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1. I am currently over twenty-one (21) years old
2. By selling or delivering ammunition to me, Ammo Supply Warehouse is not violating any state or local law or ordinance.
3. I am not under indictment for and have never been convicted in any court of a crime punishable by imprisonment for over one year
4. I am not a fugitive from justice
5. I am not an unlawful user or addicted to any controlled substance
6. I have not been adjudicated as a mental defective and I have not been committed to any mental institution
7. I am not an illegal or unlawful alien
8. I have never been and I am not expected to be discharged from the Armed Forces under dishonorable conditions
9. I have not renounced my U.S. citizenship
10. I am currently not subject to a restraining order of any kind
11. I have never been and I am not expected to be convicted in any court of a misdemeanor crime of domestic violence