Firearm Redemption Form
Fields marked with * are required. PLEASE DOUBLE-CHECK YOUR INFORMATION — INCORRECT ENTRIES WILL INVALIDATE THE FORM.
To confirm you're the gun winner, please take a photo of the front side of your Winning Gun Certificate. This side should include the security code, serial number, and gun model—all of which must be clearly visible in the photo.
*
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Date won:
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Security Code (found on the flyer)
*
Serial Number (found on the flyer)
*
Gun (found on the flyer)
*
If you choose to manually fill out the back of the Winning Gun Certificate, you can take a photo and upload it here. Otherwise, click "Next" to continue filling out the form online.
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Winner's Information
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
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Winning Location Information
Winning Location Name
*
Winning Location Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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Gun Shop Information
You are responsible for selecting a licensed firearm dealer in your area who will accept a transfer. Please provide their information below.
Gun Shop Name
*
Gun Shop Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Gun Shop Contact
*
Gun Shop Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Gun Shop Email
example@example.com
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OPTIONAL: Upload the gun shop's Federal Firearm License (FFL). Providing this will help speed up the process. Acceptable file types: PDF, DOC, DOCX, XLS, XLSX, CSV, TXT, RTF, HTML, ZIP, MP3, WMA, MPG, FLV, AVI, JPG, JPEG, PNG, GIF.
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