NFA Responsible Person Questionnaire (5320.23) accelerated for Utah

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1. ATF Form Being Submitted
2. Gun Trust or Transferee (Individual)The person acquiring the firearm. (as shown on the ATF Form 1, 4 or 5) Enter the name, trade name (if any) and address of the trust or legal entity identified on the Form 1 (Items 3a and b); Form 4 (Item 2a); or Form 5 (Item 2a)
3.a. Responsible PersonIn the case of a legal entity, including any trust, partnership, association, company (to include any Limited Liability Company (LLC)), corporation, or Licensed Entity that does not pay the Special (Occupational) Tax, any individual who possesses, directly or indirectly, the power or authority to direct the management and policies of the trust or entity to receive, possess, ship, transport, deliver, transfer or otherwise dispose of a firearm for, or on behalf of, the trust or legal entity.
3.b. Telephone - Requried (Area code and number)
3.c. E-mail address (Optional)
3.d. Other Names Used (Including alias and maiden name)
3.f. Social Security Number or UPIN (Optional, but enter if you have had delays in the past) The SSN and UPIN are not required. However, this information assists with the efficient completion of the National Instant Criminal Background Check System (NICS) background check. Please be aware that refusal to provide this information may result in a delay in the NICS background check process.
3.g. Date of Birth
3.h. Ethnicity
3.i. Race
4.a. Type of Firearm(1) a shotgun having a barrel or barrels of less than 18 inches in length; (2) a weapon made from a shotgun if such weapon as modified has an overall length of less than 26 inches or a barrel or barrels of less than 18 inches in length; (3) a rifle having a barrel or barrels of less than 16 inches in length; (4) a weapon made from a rifle if such weapon as modified has an overall length of less than 26 inches or a barrel or barrels of less than 16 inches in length; (5) any other weapon (entire citation) in 26 United States Code (U.S.C.) section § 5845(e); (6) a machinegun; (7) any silencer (as defined in 18 U.S.C. § 921), and (8) a destructive device). (As identified in Item 4b of Form 1, 4, or 5)
4.b. MakerThe person (applicant) applying to make and register the firearm., Manufacturer and/or Importer of Firearm (As identified in Item 4a of Form 1, 4 or 5)
4.c. Firearm Model (As identified in Item 4d of Form 1, 4 or 5)
4.d. Caliber or Gauge (As Identified in Item 4c of Form 1, 4 or 5)
4.e. Firearm Serial Number (As identified in Item 4g of Form 1, 4 or 5)
5. Law Enforcement NotificationEach responsible person must provide a notification on this form about the proposed making or acquisition of an NFA firearm to his/her Chief Law Enforcement Officer having jurisdiction where the responsible person is located. The Chief Law Enforcement Officer is considered to be the Chief of Police; the Sheriff; the Head of the State Police; or a State or local district attorney or prosecutor.
6. Prohibiting Questions (Prefilled No, but able to be changed. Answer honestly)
6.a. Do you intend to make any firearm listed on this form for sale for other disposition to any person described in questions 6.b through 6.l, or a person described in question 6.m who does not fall under an exception?
6.b. Do you intend to sell or otherwise dispose of any firearm listed on this form in furtherance of any felony or other offense punishable by imprisonment for a term of more than one year?
6.c. Are you under indictment or information in any court for a felony, or any other crime, for which the judge could imprison you for more than one year?
6.d. Have you ever been convicted in any court for a felony, or any other crime, for which the judge could have imprisoned you for more than one year, even if you received a shorter sentence including probation?
6.e. Are you a fugitive from justice?Any person who has fled from any State to avoid prosecution for a felony or a misdemeanor, or any person who leaves the State to avoid giving testimony in any criminal proceeding. The term also includes any person who knows that misdemeanor or felony charges are pending against them and who leaves the State of prosecution.
6.f. Are you an unlawful user of, or addicted to, marijuana or any depressant, stimulant, narcotic drug, or any other controlled substance?Warning: The use or possession of marijuana remains unlawful under Federal law regardless of whether it has been legalized or decriminalized for medicinal or recreational purposes in the state where you reside.
6.g. Have you ever been adjudicated as a mental defectiveA determination by a court, board, commission, or other lawful authority that a person, as a result of marked subnormal intelligence, or mental illness, incompetency, condition, or disease: (1) is a danger to himself or to others; or (2) lacks the mental capacity to contract or manage his own affairs. This term shall include (1) a finding of insanity by a court in a criminal case, and (2) those persons found incompetent to stand trial or found not guilty by reason of lack of mental responsibility. OR have you ever been committed to a mental institutionA formal commitment of a person to a mental institution by a court, board, commission, or other lawful authority. The term includes a commitment to a mental institution involuntarily. The term includes commitment for mental defectiveness or mental illness. It includes commitments for other reasons, such as for drug use. The term does not include a person in a mental institution for observation or a voluntary admission to a mental institution. EXCEPTION: NICS Improvement Amendments Act of 2007: A person who has been adjudicated as a mental defective or committed to a mental institution in a state proceeding is not prohibited by the adjudication or commitment if the person has been granted relief by the adjudicating /committing state pursuant to a qualifying mental health relief from disabilities program. Also, a person who has been adjudicated as a mental defective or committed to a mental institution by a department or agency of the Federal Government is not prohibited by the adjudication or commitment if either: (a) the person’s adjudication or commit ment was set-aside or expunged by the adjudicating/committing agency; (b) the person has been fully released or discharged from all mandatory treatment, supervision, or monitoring by the agency; (c) the person was found by the agency to no longer suffer from the mental health condition that served as the basis of the initial adjudication/commitment; or (d) the adjudication or commitment, respectively, is based solely on a medical finding of disability, without an opportunity for a hearing by a court, board, commission, or other lawful authority, and the person has not been adjudicated as a mental defective consistent with section 922(g)(4) of Title 18, United States Code; or (e) the person was granted relief from the adjudicating/committing agency pursuant to a qualified mental health relief from disabilities program. Persons who fall within one of the above exceptions should mark “no” in the applicable box. This exception to an adjudication or commitment by a Federal department or agency does not apply to any person who was adjudicated to be not guilty by reason of insanity, or based on a lack of mental responsibility, or found incompetent to stand trial, in any criminal case or under the Uniform Code of Military Justice.?
