This is for initial orders only. Federal Law requires that any individual purchasing or receiving rifle ammunition is at least 18 years of age, and pistol ammunition is at least 21 years of age. For non-face to face transactions, we are required to keep proof of age requirements via a signed statement. This information can be found in Title 18 USC chapter 44, section 922 (b) 1, and 922(x) 1  

 

NOT NEEDED FOR 37MM RELOADING SUPPLIES PURCHASES.

 (This is only used to purchase live ammunition for firearms.)

 

I, THE UNDERSIGNED, CERTIFY THAT I HAVE READ, UNDERSTAND AND AGREE TO SALES CONDITIONS AND LIABILITY RELEASE AS STATED HEREIN AND CATALOG OR INSERTS, AND THAT (A) I AM 18/21 (circle one) YEARS OF AGE OR OLDER, FULLY AND LEGALLY QUALIFIED TO RECEIVE MERCHANDISE ORDERED; (B) I FULLY UNDERSTAND THAT MERCHANDISE ORDERED MAY BE DANGEROUS TO USE OR STORE AND I UNDERSTAND THE NATURE, SAFETY PRECAUTIONS, CHARACTERISTICS AND RISKS TO HEALTH, OF STORAGE, USE OR OTHER AND PERSONAL CONTROL; (C) I WILL KEEP ALL MERCHANDISE COMPLETELY UNDER MY CONTROL; (D) I WILL USE AND/OR STORE ALL MERCHANDISES OUT OF THE REACH OF CHILDREN AND IN FULL COMPLIANCE WITH LOCAL, STATE AND FEDERAL LAWS; (E) I UNDERSTAND THAT EXOTIC FIREARMS LLC,  NOR ANY EMPLOYEE, AGENT OR IN ANY PART THEREOF EXTEND ANY WARRANTIES EXPRESSED OR IMPLIED OR TO MAKE ANY STATEMENT OF USAGE; (F) I FULLY, WITHOUT RESERVATION OR CONDITION, AGREE TO ABSOLVE AND HOLD HARMLESS AND INDEMNIFY EXOTIC FIREARMS LLC, ALL EMPLOYEES, AGENTS OR ANY IN PART THEREOF FROM ALL INJURIES RESULTING IN ANY WAY FROM THE PURCHASE, USE, POSSESSION, DISTRIBUTION, SALE/RESALE, TRANSPORTATION, HANDLING AND/OR STORAGE OF MERCHANDISE OR ITEMS/SUBSTANCES MADE FROM SAME; (G) I FURTHERMORE AGREE TO RE-IMBURSE EXOTIC FIREARMS LLC OR ANY AGENT THEREOF FOR ANY AND ALL COST, FEES OR EXPENSES IN DEFENSE OF ANY CLAIMS OR JUDGEMENTS THAT MAY ARISE AS A RESULT FROM THE PURCHASE, TRANSPORTATION, HANDLING, POSSESSION, STORAGE, SALE/RESALE AND/OR USE OF MERCHANDISE ORDERED.

I AGREE THAT ALL TERMS AND CONDITIONS OF THIS STATEMENT AND SALE APPLY EQUALLY TO ALL PURCHASES, PAST, PRESENT AND FUTURE AS WELL AS ORDERS CALLED IN BY TELEPHONE.  I HAVE READ, UNDERSTAND AND AGREE FULLY, WITHOUT RESERVATION OR CONDITION LISTED HEREIN.
 

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SIGNATURE OF BUYER (QUALIFIED ADULT)                  DATE

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Print name                                       DATE OF BIRTH 

 

Please include a copy of your ID with this form for age verification

Print out this form then fill out, sign and date it, then email, or  fax it to:

Email: buyerstatement@exotic-firearms.com
Fax :1-541-722-7091

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