This form is for reporting accidents and injuries involving junk guns.

Report Junk Gun Accidents and Injuries

Brandon's Arms is committed to helping prevent accidental deaths and injuries caused by defective and junk guns. Please help us identify these guns by completing this form.

About You

Tell us about yourself and your role in the accident. You may provide information about other people involved below.

I am the gun owner. I am the user of the gun involved. I am the accident victim.

First Name Last Name Email [required] Street City State Country Zip Code Age Phone Number

About the Gun

Brand Model Serial # Caliber All Printing on Gun

About the Accident and/or Injury

Please provide as much detail as possible.

Accident Date Nature of Injury How Injury Occurred Location

Was Accident Reported?

Please indicate if the accident/injury was reported to a law enforcement agency.

What agency accepted the accident/injury report? Report Number

Submit Your Report

Submit the form now if you do not have additional information about the gun owner, user and/or accident victim. Use the fields below to provide additional information about the owner, user or accident victim if they are different than you.

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Gun Owner Information

First Name Last Name Email Street City State Country Zip Code Age Phone Number

Gun User Information

Tell us about who was using the gun at the time of the accident.

First Name Last Name Email Street City State Country Zip Code Age Phone Number

Gun Victim Information

Tell us about the victim.

First Name Last Name Email Street City State Country Zip Code Age Phone Number

Submit Your Report