VERMONT FIREARM BILL OF SALE

Date of Sale: _________________ (mm/dd/yyyy)

1.	BUYER

Name: ______________________________________________________ (hereinafter the “Buyer”)
Address: __________________________________________________________________________
Phone #: ________________________________ 
Email: ___________________________________

2.	SELLER

Name: ______________________________________________________ (hereinafter the “Seller”)
Address: __________________________________________________________________________
Phone #: _______________________________ 
Email: ___________________________________

3.	FIREARM INFO

Make: ___________________________
Model: ___________________________ 
Type: ☐ Revolver | ☐ Pistol | ☐ Shotgun | ☐ Rifle | ☐ Other: ____________________________
Caliber/Gauge: __________
Serial Number (SN): __________ 

4.	PAYMENT (Check one)

☐ PAYMENT. The Buyer agrees to pay the Seller the following in exchange for the Firearm:
Purchase price: $_____________________ (Taxes included? ☐ Yes | ☐ No)
Paid for via the following payment method: (check one)
☐ Cash | ☐ Check | ☐ Credit / Debit Card | ☐ Other: ___________________________
☐ - GIFT. The Buyer was gifted the Firearm by the Seller.
☐ - TRADE. The Seller traded the Firearm with the Buyer to receive the following Firearm in 
exchange: ____________________________________________________________________.

5.	SELLER’S DISCLOSURE

By signing, the Seller confirms the following:

•	All details of the Firearm are correct;
•	The Firearm’s serial number is legible;
•	The Seller is the lawful owner of the Firearm;
•	The right to sell the Firearm is held by the Seller;
•	There are no known defects associated with the Firearm;
•	The Firearm is in fit condition to be used for its intended purpose(s);
•	Neither the Seller or Firearm have been used in a manner of questionable or certain illegality; and
•	The Seller assumes no responsibility after the transfer of ownership has taken place.

6.	BUYER’S DISCLOSURE

By signing, the Buyer confirms the following:

•	Is not under the legal age to own a firearm;
•	Not being convicted of and never been convicted in any court of a crime punishable by imprisonment for a term exceeding one (1) year;
•	Not a fugitive and has no outstanding warrants;
•	Not an unlawful user of or addicted to any controlled substance;
•	Has never been adjudicated as a mental defective or has been committed to a mental institution;
•	Not an alien illegally or unlawfully in the United States or an alien admitted to the United States under a nonimmigrant visa;
•	Has not been discharged from the Armed Forces under dishonorable conditions;
•	Is a citizen of the United States;
•	Is not subject to a court order that retrains the person from owning a Firearm;
•	Has not been convicted of a misdemeanor crime of domestic violence; and
•	Is not a person prohibited under State of Federal law from purchasing a Firearm.

7.	ADDITIONAL TERMS (OPTIONAL)

___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________.

8.	SIGNATURES

Buyer Signature: _____________________________________ Date: ____________________

Buyer Printed Name: _______________________________

Seller Signature: _____________________________________ Date: ____________________

Seller Printed Name: _______________________________

CERTIFICATE OF ACKNOWLEDGEMENT
(The section below is to be completed by a Notary Public ONLY.)

STATE OF _____________________
COUNTY OF ___________________

	On this ______ day of ____________________, 20____, before me _______________________________ (Name of Notary), personally appeared _______________________________ (Seller) and _______________________________ (Buyer), who proved to me through government issued photo identification to be the above-named person(s), in my presence executed the foregoing instrument and acknowledged that he/she/they executed the same as his/her/their free act and deed.

				___________________________________________
				Notary Public Signature

				My commission expires: ______________________