CPL Renewal Digital Document

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RI-060 (05/2016) MICHIGAN STATE POLICE

RI-060 (05/2016) MICHIGAN STATE POLICE

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(Type or print in ink)

PISTOL SALES RECORD

PISTOL SALES RECORD

Number of Pistols Manufacturer

Serial Number

Number of Pistols Manufacturer

Serial Number

Type: Model

Semi-Auto

Revolver

Other:

Type: Model

Semi-Auto

Revolver

Other:

Caliber

Shot

Barrel Length

Overall Length

Caliber

Shot

Barrel Length

Overall Length

Purchaser Information

Purchaser Information

Printed Name (Last, First, Middle) OR Business Name if FFL Dealer

Date of Birth

Race

Sex

Printed Name (Last, First, Middle) OR Business Name if FFL Dealer

Date of Birth

Race

Sex

Address

City

County

ZIP Code

Address

City

County

ZIP Code

Michigan CPL Number 1

Purchaser FFL Number 2

MCOLES Number 3

Michigan CPL Number 1

Purchaser FFL Number 2

MCOLES Number 3

OR

OR

OR

OR

Purchaser Signature

Telephone Number

Purchaser Signature

Telephone Number

Seller Information

Seller Information

Printed Name (Last, First, Middle) OR Business Name if FFL Dealer

Seller FFL Number 4

NICS Transaction Number 5

Printed Name (Last, First, Middle) OR Business Name if FFL Dealer

Seller FFL Number 4

NICS Transaction Number 5

Seller Signature

Date of Sale

Seller Signature

Date of Sale

Purchaser Copy Authority : MCL 28.422a, as amended. Completion : Mandatory for sale to proceed without a License to Purchase. An individual who makes a material false statement on this form is guilty of a felony.

Seller Copy Authority : MCL 28.422a, as amended. Completion : Mandatory for sale to proceed without a License to Purchase. An individual who makes a material false statement on this form is guilty of a felony.

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RI-060 (05/2016) MICHIGAN STATE POLICE

PISTOL SALES RECORD

GENERAL INSTRUCTIONS Applicability: This form can be used if the purchaser is one of the following: • Michigan resident with a valid Michigan Concealed Pistol License (CPL); • Federally Licensed Firearms (FFL) dealer; • Michigan resident who purchases a pistol from an FFL dealer who has complied with the requirements of the National Instant Criminal Background Check System (NICS); or • Michigan resident who is currently employed as a police officer certified by the Michigan Commission on Law Enforcement Standards (MCOLES). Required Fields: The following information must be provided in fields 1 through 5 as follows: • Michigan CPL Number 1 , - Required if the purchaser has a valid Michigan CPL. • Purchaser FFL Number 2 , - Required if the purchaser is an FFL dealer. • MCOLES Number 3 , Required if the purchaser is currently employed as an MCOLES certified police officer. • Seller FFL Number 4 , - Required if the seller is an FFL dealer. • NICS Transaction Number 5 , - Required if the seller is an FFL dealer unless the purchaser is a valid Michigan CPL holder or an FFL dealer. Distribution: The purchaser shall receive two copies of the form and the seller may retain one copy. Within ten days of purchase or acquisition, the purchaser must submit the registry copy to the city, village, or township police department where the purchaser resides, or the county sheriff. The law enforcement agency receiving the registry copy of this form shall enter the information into the pistol registration database within ten days and forward the form to the Michigan State Police within 48 hours.

Number of Pistols

Manufacturer

Serial Number

Type: Model

Semi-Auto

Revolver

Other:

Caliber

Shot

Barrel Length

Overall Length

Purchaser Information

Printed Name (Last, First, Middle) OR Business Name if FFL Dealer

Date of Birth

Race

Sex

Address

City

County

ZIP Code

Michigan CPL Number 1

Purchaser FFL Number 2

MCOLES Number 3

OR

OR

Purchaser Signature

Telephone Number

Seller Information

Printed Name (Last, First, Middle) OR Business Name if FFL Dealer

Seller FFL Number 4

NICS Transaction Number 5

Seller Signature

Date of Sale

Registry Copy (Within ten days of purchase, this copy must be submitted to the local police or sheriff’s office having jurisdiction where the purchaser resides.) Authority : MCL 28.422a, as amended. Completion : Mandatory for sale to proceed without a License to Purchase. An individual who makes a material false statement on this form is guilty of a felony.

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