(THIS FORM IS ONLY AN EXAMPLE)

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I___(Co-Signer 1)___________, and I____(Co-signer 2)______________as of (Date)_________ do hereby solemnly swear that the integrity of (Purchaser),_______________________ for the following firearm(s)_______________________is of sound mind, trustworthy, and is a responsible United States citizen.

I also understand that by signing this certification, I may be partially held liable in a court of law for his/her actions of misuse should they become unacceptable according to all firearm laws of the United States of America.

By signing this certification I also understand that a alegal background check has been performed on the purchaser and that no background check is required on either referenced co-signer.

I also understand that I do not have any ownership in the purchased firearm(s). I also agree that the firearm(s) cannot be gifted to another user unless the one receiving the weapon as a gift has had this document officially completed on themselves.

I also agree that the firearm(s) cannot be transferable to another owner unless a new document is completed in a gun dealership and is also signed by 2 co-signers and an employee of that retail establishment.

In conclusion I certify that by signing below, I have read all the regulations of this form and that I am over 21 years of age with no felonies or criminal record. I also sign knowing that I have read and understand my responsibility of liability and possible repercussions regarding the sale of a firearm(s) to this named individual shown as the purchaser.

Signatures of Responsible Parties:

1. Purchaser______________________

2. Cosigner #1_____________________

3. Cosigner #2_____________________

4. Firearm Establishmen___________________

5. Employee/Witness from Retail Firearm Establishment______________________

6. Dated:__________________________