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Dealer License. Any alteration to this form is expressly forbidden. Initial All employees of a Firearms Dealer or Manufacturer who directly or indirectly engage in the sale or purchase of firearms or parts thereof and ammunition are required to complete this application form. (1) Last Name ( If female, include maiden) First (3) Date of Birth / Month (7) Sex (4) Age Middle (2) Resident Address (Place of Birth - City - State or Country) (5) U.S. Citizen Yes Day Year Height Weight (11).

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