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OMB No. 1140-0039 (07/31/2012) U.S. Department of Justice Bureau of Alcohol, Tobacco, Firearms and Explosives Federal Firearms Licensee Firearms Inventory Theft/Loss Report All entries must be in
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Street Address of Federal Firearms Licensee State OR Local Jurisdiction Address of Federal Firearms Licensee. State OR Local Jurisdiction Business Name and Telephone Number Other Contact Information (including business address and email address) Contact Name: = required = required Email Address: Please include both an Email Address and a physical address.