OMB No. 1140-0090 (01/31/2011)
U.S. Department of Justice
Special Tax Registration and Return
Bureau of Alcohol, Tobacco, Firearms and Explosives
National Firearms Act (NFA)
(Please Read Instructions on Back Carefully Before Completing This Form)
Section I - Taxpayer Identifying Information
1. Employer Identification Number (Required - see instructions) 2. Business Telephone Number
FOR ATF USE ONLY
(
)
T
3. Name (Last, First, Middle)
or
Corporation (If Corporation)
FF
4. Trade Name
FP
I
5. Mailing Address (Street Address or P.O. Box Number)
T
6. City
State
Zip Code
9. Tax Period Covering (Only one
tax period per form)
Actual Location (If Different Than Above)
From:
7. Physical Address of Principal Place of Business (Show street address)
(mm/dd/yyyy)
To: June 30,
(yyyy)
8. City
State
Zip Code
10. Federal Firearms License (FFL)
Number
Section II - Tax Computation
(11a)
(11b)
(11c)
(11d)
(11e)
Tax Class
Tax Class
Tax Rate ($)
Number of
Tax
(For Items Marked*, See Instructions)
Code
(Annual)
Locations
Due
$1,000
Class 1 - Importer of Firearms
61
Class 1 - Importer of Firearms (Reduced)*
71*
500
1,000
Class 2 - Manufacturer of Firearms
62
Class 2 - Manufacturer of Firearms (Reduced)*
72*
500
Class 3 - Dealer in Firearms
63
500
Make your check or money order payable to “Bureau of Alcohol, Tobacco, Firearms and Explosives”, Write your
12. Total Tax Due
Employer Identification Number on the check and send it with the return to Bureau of ATF, Attention NFA, P.O. Box
$0.00
403269, Atlanta, GA 30384-3269.
Section III - Business Registration
13. Ownership Information:
(Check One Box Only)
Individual Owner
Partnership
Corporation
Other (Specify)
14. Ownership Responsibility (See instructions on back; use a separate sheet of paper if additional space is needed.)
Full Name
Address
Position
15.
Gross Receipts less than $500,000 (See instructions on back; use a separate sheet of paper if additional space is needed.)
Federal Firearms License (FFL) Number
Date Business Commenced (mm, dd, yyyy)
16.
New Business
17.
Existing Business With Change In:
(a) Name/Trade Name (Indicate)
(b) Address (Indicate)
(c) Ownership (Indicate)
(d) Employer Identification Number
(Old:
New:
)
(e) Business Telephone Number
(
)
18.
Discontinued Business
Section IV - Taxpayer Certification
Under penalties of perjury, I declare that the statements in this return/registration are true and correct to the best of my knowledge and belief; that this return/registration applies
only to the specified business operations at the specified location or, where the return/registration is for more than one location, it applies only to the businesses at the locations
specified on the attached list. NOTE: Violation of Title 26, United States Code 7206 with respect to a declaration under penalty of perjury, is punishable upon conviction by a
fine of not more than $100,000 ($500,000 in the case of a corporation), or imprisonment for not more 3 years, or both, with the costs of prosecution added thereto.
19. Signature
20. Title
21. Date
ATF Form 5630.7
Revised April 2007
Paperwork Reduction Act Notice
This information is used to ensure compliance by taxpayers of P.L. 100-203, Revenue Act of 1987, P.L. 100-647, Technical Corrections Act of 1988, and
the Internal Revenue Laws of the United States. ATF uses the information to determine and collect the right amount of tax.
The estimated average burden associated with this collection of information is 15 minutes per respondent or recordkeeper, depending on individual
circumstances. Comments concerning the accuracy of this burden estimate and suggestions for reducing this burden should be addressed to Reports
Management Officer, Document Services, Bureau of Alcohol, Tobacco, Firearms and Explosives, Washington, DC 20226.
An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB
control number.