R.I. Gen. Laws § 11-47-35.2
(Face of application form)
Application to Purchase Shotgun or Rifle
Date .................................... Hour .................................... A.M. P.M.
Name
Address
(Street and number) (City or town) (State)
Date of Birth Place of Birth
Height Weight Color hair
Color eyes
Scars
Tattoos
Other identifying marks
Are you a citizen of the United States
Are you a citizen of Rhode Island
How long
Where stationed
(Armed Forces only)
Number of rifles and/or shotguns to be purchased
Have you ever been convicted of a crime of violence
(See § 11-47-2 General Laws of Rhode Island)
Have you ever been adjudicated or under confinement as addicted to a controlled substance
Have you ever been adjudicated or under confinement for alcoholism
Have you ever been confined or treated for mental illness
From whom is shotgun or rifle being purchased
Seller's address
Seller's signature
Applicant's signature
(See § 11-47-23 for penalty for false information on this application)
(Reverse side of application form)
AFFIDAVIT: I certify that I have read and am familiar with the provisions of §§ 11-47-1 -- 11-47-59, inclusive, of the general laws of the State of Rhode Island, and that I am aware of the penalties for violation of the provisions of the cited sections.
Signed
County of
State of Rhode Island
Subscribed and sworn before me this ...................... day of.........A.D. 20..
Notary Public
.....................................
R.I. Gen. Laws § 11-47-35.2