Firearms Registration Firearms Registration Firearms Registration First Name* Last Name* Title Organization Street Address* City* State*AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificZip* Dealer's Name Model*M-100 CarbineM-100T CarbineM-100FS CarbineM-100FST CarbineM-110F SBRM-110FS SBRM-110FS CarbineM-110 PistolM-960 SBRLiberty ILiberty ITLiberty IILiberty IITLiberty IIILiberty IIITLiberty 50Liberty50TLiberty 100Liberty 100TOtherSerial Number* Purchase Date MM slash DD slash YYYY NameThis field is for validation purposes and should be left unchanged.