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I hereby hereby represent and warrant valid license to and peaceful possession of,
the firearm herein sold and conveyed, and further declares that the same is free and clear of all liens and
encumbrances of any kind whatsoever.
________________________ ________________________
Vendor Vendee
________________________ _______________________
BEFORE ME, a Notary Public, for and in ________________, this ___ day of _____________
personally appeared _____________________________ who presented to me their competent evidence
of identity by way of _____________________ issued at ____________________ on
____________________ all known to me to be the same persons who executed the foregoing instrument
and hereby acknowledged to me that the same is their free and voluntary act and deed.