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Courtesy FBI.gov
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According to this Ammoland report, Gun Owners of America got their hands on a leaked form that allows a person to self-report as a prohibited person to the FBI’s National Instant Background Check system, in effect forever surrendering their Second Amendment rights.

Courtesy GOA and Ammoland

I’m dubious as to the authenticity of this form. Someone may be trolling GOA. Or . . .

I suppose it could be a draft form, anticipating a potential federal law that would allow such self-reporting as some states have already done. But there’s nothing in federal law yet that would seem to allow this.

Do you see a government form number on that? I don’t, and that would make this the first .gov form I’ve seen that lacks that bureaucratic tracking element.

Then, where it references federal law, it does so by legislative bill title, but doesn’t list US Code or Code of Federal Regulations citations like every other form I’ve seen.

And how the devil do you waive your rights to laws cited only as “other pertinent provisions” without reference to anything?

Now take a look at that Washington State equivalent form. Note that it requires the form to be submitted to the clerk in person, with photo ID verified.

This alleged FBI form doesn’t even have a space for a notary public seal.

And then there’s this:

“Lack mental capacity adequately to contract or manage the details of my life”

You lack the mental capacity to contract, but you have the mental capacity to execute the form? But that’s OK, because…

“he/she understands this form and has adequate mental capacity to voluntarily execute this document.”

In effect, you have the mental capacity to declare that you don’t have the necessary mental capacity.


And you can simply email this form to NICS (presumably so you can be added to the database immediately), and follow up with a hard copy later? It would be a darned shame if someone emailed these forms in for every member of Congress, cabinet member, Michael Bloomberg, Shannon Watts….

About the only thing that seems semi-legitimate here is the email address. At least, a test message sent to it hasn’t bounced back yet.

Again, I’m dubious as heck. Either someone is trolling GOA, or some FBI bureaucrat is getting way ahead of himself. I’m looking forward to seeing the response to GOA’s FOIA request. TTAG has also contacted the FBI asking for comment.

It also occurred to me that this could be a “canary trap;” a document deliberately planted to detect and trace a leaker within the FBI. That might explain why it’s such a bizarre document.


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      • True, but the thing does say it’s supposed to be witnessed by a licensed quack to prevent benevolent passive-aggressive backstabbers from filling it out for others.

        • How hard would it be to fill in some doctor’s info? You can find license info online. Sure, it would get sorted out eventually… but only after the person found out by being denied and probably going through months, maybe years of red tape (just like mistakes from the ‘no fly’ list)

      • Carl, I agree. It seems all to easy for a teacher or professor to voluntarily fill this out for every one of their students. You know…for the children

        Also, if this document is true and someone abuses it, I highly doubt they will be charged or face any penalties. Look at the rape hoaxes on college campuses which ruin the accused (but actually innocent) persons lives and nothing happens to the accuser.

    • Someone else will use it for you. Then you get to fight it in court to reverse it spending a lot of money and potentially getting red flagged during the process. The person who sent the form in for you will get left off because they had good intentions or something.

    • At the bottom of the page it says “Questions call (844) 265-6716”. What happened when you called? You DID call didn’t you?

      • Why would anyone do that??? Do you have any idea how easy it is to catch idiots who falsely troll others? Or better put- do you realize how difficult it has become to get away with SWATTING someone, unless, of course, you happen to be a democrat US legislator?

    • “If that thing is real, I cannot imagine anyone actually using it.”

      I can.

      A Leftist proving their Progressive ‘chops’ to other Progressives. A proof of Leftist ‘Loyalty’, so to speak. I could even see the whack-job members (IOW, *all* of them) setting up booths outside of Leftist gatherings where they can get a selfie of themselves ‘signing on the dotted line’… *snicker* 😉

      • Or, courts using it as a bit of extortion in trade for dropping charges for whatever alleged offense.

        If it’s valid, there will be someone looking to exploit that power.

    • If it were real it would likely be like Iowa’s Illegal Narcotics Seller’s Stamp that drug dealers are supposed to purchase to ply their (illegal) trade. ( https://tax.iowa.gov/forms/drug-tax-stamp-order-form-70-510 ) The deal is; when a cretin is caught, not having the stamp is just one more charge that can be added to the list by the proscecuting attorney.

      Now, on this site I’d think anything that came from GOA would be gospel… I’m sure they didn’t compromise to get this form. On the other hand, they’d be easy to troll…

    • “Just sign the form. We’ll let you go home! It’s just paperwork. Just sign it. If you don’t sign it, we’ll have to keep you here, and it’s a long holiday weekend. Just sign it and you can leave.”

      Voluntary. Right.

  1. Given the inability of the federal bureaucracy to accurately collect NIC’s required data especially from other bureaucracies this might just be the tool they need….

