Get PA SP 4-134 2016

SP 4 134 1 2016 PENNSYLVANIA STATE POLICE SURCHARGE REMITTANCE FORM THE SURCHARGE REMITTANCE FORM SHALL BE COMPLETED WITHIN 14 DAYS OF A SALE TRANSFER OR INSTANTANEOUS RECORDS CHECK. 00 SURCHARGE TAXABLE HANDGUN SURCHARGE FEE TAXABLE LONG GUN SURCHARGE FEE TAXABLE FRAME/RECEIVER SURCHARGE FEE PICS BACKGROUND CHECKS APPROVED PICS FEE X 2. 00 FEE KEY ENCLOSE A CHECK FOR THE TOTAL AMOUNT DUE MADE PAYABLE TO NHG Nontaxable handgun TOTAL AMOUNT DUE NLG Nontaxable long gun NFR Nontaxable frame/rec. MAIL TO THG Taxable handgun ATTN FIREARM RECORDS UNIT TLG Taxable long gun 1800 ELMERTON AVENUE TFR Taxable frame/receiver HARRISBURG PA 17110 9758 C APPROVAL NUMBER/ NUMBER OF EACH DENIED DATE NHG NLG NFR THG TLG TFR D I VERIFY THAT THE INSTANTANEOUS RECORD CHECKS HAVE BEEN PERFORMED FOR THE ABOVE TRANSACTIONS AS REQUIRED BY Pa. C. S. SECTION 6111 OF THE UNIFORM FIREARMS ACT. I ALSO VERIFY THE FACTS THAT I HAVE SET FORTH ON THIS FORM ARE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE INFORMATION AND BELIEF. THIS VERIFICATION IS MADE SUBJECT TO BOTH THE PENALTIES OF SECTION 4904 OF THE CRIMES CODE 18 Pa C. A BUSINESS NAME DATE SPAN From To LICENSEE/DEALER OR SHERIFF NAME BUSINESS ADDRESS STATE BUSINESS TELEPHONE NO ZIP CODE FEDERAL FIREARMS LICENSE NO LICENSEE/DEALER OR SHERIFF NUMBER TYPE OF TRANSACTION TOTAL NUMBER FEES AMOUNT DUE B NONTAXABLE HANDGUN NONE NONTAXABLE LONG GUN NONTAXABLE FRAME/RECEIVER X 3. 00 SURCHARGE TAXABLE HANDGUN SURCHARGE FEE TAXABLE LONG GUN SURCHARGE FEE TAXABLE FRAME/RECEIVER SURCHARGE FEE PICS BACKGROUND CHECKS APPROVED PICS FEE X 2. 00 FEE KEY ENCLOSE A CHECK FOR THE TOTAL AMOUNT DUE MADE PAYABLE TO NHG Nontaxable handgun TOTAL AMOUNT DUE NLG Nontaxable long gun NFR Nontaxable frame/rec* MAIL TO THG Taxable handgun ATTN FIREARM RECORDS UNIT TLG Taxable long gun 1800 ELMERTON AVENUE TFR Taxable frame/receiver HARRISBURG PA 17110 9758 C APPROVAL NUMBER/ NUMBER OF EACH DENIED DATE NHG NLG NFR THG TLG TFR D I VERIFY THAT THE INSTANTANEOUS RECORD CHECKS HAVE BEEN PERFORMED FOR THE ABOVE TRANSACTIONS AS REQUIRED BY Pa* C. S* SECTION 6111 OF THE UNIFORM FIREARMS ACT. I ALSO VERIFY THE FACTS THAT I HAVE SET FORTH ON THIS FORM ARE TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE INFORMATION AND BELIEF* THIS VERIFICATION IS MADE SUBJECT TO BOTH THE PENALTIES OF SECTION 4904 OF THE CRIMES CODE 18 Pa C. S* SECTION 4904 RELATING TO UNSWORN FALSIFICATION TO AUTHORITIES AND THE UNIFORM FIREARMS ACT. SIGNATURE OF LICENSEE/DEALER OR SHERIFF. A BUSINESS NAME DATE SPAN From To LICENSEE/DEALER OR SHERIFF NAME BUSINESS ADDRESS STATE BUSINESS TELEPHONE NO ZIP CODE FEDERAL FIREARMS LICENSE NO LICENSEE/DEALER OR SHERIFF NUMBER TYPE OF TRANSACTION TOTAL NUMBER FEES AMOUNT DUE B NONTAXABLE HANDGUN NONE NONTAXABLE LONG GUN NONTAXABLE FRAME/RECEIVER X 3. 00 SURCHARGE TAXABLE HANDGUN SURCHARGE FEE TAXABLE LONG GUN SURCHARGE FEE TAXABLE FRAME/RECEIVER SURCHARGE FEE PICS BACKGROUND CHECKS APPROVED PICS FEE X 2. 00 SURCHARGE TAXABLE HANDGUN SURCHARGE FEE TAXABLE LONG GUN SURCHARGE FEE TAXABLE FRAME/RECEIVER SURCHARGE FEE PICS BACKGROUND CHECKS APPROVED PICS FEE X 2. 00 FEE KEY ENCLOSE A CHECK FOR THE TOTAL AMOUNT DUE MADE PAYABLE TO NHG Nontaxable handgun TOTAL AMOUNT DUE NLG Nontaxable long gun NFR Nontaxable frame/rec* MAIL TO THG Taxable handgun ATTN FIREARM RECORDS UNIT TLG Taxable long gun 1800 ELMERTON AVENUE TFR Taxable frame/receiver HARRISBURG PA 17110 9758 C APPROVAL NUMBER/ NUMBER OF EACH DENIED DATE NHG NLG NFR THG TLG TFR D I VERIFY THAT THE INSTANTANEOUS RECORD CHECKS HAVE BEEN PERFORMED FOR THE ABOVE TRANSACTIONS AS REQUIRED BY Pa* C. .