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Firearm Barter Agreement
Entity Initiating Barter (Offerer)
Name
City, State
Entity Accepting Barter (Offeree)
Name
City, State
Item Offered by Offerer
Item Offered by Offeree
Manufacturer
Model
Serial #
Manufacturer
Model
Serial #
The above mentioned firearms are being exchanged, as-is. Both parties disclaim any liability with regard to future possession, storage, or use of the firearms. Furthermore, each will rely on the below mentioned acknowledgements in making this transfer.
I certify that I am not restricted or forbidden by law from owning, buying, or selling a firearm and that I:
I truthfully state that I AM NOT a person who cannot legally buy, receive, and posses firearms and/or ammunition.
Have NEVER been convicted in any court of a felony or other crime punishable by imprisonment.
Am NOT a fugitive from justice.
Am NOT an unlawful user of or addicted to any controlled substance.
Have NEVER been adjudicated as a mental defective and have NEVER been committed to a mental institution
Am NOT an alien illegally or unlawfully in the United States or an alien admitted to the United States under a nonimmigrant visa.
Having been a citizen of the United States, has NEVER renounced his or her citizenship.
Am NOT subject to a court order that restrains the person from harassing, stalking, or threatening an intimate partner or child of such intimate partner.
Have NOT been convicted of a misdemeanor crime of domestic violence.
CAN lawfully receive, possess, ship, or transport a firearm.
Am NOT a person who is under indictment for a felony or other crime punishable by imprisonment.
Offerer
Offeree
Date
Date