"Firearm Release Request Form" - City of Memphis, Tennessee

Firearm Release Request Form is a legal document that was released by the Tennessee Department of Commerce and Insurance - a government authority operating within Tennessee. The form may be used strictly within City of Memphis.

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FRR_PAGE 1 of 2

MEMPHIS POLICE DEPARTMENT

201 Poplar Avenue, Memphis, TN 38103

Office: (901) 636-3716 E-Mail: MPD.LegalOffice@MemphisTN.gov

FIREARM RELEASE REQUEST FORM

DISCLAIMER: This form is to be used only by the owner of a firearm which is in the custody or control of the Memphis

Police Department’s Property and Evidence Unit in an attempt to redeem the firearm. This form exists only as an official

claim of said property and may not be used to transfer a firearm or to prove ownership of a firearm. Submission of this

form does not guarantee eligibility to retrieve property being held with the Memphis Police Department.

(Please refer to page 2 of 2 for additional information.)

A. Applicant Information

Last Name:

First Name:

Middle Initial:

Suffix:

Address:

City:

State:

Zip Code:

Date of Birth (MM/DD/YYYY):

Social Security Number:

Race:

Sex:

Driver License Number:

Home Phone Number (Include Area Code):

Mobile Phone Number (Include Area Code):

E-mail Address:

B. Case and Firearm(s) Information

(Please refer to page 2, part B before completing this section)

Incident Report Number (10 digits, ending in ‘ME’):

Property Receipt Number:

Check all that apply:

Make:

Model:

Serial Number:

Reported as Missing or Stolen

Make:

Model:

Serial Number:

NOT Reported as Missing or Stolen

Make:

Model:

Serial Number:

Applicant is Beneficiary or Attorney

Ship weapon to Law Enforcement Agency? Yes ______

No______

C. Declaration

I declare under penalty of perjury under the laws of the State of Tennessee that the foregoing is true and correct and that I am the lawful owner or

legal beneficiary of all firearms that I seek to have returned. I expressly authorize the Memphis Police Department to perform firearms eligibility

checks of all relevant state and federal databases, including the Federal Bureau of Investigation’s National Instant Criminal Background Check

System. I also understand that if I currently possess or own firearms and the results of this check reveal that I am ineligible either to lawfully

possess or purchase firearms, I must relinquish any and all firearms in my possession.

Signature: _______________________________________________________

Date: _____________________________________

OFFICE USE ONLY

Proof of Ownership Included w/Application

Proof of Ownership NOT Included w/Application

Case Reflects Pending Court Disposition

Date Received:

Date Processed:

Processed by (Last Name and IBM#):

Stamp Approved or Denied Here

Officer Assigned (Last Name and IBM#):

Precinct:

Date Submitted:

Date Returned:

Location ID:

FRR_PAGE 1 of 2

MEMPHIS POLICE DEPARTMENT

201 Poplar Avenue, Memphis, TN 38103

Office: (901) 636-3716 E-Mail: MPD.LegalOffice@MemphisTN.gov

FIREARM RELEASE REQUEST FORM

DISCLAIMER: This form is to be used only by the owner of a firearm which is in the custody or control of the Memphis

Police Department’s Property and Evidence Unit in an attempt to redeem the firearm. This form exists only as an official

claim of said property and may not be used to transfer a firearm or to prove ownership of a firearm. Submission of this

form does not guarantee eligibility to retrieve property being held with the Memphis Police Department.

(Please refer to page 2 of 2 for additional information.)

A. Applicant Information

Last Name:

First Name:

Middle Initial:

Suffix:

Address:

City:

State:

Zip Code:

Date of Birth (MM/DD/YYYY):

Social Security Number:

Race:

Sex:

Driver License Number:

Home Phone Number (Include Area Code):

Mobile Phone Number (Include Area Code):

E-mail Address:

B. Case and Firearm(s) Information

(Please refer to page 2, part B before completing this section)

Incident Report Number (10 digits, ending in ‘ME’):

Property Receipt Number:

Check all that apply:

Make:

Model:

Serial Number:

Reported as Missing or Stolen

Make:

Model:

Serial Number:

NOT Reported as Missing or Stolen

Make:

Model:

Serial Number:

Applicant is Beneficiary or Attorney

Ship weapon to Law Enforcement Agency? Yes ______

No______

C. Declaration

I declare under penalty of perjury under the laws of the State of Tennessee that the foregoing is true and correct and that I am the lawful owner or

legal beneficiary of all firearms that I seek to have returned. I expressly authorize the Memphis Police Department to perform firearms eligibility

checks of all relevant state and federal databases, including the Federal Bureau of Investigation’s National Instant Criminal Background Check

System. I also understand that if I currently possess or own firearms and the results of this check reveal that I am ineligible either to lawfully

possess or purchase firearms, I must relinquish any and all firearms in my possession.

Signature: _______________________________________________________

Date: _____________________________________

OFFICE USE ONLY

Proof of Ownership Included w/Application

Proof of Ownership NOT Included w/Application

Case Reflects Pending Court Disposition

Date Received:

Date Processed:

Processed by (Last Name and IBM#):

Stamp Approved or Denied Here

Officer Assigned (Last Name and IBM#):

Precinct:

Date Submitted:

Date Returned:

Location ID:

FRR_PAGE 2 of 2

MEMPHIS POLICE DEPARTMENT

201 Poplar Avenue, Memphis, TN 38103

Office: (901) 636-3716 E-Mail: MPD.LegalOffice@MemphisTN.gov

FIREARM RELEASE REQUEST FORM

Proper Use of the Firearm Release Form (FRR)

This application is only to be completed by the firearm owner who is seeking to retrieve his/her property currently

held in the custody or control of the Memphis Police Department’s Property and Evidence storage facility. An

attorney or beneficiary may complete and submit an application in the event the actual owner is unable to do so.

Application Submission Requirements

Persons seeking the return of a firearm must submit a completed application with proof of ownership and a valid

state-issued photo identification card. (Acceptable forms of proof of ownership are: Original or duplicate copy of

the Bill of Sale or receipt issued at the time of purchase OR a notarized letter stating sole ownership, Make,

Model and Serial Number. If a Bill of Sale or receipt is handwritten, it must also be notarized.) Applications MUST

include an Incident Report Number, Property Receipt Number and Serial Number in order to be properly

processed. Incomplete applications will be returned without being processed. Photos of applications are not

permissible. An Interstate Identification Index (III) background check will be conducted to determine whether the

requestor is eligible to possess firearms under state and federal law.

Upon receipt of completed application, a notice of receipt will be sent to applicant via e-mail or via U.S. mail if no

e-mail address is provided.

Submit completed application, proof of ownership and proper ID by mail:

Memphis Police Department

201 Poplar Avenue

Memphis, TN 38103

Attn: Legal/FRR Application

or by e-mail:

MPD.LegalOffice@MemphisTN.gov

Part A – Owner Information

Enter the information as requested. If applicant is a beneficiary, please enter your personal information as the

owner. If applicant is an attorney representing a client, please enter the client’s personal information.

Part B – Case and Firearm(s) Information

Applicants may request multiple firearms per one application if each firearm is tagged under the same Incident

Report Number. To request additional firearms tagged under different Incident Report Numbers, please print and

submit a separate application.

Part C –Declaration

Applicant must sign and date the declaration on this application.

*This page is to be kept for your records. Please do not submit with application.

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