ARMS LICENCE FORM

Application for Grant of New Arms License

INSTRUCTION
1. 2. 3. 4. 5. 6. A separate Licence form should be fled for each weapon. Form should be filled in English using capital letters. Use a ballpoint pen with Blue or Black ink. Submit a photocopy of NIC with the application form. In case of weapon retainer fill a separate form of Retainer. All photographs should have blue background. The name and NIC Number of the Licencee must be written on backside of their respective photographs.

SECTION I PERSONAL INFORMATION

Name of Applicant Fathers Name Present Address of Applicant ( Line 1) Present Address of Applicant ( Line 2) City Province / State Permanent Address of Applicant ( Line 1) Permanent Address of Applicant ( Line 2) City Province / State Police Station Place & No. Domicile N. I. C. No. Post Code / Zip Code Telephone (Area Code +No) Fax (Area Code +No) Post Code / Zip Code Telephone (Area Code +No) Fax (Area Code +No)

Detail of Occupation
Govt Service Private Simi Govt Trade & Industry Corporation Commerce Armed Forces Agriculture Autonomous Body Prof. / Consultants Others Others

In Case of Government Servant, Name of Department National Tax No.

Qualifications

Monthly Income

BPS

SECTION II LICENCE APPLIED FOR

Type of weapon applied for
Pistol Revolver Shotgun Rifle Others

Weapon Caliber Bore Reasons for need of Arms Licence Do you already possess Weapons?

Limit of Cartridges requested for

Sports Protection Yes Display No Others

(If Yes, submit details on the Information for Currently Hold Weapons form along with this application). Do you claim exemption from the payment of licencee fee? If Yes, give reasons Yes No

SECTION III DECLARATION

I hereby declare and certify that the above statements are true to the best of my knowledge and belief, and I understand that furnishing false or fabricated information will result in summary rejection of my application and in criminal prosecution.
Past One Photograph

1.5 x 2 Blue Background & Attached Two

Signature

Thumb Impression

Official Use Only

FOR OFFICIAL USE ONLY SECTION IV RECOMMENDATIONS

RECOMMENDATIONS OF THE DISTRICT POLICE OFFICER / TOWN POLICE OFFICER_ _____
(In case of Government Servant recommendations of the Head of Department)

a. b.

Certified that the details given above are correct in the best of my knowledge and belief. I recommend / not recommend of the issuance of licence.

SIGNATURE NAME OFFICIAL SEAL DESIGNATION

___________________________________ ___________________________________ ___________________________________

RECOMMENDATION OF THE DISTRICT COORDINATION OFFICER

____________________________________________________________________ __________________ Decision / Comments of Home Department Official Seal

Official Seal of Home Department

LICENCE No._____________________________ DATE OF ISSUE __________________________ TYPE OF WEAPON________________________ QUANTITY OF AMMUNITION ALLOWED_______ DISTRICT COORDINATION OFFICER