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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