Jus123 Form PDF Details

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QuestionAnswer
Form NameJus123 Form
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namescertify, PAWNBROKER, JUS, DOJ

Form Preview Example

State of California

JUS 123

(orig. 2/09)

PAWNBROKER/SECONDHAND DEALER REPORT

One Copy Each to Law Enforcement Agency, DOJ & Dealer

Department of Justice

Page 1 of 1

Pursuant to Business and Professions Code section 21628 and Financial Code 21208

C

 

 

 

U

Last Name

First Name

Middle Initial Date of Birth

SI

T

N

 

 

 

OR

 

O

F Driver's License Number

 

Issuing State

 

California Identification Card Number

MO

E

R

Address

City

State

 

 

 

 

SI

T

N

License Number

 

Police Division

 

O

F

 

 

 

 

R

O

 

 

 

 

E

 

 

Store Name

 

Address

City

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Article

 

 

Brand Name

 

T

 

 

R

 

 

Serial Number

Model

 

A

 

 

NI

S

T

Transaction Date (MM,DD,YEAR)

Loan/Buy Number

A

E

 

 

 

 

 

 

 

C

M

 

 

Pawn

 

Buy

 

Consign

T

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

IProperty Description (One Item Only, Size, Color, Material, etc…)

O

N

Amount

Trade

 

 

 

Check One

F

 

 

 

 

 

 

 

Make

 

 

I

 

 

Handgun

 

 

 

 

 

 

 

 

R

O

 

(Pistol)

 

 

 

E

N

 

 

 

 

 

Model

 

 

 

A

L

 

Rifle

RY

MSerial Number

S

Shotgun

Cal/Gauge

Check One

Revolver

Semi Automatic

Bolt Action

Lever Action

Pump

Single Shot

DBL Barrel

Over/Under

X

CUSTOMER'S SIGNATURE I certify under penalty of perjury that to my knowledge and belief the

information above is true and complete and I am the owner, or have the authority of the owner, to sell or pledge the property.

X

STORE PERSON'S SIGNATURE

Customer's Right Thumb Print

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This PDF form needs some specific information; in order to ensure correctness, please be sure to heed the subsequent steps:

1. Fill out the certify with a number of essential blanks. Note all the information you need and be sure absolutely nothing is left out!

jus123 writing process outlined (stage 1)

2. Now that the previous array of fields is complete, you need to add the required specifics in T R A A N I S T Transaction Date, Pawn, LoanBuy Number, Amount, Consign, Trade, Property Description One Item Only, Buy, Make, F I R O E N Model A L R Y M S, Serial Number, CalGauge, Check One, Check One, and Handgun Pistol so that you can move on to the third part.

Check One, Check One, and Serial Number inside jus123

When it comes to Check One and Check One, be certain that you do everything correctly in this section. These two are the most significant fields in the page.

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