ason: Relinquished Custody Date and Time Accepted Custody Date and Time Signature: Signature: Printed Name/Agcncy: Printed Name/Agency: ■ Rcason: Reason: Relinquished Custody Date and Time Accepted Custody Date and Time Signature: Signature: Printed Name/Agency: Printed Name/Agency:

Reason: Relinquished Custody Date and Time Accepted Custody Date and Time Signature: Signature: Printed Name/Agency: Printed Name/Agency: Rcason: Reason: Firearm Certification by (FI/SWAT) / Explosive Material Certifkation by (SARI): Printed Name: Signature: Date: ATF Trace Form Completed:

ixoh 1 41 O SeStv" — i Reason, n OT/) /ri. • 3.7c,vm Reason: - Date and Time i . • add ins litil9 /71:PQ tOoit Reason: eaCif isnti, Rcason: (2)zancie c- r I Date and Time Date and Time Accepted Custody , ," rj Signature: i t`Xartv Printed Name/Agency: i Reason: J.Ini ÷ 4pin

quishedtustody Date and Time. Accepted Custody Date and 'rime Signature: ) „9, -1., 27 ,-, ,, Signature: Printed N' Printed Name/Agency: Rcason: cyrngt ;,)4r — 17-1 07/%1 ie.:- Reason: Relinqdishedtustody Date and Time Accepted Custody Date and Time Signature: Signature: Printed