Fillable Printable Pistol Transfer Application
Fillable Printable Pistol Transfer Application
Pistol Transfer Application
2.Send within 7 days after delivery of the firearm to:
Department of Licensing, Firearms Section, PO Box 9649, Olympia,WA 98507-9649
3. Retain a copy for your records for 6 years.
(choose one)
X
X
Pistol Transfer Application
Dealer: Make sure this form is completed in full and is clearly legible.
1. Send by the close of the business day to the appropriate Chief of Police or Sheriff.
Section A – Firearm description – Type all information
Pistol serial number MakeOther (no abbreviations)
Caliber Barrel length (in.) Type Model number or name Condition Application initiated (date and time)
New Used a.m. p.m.
Section B – Buyer information
Buyer name (Last, First, Middle, Suffix) Gender U.S. citizen
Male Female Yes No
Home address (Number, Street, Apartment number)
City State ZIP code County
Date of birth Place of birth (City, State or Province, and Country) Height (ft, in) Weight (lbs) Eye color
Race (choose all that apply)
American Indian/Alaska Native Asian Black Native Hawaiian/Pacific Islander White
Permanent resident card number Washington State alien firearms licenseOccupation
Number Expires
Answer the following
I have been a resident of Washington at the address above for the previous consecutive 90 days.................
Yes No
If "no", provide previous address(es):
Concealed pistol license number Expiration date Issuing authority
Driver license or state ID card number State (Area code) Telephone number
Caution:Although state and local laws do not differ, federal law and state law on the possession of firearms differ.If you are
prohibited by federal law from possessing a firearm, you may be prosecuted in federal court. State permission to purchase a
firearm is not a defense to a federal prosecution.
Buyer: Read the following statement carefully
I certify I am eligible to possess a pistol under RCW 9.41.040 and 9.41.045. I understand by signing this application I am waiving
confidentiality and requesting the Department of Social and Health Services, mental health institutions, and other health care
facilities, to release information relevant to my eligibility to purchase a pistol to a court or law enforcement agency. I certify under
penalty of perjury under the laws of the state of Washington
that the statements and other information set forth in this application
are true and
correct. RCW 9A.72.040
Buyer signature (Full legal name)
Section C – Dealer information
Date weapon was deliveredUBI number Business ID Location ID Stamp area
Federal firearms license number
Dealer / Store name
Address (Number, Street, City, State, ZIP code)
(Area code) Dealer telephone number Email
Dealer signature
FIR-652-001 (R/5/17)WA
Private transfer
Approval code
Dealer transaction #
Appropriate LEA
City County
Click here to START or CLEAR, then hit the TAB button
Form has changed - mark private transfer checkbox at right if private transfer.
Choose one:
Choose one:
PistolRevolver
Choose one:
Buyer - Print the completed form and sign your full legal name here
Dealer - Print the completed form and sign here.
