***Application to Purchase Shotgun or Rifle
***Date Hour **A.M. P.M.
***Name
***Address
***(Street and number)*** ***(City or town)******(State)
***Date of Birth Place of Birth
***Height Weight Color hair
***Color eyes
***Scars
***Tattoos
***Other identifying marks
***Are you a citizen of the United States
***Are you a citizen of Rhode Island
***How long
***Where stationed
***(Armed Forces only)
***Have you ever been convicted of a crime of violence
***(See § 11-47-2 General Laws of Rhode Island)
***Have you ever been adjudicated or under confinement as addicted to a controlled substance
***Have you ever been adjudicated or under confinement for alcoholism
***Have you ever been confined or treated for mental illness
***From whom is shotgun or rifle being purchased
***Seller's address
***Seller's signature
***Applicant's signature
***Date Hour **A.M. P.M.
***Name
***Address
***(Street and number)*** ***(City or town)******(State)
***Date of Birth Place of Birth
***Height Weight Color hair
***Color eyes
***Scars
***Tattoos
***Other identifying marks
***Are you a citizen of the United States
***Are you a citizen of Rhode Island
***How long
***Where stationed
***(Armed Forces only)
***Have you ever been convicted of a crime of violence
***(See § 11-47-2 General Laws of Rhode Island)
***Have you ever been adjudicated or under confinement as addicted to a controlled substance
***Have you ever been adjudicated or under confinement for alcoholism
***Have you ever been confined or treated for mental illness
***From whom is shotgun or rifle being purchased
***Seller's address
***Seller's signature
***Applicant's signature