6.h. Have you been discharged from the Armed Forces under dishonorable conditions?
6.i. Are you subject to a court order restraining you from harassing, stalking, or threatening your child or an intimate partner or child of such partner?Under 18 U.S.C § 922 firearms may not be sold to or received by person subject to a court order that: (a) was issued after a hearing which the person received actual notice of and had an opportunity to participate in; (b) restrains such person from harassing, stalking, or threatening an intimate partner or child of such intimate partner or person, or engaging in other conduct that would place an intimate partner in reasonable fear of bodily injury to the partner or child; and (c)(i) includes a finding that such person represents a credible threat the physical safety of such intimate partner or child, or (ii) by its terms, explicitly prohibits the use, attempted use, or threatended use of physical force against such intimate partner or child that would reasonably be expected to cause bodily injury. An “intimate partner” of a person is the spouse or former spouse of the person, the parent of a child of the person or an individual who cohabitates or has cohabitated with the person.
6.j. Have you ever been convicted in any court of a misdemeanor crime of domestic violence?A Federal, State, local, tribal offense that is a misdemeanor under the Federal, State, or tribal law and has, as an element, the use or attempted use of physical force, or the threatened use of a deadly weapon, committed by a current or former spouse, parent, or guardian of the victim, by a person with whom the victim shares a child in common, by a person cohabitating with, or has cohabited with the victim as a spouse, parent, or guardian, or by a person similarly situated to a spouse, parent, or guardian of the victim, or by a person who has a current or recent former dating relationship with the victim (as defined in 18 U.S.C. § 921(a)(37)). The term includes all misdemeanors that have as an element the use or attempted use of physical force, or the threatened use of a deadly weapon (e.g., assault and battery), if the offense is committed by one of the defined parties. (See Exception in the definition of “Prohibited Person”). A person who has been convicted of a misdemeanor crime of domestic violence also is not prohibited unless: (1) the person was represented by a lawyer or gave up the right to a lawyer; or (2) if the person was entitled to a jury, was tried by a jury, or gave up the right to a jury trial. Persons subject to this exception should mark “no” in the applicable box.
6.k. Have you ever renounced your United States citizenship?
6.l. Are you an alien illegally or unlawfully in the United States?
6.m.1. Are you an alien who has been admitted to the United States under a nonimmigrant visa?
6.m.2. If you answered yes to Item 6.m.1., do you fall into any of the exceptions stated in the instructions?An alien admitted to the United States under a nonimmigrant visa includes, among others, persons visiting the United States temporarily for business or pleasure, persons studying in the United States who maintain a residence abroad, and certain temporary foreign workers. These aliens must answer “yes” to this question and provide the additional documentation required. Permanent resident aliens and aliens legally admitted to the United States pursuant to either the Visa Waiver Program, or to regulations otherwise exempting them from visa requirements, may answer “no” to this question, and are not required to submit the additional documentation. An alien admitted to the United States under a nonimmigrant visa is not prohibited from purchasing, receiving or possessing a firearm if the alien: (1) is in possession of a hunting license or permit lawfully issued by the Federal Government a State, or local government, or an Indian tribe federally recognized by the Bureau of Indian Affairs, which is valid and unexpired; (2) was admitted to the United States for lawful hunting or sporting purposes; (3) is an official representative of a foreign government who is accredited to the United States Government, or the Government’s mission to an international organization having its headquarters in the United States; (4) is an official representative of a foreign government who is en route to or from another country, to which that alien is accredited; (5) is an official of a foreign government or a distinguished foreign visitor who has been so designated by the Department of State; (6) is a foreign law enforcement officer of a friendly foreign government entering the United States on official law enforcement business; (7) has received a waiver from the prohibition from the Attorney General of the United States. (If so, attach the appropriate exception documentation to this questionnaire)
7. If you are an alien, record your U.S.-Issued Alien or Admission Number (AR, USCIS, or I-94 number):
8. Have you been issued a Unique Personal Identification Number (UPIN)?The SSN and UPIN are not required. However, this information assists with the efficient completion of the National Instant Criminal Background Check System (NICS) background check. Please be aware that refusal to provide this information may result in a delay in the NICS background check process.
9.a. Country of Citizenship
9.b. State of Birth
9.c. Country of Birth
Signature of Responsible Person
Certification Date

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