    But yeah it’s a sham document.

  2. There are people who suffer from mental illness and/or suicidal inclinations who in periods of lucidity want to remove their own ability to purchase firearms. If they have not been adjudicated, they would not be a prohibited person. This form, if it is real, seems a reasonable attempt to give these people some degree of protection if they ask for it and have a doctor sign off on it.

    Better this than having them end up in front of a judge.

    Of course, anyone following your suggestion to mail in falsely filled out forms should spend some time in front of a judge.

    • The form is real and NICS requires that a clinician familiar with the individual sign it. Mr Mallory is correct in its purpose. Adjudication of mental illness 18 USC 922(g)(4) is a high bar that many suffering from mental illness never have occasion to reach. Understanding that a manic episode may be followed by years of “normal” behavior before another episode puts this form in context. While I believe it could certainly happen, any government official pressuring an individual to sign this form in exchange for something would , I think, be in violation of ethics guidelines or in some cases the law.

  3. Sign this paper or your kids go to foster care and you never see them again.
    I can see this playing out in some of the more oppressive states.

  4. It looks fake for all the reasons others have mentioned.

    On the “mental capacity” angle, that obviously is playing on the nonsense that someone who needs help with their finances is also unable to safely and lawfully own firearms. Such as certain older people or disabled veterans.

    If a person is a danger to them self or others and is so determined in a court of law where due process and legal representation is truly provided, then okay.

    But how is it that such a person is not under lock and key anyway?

  5. I can see someone denying themselves firearms – I did when I was younger. I drank and had a temper. Thank God that I realized that I was out of control(when I drank too much) and would never hit my kids – discipline is one thing, but done in anger, turns to retribution. I did not want to hurt my kids and I never wanted to be in a situation where I shot someone out of anger. I was responsible enough to know when not to have a firearm, and I wish others are.
    As responsible gun owners, we should all be able to self police, no form required.

  6. I could easily see these forms being slipped In at doctors office’s,hospitals,loan application even school registrations, seriously what makes you think this would only be In gun stores??

  7. Oh I can easily see this being real…they want you to call a gubmint suicide “hotline”. AND sign up for POT. And tell your pediatrician about guns in the house😩

  8. “It also occurred to me that this could be a “canary trap;” a document deliberately planted to detect and trace a leaker within the FBI. That might explain why it’s such a bizarre document.“

    That makes allot of sense. Wether you love leaks or hate them the gov right now is very leak prone. They’ve even failed to keep the militaries legitimate UFO footage from being leaked.

      • Let’s look at the Second again. Those “prerequisites”? It looks like American citizenship is the only prerequisite in there. So, yeah, it’s unconstitutional.

        • “It looks like American citizenship is the only prerequisite in there.”

          U.S. citizenship is not a prerequisite for the rights of the people of the United States.

  9. Each Democrat running for president needs to submit one each of these forms with copies kept on file in n a secure location.

    For the children.

  10. I myself was involuntarily added to this last as a teen & am in the process of restoring my rights. Even though I’m prohibited I got my FSC, so I’m a bit confused as to how I’m banned but i can go ahead n try as many times as i want to make a purchase just to end in denial. Currently my investigation is still open but yeah. Its been a cow trying to fix this mess.

  11. In addition to people helpfully filling it out for others I have no doubt the government would say something like “Fill out this form and we’ll give you more welfare.” Plenty of ways to trick retards into signing their rights away.

  12. Mail a blank copy to your favorite leftist politician, or better still, help them to do the right thing by filling it out and mailing it in for them!

  13. These need to be passed out with Dem/Lib voter registration and included in all Dem/Lib requests for funds/donations to their Party.

    Anything that adds people to the “Firearms Restricted Persons” category/list, makes the anti gun folks happy.

  14. Guess how this is REALLY going to be used…….by malicious people against others.
    Don’t like someone? Know they are into firearms? Fill out one of these forms as if
    you were that person and submit it. Once the form and the persons name get into
    the system it will be a NIGHTMARE FROM HELL for the victim of this type of abuse
    to get their name cleared and removed from said list. In short it’s just another BACK

  15. There is indeed a form you can submit to have a check denied, thats not it pictured though. At least not the 1 I’ve seen.

    I work local LEO as a Mental Heath officer and had a frequently suicidal consumer ask if it could be done.

    I called our local ATF Agent and he found a form you can submit on yourself. Didn’t make you a prohibited person technically but you’ll get a denial if you buy a gun from an FFL.

  16. This is a form to be used for red flag laws. If the court determines (or the LEA supervisor on the scene) determines that the “subject” can no longer represent themselves, then this will be submitted for the subject. Presumably, this would also be useable by the subject in “plea bargain” style situations (e.g., “you submit this and we won’t press charges”).


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