USPSA Certified Ammunition Manufacturers Declaration
Date of Declaration
*
-
Month
-
Day
Year
Date
Company Name
*
The Official Brand Name for your Ammunition
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Company Website
*
For publication on USPSA Web Page
How will customers purchase your ammunition?
*
Web Store, Retail Outlet, Telephone order, etc.
Web Store Address
For publication on USPSA Web Page
Retail Outlets
Contact Person
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
ATF License
*
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Please upload a .pdf copy of your ATF License
Cancel
of
Federal Tax ID#
*
How much ammunition of each SKU or caliber and bullet weight below did you produce in the 12 months prior to making this declaration?
*
250,000 - 500,000 rounds
500,000-1,000,000 rounds
More than 1,000,000 rounds
Please list the products you wish to qualify for USPSA Certified Ammunition
*
SKU
Product Name
Caliber
Velocity,
feet per second
Bullet Weight, in grains
Power Factor (Major/minor)
OAL, inches
Item 1
Item 2
Item 3
Item 4
Item 5
Item 6
Item 7
Item 8
Item 9
Item 10
Item 11
Item 12
Please upload a summary of your testing procedures for Quality Control, Velocity, Bullet Weight, and how you track results, i.e., Lot number, Batch number, Random sample number, etc.
*
Browse Files
Cancel
of
How will this ammunition be distributed?
*
Direct Shipment to Match
Retail Outlet
Both
I certify that the information provided is accurate, the loads submitted achieve the declared USPSA Power Factor, the ammunition is available for sale to the general public, and I agree to adhere to the USPSA Certified Ammunition Policy
*
Signature
Clear
Please type the name of the person signing above
*
Submit
Please submit a 50 round sample of each item to:
DNROI
3669 Christina Ave.
Baton Rouge, LA 70820
Should be Empty: