d Name/Agency: Reason: Reason: Firearm Certification by (FI/SWAT) / Explosive Material Certification by (SABI): Printed Name: Signature: Date: MT Trace Form Completed: 0 NCIC: K casc ID: ?We- NY • yes I 2,27? Barcodc: ,6 5/ 6 / 5 6 . This form is incomplete without reference to the FD-/087. EFTA00132237 PD