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Ny State Police Amendment Form 2014
CHANGE
TRANSFER
DUPLICATE
SURRENDERED
REVOKED
DECEASED
OTHER
LOST/STOLEN FIREARM
AMEND LICENSE FOR THE FOLLOWING
1.
NEW NAME
2.
NEW ADDRESS
3.
FOLLOWING WEAPON(S) AQUIRED FROM: (NAME, ADDRESS)
MAKE
4.
MODEL
CALIBER
SERIAL NUMBER
MODEL
CALIBER
SERIAL NUMBER
CALIBER
SERIAL NUMBER
FOLLOWING WEAPON(S) DISPOSED TO: (NAME, ADDRESS)
MAKE
5.
REVOLVER OR
AUTOMATIC
FOLLOWING WEAPON(S) HAS BEEN:
REVOLVER OR
AUTOMATIC
LOST
STOLEN
DESTROYED
LAW ENFORCEMENT AGENCY REPORTED...
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