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RepublicofthePhilippines DepartmentoftheInteriorandLocalGovernment NATIONALHEADQUARTERS,PHILIPPINENATIONALPOLICE OFFICEOFTHECHIEF,PNP Secretariat,PermittoCarryFirearmsOutsideofResidence CampCrame,QuezonCity

2x2 Photo Taken Within Six (6)Months From Date of Application

PERMIT TO CARRY FIREARMS OUTSIDE OF RESIDENCE (PTCFOR)


New PTCFORCTRLNO: Renewal

DATEFILED:
PersonalData

LastName: FirstName:

FEES: P150.00ONLY
Presidentialappointeesand highrankinggovernment officials Electedofficial(Governorup) PNP/AFP/Reservist/(Officers) BJMP SeniorCitizens Justices

MiddleName: Qualifier: TIN: DateofBirth:


Qualification

Profession: OfficeAddress: OfficeTel.No:


HomeAddress

NameofOffice:

P1,150.00ONLY
Electedofficials(Vice Governordown) BFP/CoastGuard/Custom Police/AirportPolice Sheriff

No./Street: Region: TelephoneNo.:

City/Town/Province: CellphoneNo:
FirearmsData
Right Thumb Mark

P4,150.00ONLY
Businessmen/Private Individuals/Professionals GovernmentEmployees

AdminCtrlNo: Kind: Make: Caliber:

NOTE:FileyourApplications withthePTCFORSecretariat.

SerialNumber:

PLEASEDONOTDEALWITHFIXERS.

REQUIREMENTS: NEW APPLICANT 1) Two (2) ID Pictures (2x2) Taken not earlier than six (6) months from the date of filing. 2) Threat assessmentfromthelocalpolicestation3)Photocopyoffirearmslicense.4)DI(DirectorateforIntelligence),R2orWAIS,CIDGClearance. RENEWAL1)Two(2)IDPictures(2x2)Takennotearlierthansix(6)monthsfromthedateoffiling.2)Affidavitshowingthatthepersonisstill underthreat.3)PhotocopyofPreviousPTCFORCARD4)PhotocopyofFIREARMSlicense.

AFFIDAVITOFUNDERTAKING I HEREBY CERTIFY that all statements herein are true and correct. I further certify that I have no criminal conviction or pendingcriminal/administrativecasebeforeanycourtoflaworadministrativebodyasofthisdate.Neitheristhefirearmdescribed hereininvolvedinanycasebeforeanycourtoflaworadministrativebody.DuringthevalidityofmyPTCFOR,Iundertaketoinform theC,PNPwithinfive(5)daysfromknowledgeofanycasethatmaybefiledagainstme. Signature SUBSCRIBED AND SWORN to before me this ______ day of ________________20___applicantexhibitedtomehis/herattachedproofofidentity. RECOMMEND APPROVAL / DISAPPROVAL JOHN DANGAYO LUGLUG Police Superintendent Chief, PTCFOR Secretariat

NOTARY PUBLIC

APPROVED / DISAPPROVED ATTY RAUL M BACALZO, Ph. D. Police Director General Chief, PNP
PTCFOR Form No.1 Effective November 17, 2010 PTCFOR CONTACT NR 723-0401 LOC- 5265

____________________ Date PDG(ATTY)RAULMBACALZO,Ph.D. Chief,PhilippineNationalPolice CampCrame,QuezonCity Attention: ATTYDARWINCLARKBPAZ PoliceChiefInspector Chief,Processing,PTCFORSecretariat DearSir: May I respectfully request for the issuance of a Permit to Carry Firearms Outside of Residence(PTCFOR)formylicensedfirearmdescribedasfollows: Kind: Make: Caliber: SerialNumber: FALicenseAdminControlNo.: Presently,Iamdesignatedasthe____________________________________________ of __________________________________________________ and a firearm holder with no violations committed on any of the rules and regulations on firearm laws as implemented by thePNP. Due to the nature of my position, office or calling, my life has been the subject of severalthreatsbroughtaboutbytheenforcementofmyfunctionsandresponsibility,whichI havetouphold.Attachedaredocumentsrequiredtosupportmyapplication. Iwouldbeverygladtocomplywithotherrequirementsincludingapersonalinterview, asmayberequiredbytheChief,PNPorhisauthorizedrepresentative. IfurtherrecognizetheauthorityvestedintheChief,PNPtorevoke,cancelsuspendor nullifytheissuedPTCFORatanytime. Lastly,IundertaketocomplywithallPNPrules,regulationsandguidelinesknowingfully wellthatthegrantingofthePTCFORisamereprivilege. Respectfullyyours, Applicant ContactNo. MailingAddress
PTCFOR Form No. 2 Effective November 17, 2010

REPUBLIC OF THE PHLIPPINES PROVINCE OF _______________

AFFIDAVIT
I, _____________________________________________ of legal age,

____________ citizen, married / single / widower with permanent address at ____________________________________________________________ after having been duly sworn to in accordance with law do hereby depose and say;

That, I am a registered owner of firearms specified as follows: Kind: Make: Caliber: Serial Number: FA Lic Admin Control No :

That I am a ________________________________________ and due to the nature of my work/job my life has been the subjects of several threats, and

That, I am executing this affidavit to support my request for the approval of my PTCFOR.

That, to attest the truthfulness of the statements, I hereunto affixed my signature this ______ day of _______________ 20___ at ________________________

(Affiant)

SUBSCRIBED AND SWORN TO before me this ______ day of ______________ 20___ at _______________________________________ applicant exhibited to me his / her Community Tax Certificate No. _____________ issued at _________ 0n _______
Doc No. Book No. Page No. Series of ____________ ____________ ____________ ____________ NOTARY PUBLIC