Lou's Guns Police Supply
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| SAMPLE AUTHORIZATION LETTER COPY THIS SAMPLE FORM ONTO YOUR DEPT LETTERHEAD (To be used for purchasing PISTOLS when being shipped to a department) |
INSTRUCTIONS It is a requirement that the Authorization Letter be printed on official agency letterhead. Original signatures are required; no rubber stamps or copies are permitted. Original documents are required when placing an order; no fax copies will be accepted. |
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COPY
THIS SAMPLE FORM ONTO YOUR DEPT LETTERHEAD TO
: Lou’s Police Distributors
Date ______________
7815 West 4th Avenue
Hialeah, FL 33014 RE:
Officers
Legal Name :
________________________________________
Contact Phone Number : _________________________________
Firearm
Description and Model ___________________________ I
hereby certify, under penalty of perjury, the above named law
enforcement officer will
use the requested firearm
for use in performing official duties and that the requested
firearm
is not being acquired for personal use or for purposes of
transfer or
resale. I
further certify, under penalty of perjury, that a records check has been
conducted on the
law enforcement officer who is purchasing the firearm and reveals no
convictions for
misdemeanor crimes of domestic violence. ________________________________
_____________________________________ Purchaser
Signature
Person
of Authority Within Agency Signature Print
Name : ______________________
Print Name: _________________________ Date:
__________________
Title: _______________________________ Department
Shipping Address: (if Shipping)
__________________________________
__________________________________________ __________________________________________ ____________________________________________________________________________ (MUST
BE ORIGINAL:
NO COPIES OR FAXED COPIES.) |
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