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Before you Start… The following information explains certain parts of the form and
will help you answer some of the questions. You should read the
Use this form if you are an approved verifier to provide the Registrar instructions as you fill in your form. If you are still unsure about a
of Firearms with verification of a firearm. question, call 1 800 731-4000 for assistance.
Mail your completed application form and all attachment(s) to: Box 3 j) Action
Royal Canadian Mounted Police Using the legend provided on the application form, enter the code for
P.O. Box 1200 firearm action. For example, if you are verifying a firearm with a bolt
Miramichi NB E1N 5Z3 action, print BA in the box. Only print one code. If none of the codes
are applicable, print OT (Other) and specify the action in the
Please remember… space provided.
Whenever you handle firearms, follow all safety precautions.
D - Verifier Information
Box 8 a)
Provide your verifier number in Box 8 a).
Boxes 8 b) and c)
Provide your name (last and first) in Boxes 8 b) and c).
Boxes 8 g) and h)
Sign and date the form.
B - Firearm Information
Legend - Type Legend - Action
CG = Combination Gun CV = Commercial Version A = Air, spring or gas exceeding 152.4 m/sec (500 ft/sec) and 5.7 joules (4.2 foot-pounds)
HG = Handgun MG = Machine Gun BA = Bolt Action CA = Converted Automatic FA = Full Automatic
RI = Rifle SG = Shotgun LA = Lever Action MB = Multi-Barrel PA = Pump Action
SM = Submachine Gun R = Revolver SA = Semi-Automatic SS = Single Shot
OT = Other, please specify
3. a) Registration Certificate Number (if applicable) 3. b) Firearm Identification Number (if applicable) 3. c) If firearm is a frame / receiver only and
cannot discharge ammunition, check this box.
3. d) Class 3. e) Serial Number 3. f) Make
Non-Restricted Restricted Prohibited
3. g) Manufacturer (if different from make) 3. h) Model 3. i) Type
D - Verifier Information
8. a) Verifier's Number 8. b) Last Name 8. c) First Name
8. d) Firearms Business Licence 8. e) Legal Name of Business (if applicable) 8. f) Telephone Number
Number (if applicable)
Information contained in this application is obtained under the authority of the Firearms Act. The information will be used to determine eligibility and
to administer and enforce the firearms legislation. In addition to the provisions outlined in the Firearms Act, individual rights regarding personal
information are governed by the applicable federal, provincial or territorial legislation relating to access to information and privacy.