

   

A.

OWNER INFORMATION

                                       

LAST NAME

           

FIRST NAME

             

MIDDLE NAME

               
 

B.

HANDGUN/LONG GUN INFORMATION

                                 

DATE PURCHASED/ACQUIRED

 

SERIAL NUMBER

     

If Long Gun:

 

If Handgun:

               

Mo

Day

 

Yr

 

Rifle

Shotgun

 

Semiauto

Revolver

 

Single Shot

Other

       

MAKE (As stamped on firearm)

 

MODEL (3032 Tomcat, KP95, 17C, etc.)

 

CALIBER

FIREARM ORIGIN (U.S., Italy, China, etc.)

BARREL LENGTH

   

IN.

CM.

MM.

C.

ASSAULT WEAPON/.50 BMG RIFLE INFORMATION - Voluntary cancellation of registration pursuant to 11 CCR 5473.

AWR /.50 BMG Registration #

SERIAL NUMBER

MAKE (As stamped on firearm)

 

MODEL (AK47, AR15, TEC 9, etc.)

 

CALIBER

   

D.

DISPOSITION

                                           

Seized by or surrendered to Law Enforcement Agency (LEA) - LEA name and Signature Required:

                 

LEA:

Report #:

 

Date:

And/or “Agent” or Representative:

Signature:

           

Date:

                                                   

Reported to LEA as

Lost or

Stolen

 

Report #:

Date:

Sold/Transferred to a licensed firearms dealer:

                                 
 

Name of dealer:

 

Date:

 

Dealer address:

                 

Sold/Transferred to a family member or private party:

                                 
 

Name of transferee:

Date of transfer:

 

Address/Phone of transferee:

                 
 

Firearms Ownership Record/Operation of Law/Intrafamilial Transfer submitted.

   

Verified Destroyed:

Description of destruction method:

Copy of completed form or DOJ acknowledgement letter attached.

Date of destruction:

 

Verification (i.e. insurance claim) attached.

                                 
                         

Date residency

No Longer Resident of California:

Name of new state/country of residence:

established:

 
 

Copy of government-issued identification attached. (from new state/country of residence)

                   

Transferred firearms to person/dealer in another state:

                       

Name of transferee:

Date of transfer:

 

Address of transferee:

       
 

Documentation of sale/transfer attached.

FFL # (if applicable):

Returned to dealer/manufacturer:

     
 

Name of dealer/manufacturer:

 
 

Address of dealer/manufacturer:

Date of return:

         
 

Documentation from manufacturer attached.

                                 

E.

DECLARATION

                                           

I hereby certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct, and that I no longer own or possess the firearm described above.

   

SIGNATURE

                           

DATE