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

This fillable "Firearm Release Request Form" is a document issued by the Tennessee Department of Commerce and Insurance specifically for Tennessee residents.

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

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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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