Proof Firearms Turned In SoldCal. Super. - 6th Dist.February 10, 2021CH .800 Proof Of Firearms Turned In, Sold, Clerk stamps date here when formis filed. or Stored Protected Person Name: HASQQU Agp/KAK F I L ERestrained Person a. Your Name 73Mayfl KI )WMfiA/gkfl FEB 1 9 202; Your Lawyer (ifyou have onefor this case): Clerk of th Co rt ' - Superb! Cou nu ClaraName. State Bar No.. BY "S gflgzry d5? DEPUTY Firm Name: FM Fill in coun name and street address: Superior Court of California, County of b_ Your Address (lfyou have a lawyer, give your lawyer’s information. Ifyou d0 not have a lawyer and want t0 keep your home address privale, you may give a diflerem mailing address instead. You do n01 have t0 give telephone, fax, 0r e-mail. ).' Address: /3‘/5‘ SILLEIC WM LIV City: Srm ”(.2 {E State: (m Zip; 2513;“ Telephone: 0£&QJ 3 5-D Fax: Cour? fills in case number when form is filed. E-MailAddress: Caselmmooq8§q® To the Restrained Person: If the coun has ordered you to tum in, sell, or store your firearms, you may use this form to prove to the court that you have obeyed its orders. When you deliver your unloaded weapons, ask the law enforcement officer or the licensed gun dealer to complete item@ 0r® and item© After the form is signed, file it with the court clerk. Keep a cop) for yourself. I’or help. read Form CH-SOO-INFO, How [)0 I Turn in, Sell. 0r Smre M_\' Firearms? ® ~ To Law Enforcement ® To Licensed Gun Dealer Fill out items <4) and©of this form. Keep a Fill out itcms© and© of this form. Keep a copy and give aha original to the person who copy and give the original t0 the person who sold turned in the firearms you the firearms or stored them with you. The firearm listed m© were tumed m 0n: The firearms “Sted in© we’e Date Z/C 2’ at '2-w D a m E p m D sold to me D transferred to me for storage on: To; 0F( ‘ mM c tn TA bum Date:--- a" -C' a'm- D P-m- Name and title 0f Ia'w enforcement agent T01 S‘Afl/ 3‘6 5’E F6LICE Name oflicensed gun dealer Name oflaw enforcement agencyw ( W Al (fl,fl Sr License number Telephone ?sz TofE , CM 1‘71! J A'ddress Address 2:332: ?ngirgirgggizftfizgireyigrflgthé laws» I declare under penalty of perjury under the laws 'b ve “:56 I acon t of the State of California that the information ’a o e ' fl LI 6‘ L, above is true and correct. Signature of law enforcement agent ’ Signature ofgun dealer Judicial CouncilofCalilomia. www.oourts‘cagov PrOOf Of Firearms Turned In, SOId, 0r Stored CH'BOO, Page 1 Of 2 Revised July 1, 2014, Opuonal Form . , 9coca o: cam procedure. g 527.9. (Civil Harassment Prevention) Penal Code § 29830 Case Number: ® Firearms Make Mod_el Serial Number a. qu< 63‘7 81<2
