Certificate Of Arms Storage Form printable pdf download

Certificate of Arms Storage

I, the undersigned, acting for and on behalf of_____________________________________

(Name & complete address of Organization)

______________________________________

, certify that:

1. Rifles received from the US Army TACOM Life Cycle Management Command will

be stored as specified below: (check one)

a. _____ In the arms room of a National Guard Armory, US Army Reserve

Center, Military Installation or local Law Enforcement Agency;

b. _____ In a secured room located within the organization inaccessible to the

general public;

c. _____ Other, please specify_____________________________________.

2. I hereby certify that to the best of my knowledge and belief this storage facility

meets the requirements of local, state and federal laws applicable to the security of firearms

and that all of my statements are true, correct, complete and made in good faith. I

understand and acknowledge that concealing material fact and/or making a false statement

is a violation of Title 18 USC §1001 and may result in the cancellation of the Conditional

Deed for any US Army property on loan to my organization and is punishable by fine or

imprisonment.

SIGNATURE: _______________________________

NAME: __________

____________________

(Typed or Printed)

TITLE: _____________

_________________

Notary Public Endorsement

COUNTY OF_____________________________ STATE OF___________________

I, the undersigned, certify that I am a duly commissioned, qualified, and authorized notary public. Before

me personally and within the territorial limits of my warrant of authority, appeared the above named

individual, who is known by me to be the person who is described herein, whose name is subscribed to,

and who signed this Certificate of Arms Storage and who, having been duly sworn, acknowledged that

this instrument was executed after its contents were read and duly explained, and that such execution

was a free and voluntary act and deed for the uses and purposes herein set forth.

IN WITNESS WHEREOF, I have hereunto set my hand and affix my official seal on

this _____Day of __________________, 20___.

____________________________________ My Commission expires:____________

Notary Public

Certificate Of Arms Storage Form