Use this template/form as an Affidavit Stating Ownership of an Acceptable Gun Safe or Lock Box in the State of California
Text version of this Form
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Affidavit Stating Ownership of an Acceptable Gun Safe or Lock Box
The _________________________ ________________________ gun safe that I possess meets
the standards set forth by section 977.50 of the California Code of Regulations (check all that apply):
___ 1. A gun safe that is able to fully contain firearms and provide for their secure storage, and is listed as an
Underwriters Laboratories (UL) Residential Security Container. A UL Residential Security Container will bear a
mark identifying itself as meeting the UL Residential Security Container requirements.
___2. A gun safe that meets all of the following standards:
(a) Shall be able to fully contain firearms and provide for their secure storage.
(b) Shall have a locking system consisting of at minimum a mechanical or electronic combination lock. The
mechanical or electronic combination lock utilized by the safe shall have at least 10,000 possible
combinations consisting of a minimum three numbers, letters, or symbols. The lock shall be protected by a
case-hardened (Rc 60+) drill-resistant steel plate, or drill-resistant material of equivalent strength.
(c) Boltwork shall consist of a minimum of three steel locking bolts of at least ½ inch thickness that intrude
from the door of the safe into the body of the safe or from the body of the safe into the door of the safe,
which are operated by a separate handle and secured by the lock.
(d) A gun safe shall be capable of repeated use. The exterior walls shall be constructed of a minimum 12
gauge thick steel for a single-walled safe, or the sum of the steel walls shall add up to at least .100 inches
for safes with two walls. Doors shall be constructed of a minimum one layer of 7-gauge steel plate
reinforced construction or at least two layers of a minimum 12-gauge steel compound construction.
(e) Door hinges shall be protected to prevent the removal of the door. Protective features include, but are not
limited to: hinges not exposed to the outside, interlocking door designs, dead bars, jeweler’s lugs and active
or inactive locking bolts.
I certify that the safe will accommodate the firearm(s) I am taking delivery on ________________. I declare
under penalty of perjury that all statements made in this affidavit are true and complete.
This section is to be used when a receipt for the gun safe is not available
_____ I own and possess the gun safe referenced above.
Affidavit Stating Ownership of a DOJ-Certified Lock Box
(This affidavit applies only to lock boxes listed on the Roster of Firearms Safety Devices Certified for Sale and is not valid for
any other type of firearms safety device. Firearms Dealer: This affidavit is only valid when accompanied by a receipt.)
I own and possess a _________________________ ________________________ lock box that is listed on the
Roster of Firearms Safety Devices Certified for Sale that will accommodate the firearm(s) I am taking delivery
of on ________________. The DOJ-certified lock box was not presented at the time the firearm was acquired
because the lock box was permanently affixed at some other location or too large and/or heavy to present at the
time of acquisition. I declare under penalty of perjury that all statements made in this affidavit are true and