The image shows a close-up of a tax paid transfer and firearm form. The form is divided into two sections. The top section is titled "Tax Paid Transfer and Firearms" and has a black and white image of a dollar bill with the words "Havoc-45" written on it. Below the image, there is a description of the form, which states that the form is for the National Firearms Act Branch of the United States.

The bottom section has a list of details about the form. There is also a note that states that it is a type of transfer that can be used to transfer firearms from one state to another. The note also mentions that the transfer is for a tax-paid firearm and that it can be transferred to another state. There are also two red stamps on the right side of the image that appear to be from the same state.