Date and Time Accepted Custody Date aid Time Signature: 5,3/) .) f I'1(.4 •I'l Signature: Printed Name/Agency: Printed N Reason: Reason: arefla/Onf irrhyef- in U. a r i f Firearm Certification by (FI/SWAT) / Explosive Material Certification by (SABT): Printed Name: Signature: Date: ATF Trace