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MARYLAND STATE POLICE

APPLICATION

FOR

MANDATORY REGISTRATION

OF

REGULATED FIREARMS

INSTRUCTIONS: All new residents of Maryland must register all regulated firearms within 90 days after establishing residency by completing the
information on this Application. All information on this Application must be completed by the new resident.
REGISTRANT INFORMATION
Drivers License ID #: ______________________________ State: _________________ Social Security #: _______-______________
Last Name: __________________________________ First: ________________________ Middle: _________________ Suffix:
_____
Street Address: ____________________________________________________________________ Check if Baltimore City resident

Town/City: ________________________________ County: _______________________ State: _______ Zip Code: _______________


DOB: ____/____/_______ Place of Birth (City & State): __________________ (Country): ___________ Height: _____ Weight:
_____
Race: _______________ Sex: _______ Eyes: ___________ Hair: ___________ Occupation:
__________________________________
Home Phone: (________) ________-_______________
a. FIREARM INFORMATION

Work Phone: (________) ________-_______________

Make: _____________________________ Caliber: ___________ Type: _________________ Finish: _________________ Barrel length:
________
Model: ______________________________________ Serial #: ____________________________ Country of Origin:
________________________
b. FIREARM INFORMATION
Make: _____________________________ Caliber: ___________ Type: _________________ Finish: _________________ Barrel length:
________
Model: ______________________________________ Serial #: ____________________________ Country of Origin:
________________________
c. FIREARM INFORMATION
Make: _____________________________ Caliber: ___________ Type: _________________ Finish: _________________ Barrel length:
________
Model: ______________________________________ Serial #: ____________________________ Country of Origin:
________________________
d. FIREARM INFORMATION
Make: _____________________________ Caliber: ___________ Type: _________________ Finish: _________________ Barrel length:
________
Model: ______________________________________ Serial #: ____________________________ Country of Origin:
________________________
e. FIREARM INFORMATION
Make: _____________________________ Caliber: ___________ Type: _________________ Finish: _________________ Barrel length:
________
Model: ______________________________________ Serial #: ____________________________ Country of Origin:
________________________
f. FIREARM INFORMATION
Make: _____________________________ Caliber: ___________ Type: _________________ Finish: _________________ Barrel length:
________
Model: ______________________________________ Serial #: ____________________________ Country of Origin:
________________________
g. FIREARM INFORMATION
Make: _____________________________ Caliber: ___________ Type: _________________ Finish: _________________ Barrel length:
________
Model: ______________________________________ Serial #: ____________________________ Country of Origin:
________________________
h. FIREARM INFORMATION
Make: _____________________________ Caliber: ___________ Type: _________________ Finish: _________________ Barrel length:
________
Model: ______________________________________ Serial #: ____________________________ Country of Origin:
________________________
(THIS SECTION FOR MARYLAND SATE POLICE USE ONLY)

Date form received: ____________________________________________ Reviewer:


________________________________________________
Comments:
______________________________________________________________________________________________________________
NOTICE: Lost or Stolen Firearms. If a regulated firearm is lost or stolen, the owner of the regulated firearms shall report the loss or theft
to the local law enforcement agency within 72 hours after the owner first discovers the loss or theft. THE OWNER MUST ALSO NOTIFY ANY
SUBSEQUENT RECIPIENT OF THE FIREARM OF THIS REQUIREMENT.
(Sign upon completion of this Application)
Signature of Registrant
Registrant
________________________________________________________________________________________
_____/_____/_______
MSP 77D (10/1/13)

Date