SAMPLE Secondhand Dealer's Property Form - Provided as a courtesy
CONTACT A PROPERTY INVESTIGATOR IN YOUR LOCAL POLICE OR SHERIFF DEPARTMENT TO GET THE CORRECT FORM FOR YOUR AREA
dealer Name & addreSS
date
coNtrol #
dePt. #___________________________________ time ______________________ am Pm delivery/ Pick-uP date ____________________________
tyPe of traNSactioN PurchaSe
Name (laSt) (firSt) (middle)
buy-Sell
date of birth
loaN
coNSigNmeNt
SeX (m/f) race
trade
Seller iNformatioN
w. white b. black i. americaN iNdiaN a. aSiaN/orieNtal
reSideNtial addreSS (Street, apt. No., city, State & zip)
home PhoNe (area code & Number)
(
Place of emPloymeNt
) )
wgt. eyeS
hair ideNtifyiNg markS
buSiNeSS PhoNe (area code & Number)
(
dl # / official Photo id # tyPe ageNcy/State hgt.
tyPe h. r. S. a. b. handgun rifle Shotgun airgun black Powder
actioN r. S. b. l. P. S. revolver Semi-auto bolt action lever Pump Single Shot
fiNiSh c. b. S. X. chrome/Nickel blue Steel Stainless Steel other
tyPe r. ring w. watch N. Necklace b. bracelet P. Pendant/charm e. earrings c. chain l. cuff links X. other
metal y. yellow gold w. white gold S. Sterling Silver P. Platinum t. tri-color X. other
geNder m. men's w. women's N. Not applicable
Style S. Serpentine h. herringbone r. rope b. box link f. figaro a. cameo c. class/School P. band o. Solitaire N. Nugget d. cluster m. monogram X. other
braNd
StoNe ShaPe o. oval r. round P. Pear e. emerald m. marquise h. heart X. other
StoNe color c. clear g. green a. amber P. Purple b. blue r. red/Pink y. yellow k. black o. brown w. white
barrel 1. 2. 3. 4. Single double over/under other
Serial Number
Jewelry
firearm
codeS
owNer aPPlied Number
item tyPe
model/maNufacturer Number
ProPerty
deScriPtioN of item (iNScriPtioNS, color, Size, markS, deSigN, School, year, iNitialS, barrel, leNgth)
tyPe
actioN
gauge/caliber
fiNiSh
barrel
amouNt Paid
$
Serial Number owNer aPPlied Number item tyPe braNd SecoNd StoNe firSt StoNe tyPe metal kt wt geNder Style Size leNgth # StoNeS ShaPe ct wt color # StoNeS ShaPe ct wt color model/maNufacturer Number
ProPerty
deScriPtioN of item (iNScriPtioNS, color, Size, markS, deSigN, School, year, iNitialS, barrel, leNgth)
tyPe
actioN
gauge/caliber
fiNiSh
barrel
amouNt Paid
$
Serial Number owNer aPPlied Number item tyPe braNd SecoNd StoNe firSt StoNe tyPe metal kt wt geNder Style Size leNgth # StoNeS ShaPe ct wt color # StoNeS ShaPe ct wt color model/maNufacturer Number
ProPerty
deScriPtioN of item (iNScriPtioNS, color, Size, markS, deSigN, School, year, iNitialS, barrel, leNgth)
tyPe
actioN
gauge/caliber
fiNiSh
barrel
amouNt Paid
$
Serial Number owNer aPPlied Number item tyPe braNd SecoNd StoNe firSt StoNe tyPe metal kt wt geNder Style Size leNgth # StoNeS ShaPe ct wt color # StoNeS ShaPe ct wt color model/maNufacturer Number
ProPerty
deScriPtioN of item (iNScriPtioNS, color, Size, markS, deSigN, School, year, iNitialS, barrel, leNgth)
tyPe
actioN
gauge/caliber
fiNiSh
barrel
amouNt Paid
$
SecoNd StoNe firSt StoNe tyPe metal kt wt geNder Style Size leNgth # StoNeS ShaPe ct wt color # StoNeS ShaPe ct wt color
538.16(1) any personal property pawned with a pawnbroker, whether the pawn is a loan of money or a buy-sell agreement, is subject to sale or disposal if the pawn is a loan of money and the property has not been redeemed or there has been no payment on account made for a period of 90 days, or if the pawn is a buy-sell agreement and the property has not been repurchased from the pawnbroker or there has been no payment made on account within 60 days. the seller or designated purchaser may repurchase the above described for the original purchase price plus storage and handling charges and applicable taxes, if the seller exercises the option on or before the time period agreed from the above date. this paper must be presented at the time of repurchase. buyer is not responsible for loss or damage. all renewals and repurchases must be in cash. i understand that all items not repurchased or renewed within the established time period below will be sold without notices being sent. designated Purchaser _____________________________ repurchase Price 1-30 day $ ______________ 31-60 day $ _______________ _____ day $ ____________ initials of customer _________
total Paid right thumb Print of Seller
dePt. #
coNtrol #
in consideration of the sum listed below, paid in hand and receipt acknowledged by seller, said seller does herein sell, transfer and assign all of his rights, title and interest in the above described property to the dealer. total Paid _____________________________________________________________ initials of Seller _____________________________ i verify that i am eighteen years or older, and i am the rightful owner of the above described property which is being sold or pledged, or that i am entitled to sell or pledge such goods, and that the property is clear of all liens and encumbrances, including liens for past due child support. if proven otherwise, i promise full restitution, and understand that i will be criminally prosecuted to the fullest extent of the law. dealer's representative _____________________________________ Person receiving Property Seller's Signature
___________________________ _________________________________________________ gt-200404, r. 07/08
effective July 1, 1993