Exhibit_04__Firearm_Certification_FO.pdf
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- TIRMS-17-R-00010
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EXHIBIT 04 - FIREARMS CERTIFICATION
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Exhibit 4
FIREARM QUALIFICATION CERTIFICATION
CONTRACT NUMBER: ____________________________________
ARMED SECURITY OFFICER:______________________________
Print Name
RANGE LOCATION /NAME: ________________________________
FIREARM MAKE/MODEL/SER # _____________________________
COURSE OF FIRE:_______________ TARGET:_________________
DATE: _______________________ TIME: ____________________
INSTRUCTOR: ___________________________________________
(Signature)
IRS REPRESENTATIVE:____________________________________
(Signature)
SCORE: ________________________ EXPIRES: ________________
(Date)
(THIS CARD MUST BE CARRIED AT ALL TIMES WHILE ON DUTY)
DEPARTMENT OF THE TREASURY
INTERNAL REVENUE SERVICE
WASHINGTON, DC 20224
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