Retirement Duty Weapon Transfer Request

Full Name

First NameMiddle NameLast Name

Rank / Role

Department / Unit

Work Phone

Please enter a valid phone number.Format: (000) 000-0000.

Email Address

example@example.com

Preferred Contact Method

Internal Employee / Service Reference (Optional)

Weapon Make

Weapon Model

Serial Number

Caliber / Gauge

Asset / Property Tag

Current Storage / Location

Ownership / Control Status

Other

Retirement Effective Date

Date

Requested Transfer Date

Date

Reason for Transfer

Requester Role

Recipient Type

Recipient Name

First NameMiddle NameLast Name

Organization Name

Contact Phone

Please enter a valid phone number.Format: (000) 000-0000.

Contact Email

example@example.com

Pickup / Transfer Location

Street Address

Street Address Line 2

CityState / ProvincePostal / Zip CodeCountry

Approval Status

Approving Official Name

First NameMiddle NameLast Name

Approving Official Title

Approval Date

Date

Verification Method

Approval, Inventory, and Compliance Notes

Authorized Signature

Special Instructions or Exceptions

Retirement Duty Weapon Transfer Request

Requester Information

Duty Weapon Details

Retirement and Transfer Request Details

Recipient or Receiving Entity Information

Approval and Verification Details

Acknowledgement and Submission Notes