OMB No. 1140-0065 (05/31/2010)
U. S. Department of Justice
Bureau of Alcohol, Tobacco, Firearms and Explosives
                                                            Requisition for Forms or Publications

                                                            ATF Use Only
Note:  To better serve you, please:  1.  Order a year’s supply at a time, if possible.  2.  Keep a copy of this order for your records.Order Number:
Send To:   ATF DISTRIBUTION CENTER 1. Date Requested                 2. User’s Requisition Number
           1519 CABIN BRANCH DRIVE
           LANDOVER, MD  20785-3816
                                   3. For Information Call  (Name, Tel. No., Ext.)

4. Delivery
                        NormalPriority
                                                            (Specify)             (Delivery Date)
5. Supervisor Approval                                                            6. Office Code

     Form or                       Title or Description                           Quantity                                             Quantity
Publication No.                                                                   Requested                                            Furnished

                                                                                  Total:

                                                            Delivery Address
Name

Complete Street Address (Exclude P.O. Box and Route Numbers)

City, State and Zip Code

                                                   Paperwork Reduction Act Notice

This request is in accordance with the Paperwork Reduction Act of 1995.  The information requested on this form is necessary to fulfill requests from the
public for various forms and publications concerning firearms and explosives.  The supplying of information by the respondent is voluntary.

The estimated average burden associated with this collection of information is 3 minutes per respondent or recordkeeper depending on individual circum-
stances.  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.
                                                                                                                                       ATF Form 1370.3
                                                                                                                                       Revised August 2009