Form Cv-434 - Order To Sheriff For Firearms Record Check/response Of Sheriff
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1STATE OF WISCONSIN, CIRCUIT COURT,
COUNTY
Amended
IN THE MATTER OF THE POSSESSION OF FIREARMS BY
Order to Sheriff for
Firearms Record Check/
Response of Sheriff
Name of person subject to firearm restriction
Case No.
Date of Birth
The above named person has petitioned the court to return firearms which were ordered surrendered in an
injunction dated
. A copy of the petition is attached.
THE COURT ORDERS:
The sheriff of this county complete the bottom portion of this order within 5 business days of receipt indicating
whether or not this person
• has been convicted of a felony in a state or federal court;
• has been convicted of a misdemeanor crime of domestic violence;
• is prohibited by an order of any federal or state court from possessing a firearm, other than the order in this
case; or
• is for any other reason known to the sheriff to be prohibited from possession of a firearm.
BY THE COURT:
Circuit Court Judge/Family Court Commissioner
Title (Print or Type Name if not eSigned)
Date
RESPONSE OF SHERIFF
As ordered, I conducted the following records check
An NCIC records check, as of
.
[Date]:
A CIB records check, as of
.
[Date]:
A firearms restriction records check, as of
.
[Date]:
This records check indicated that this person
has not
has
been convicted of a felony in a state or federal court.
has not
has
been convicted of a misdemeanor crime of domestic violence.
is not
is
prohibited by an order of a federal or state court from possessing a firearm other than
the order in this case.
is not
is
prohibited from possession of a firearm for other reasons known to me.
(Attach further information for any affirmative answer.)
Signature
DISTRIBUTION:
Title
1.
Court
2.
Sheriff
Date
CV-434, 02/17 Order to Sheriff for Firearms Record Check/ Response of Sheriff
§813.1285(7), Wis. Stats., 18USC §921.922
This form shall not be modified. It may be supplemented with additional material.
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