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Chapter 44 Title 18 Acknowledgment Form
Chapter 44 Title 18 U.S.C., 922 Section (g) states:
It shall be unlawful for any person:
1. who has been convicted in any court of a crime punishable by imprisonment for a term of
one year;
2. who is a fugitive from justice;
3. who is an unlawful user of or addicted to any controlled substance (as defined in section 102 of
the Controlled Substances Act 21 U.S.C., 802);
4. who has been adjudicated as a mental defective or who has been committed to a mental
institution;
5. who, being an alien, is illegally or unlawfully in the United States;
6. who being discharged from the armed forces under dishonorable conditions; or,
7. who having been a citizen of the United States, has renounced his citizenship;
8. who has been convicted in any court of a misdemeanor crime of domestic violence
9. who is subject to a court order that restrains such person from harassing, stalking or
threatening an intimate partner of such person, or engaging in other conduct that would
place an intimate partner in reasonable fear of bodily injury to the partner or child.
to ship or transport in interstate or foreign commerce, or possess in or affecting commerce, any firearm
or ammunition; or to receive any firearm or ammunition which has been shipped or transported in
interstate or foreign commerce.
You are being issued a Massachusetts Firearms Identification Card under M.G.L., Chapter 140 Section
129B. However, if you fall into one of the categories listed above, federal law deems you "disabled."
(i.e., prohibited) Due to the fact that you may not be able to possess a firearm under federal law, you
should be aware that you may only possess;
1. aerosol weapon
2. a primitive firearm (an antique firearm manufactured prior to 1898).
This department may notify the U.S. Bureau of Alcohol, Tobacco and Firearms or other Criminal
Justice Agency of the issuance to you of a Firearms Identification Card. Please sign below indicating
your receipt and acknowledgement of this notice.
Printed Name:
Signature:
Date:
Witness:
Title/Rank:
documendfid_fed.doc 10/98