Fillable Printable Firearms Licence Application Form - Australia

Firearms Licence Application Form - Australia

Australian Capital Territory

Firearms Registry

ADULT FIREARMS LICENCE APPLICATION

You are required to provide 100 points of identity with your application for a

new licence under this Act.

1. APPLICANT DETAILS Please Use

BLOCK LETTERS in dark pen only.

To be completed by

The applicant for this

Licence.

Family Name

You are required to provide 100 points of identity with your application for a new licence under this Act.

The applicant to

complete.

This information is

required to support your

genuine reason.

Genuine Reasons

(See the Genuine

Reason Guide for further

details

Sport or Target

Shooting: Club Member,

Recreational Hunting or

Vermin Control on rural

land,

(Continued next page)

ACT Firearms Registry

Use Only

Licence Number:

AFP 3001 (1/09) Pg 1 of 6

The applicant to

complete.

1. APPLICANT DETAILS Please Use BLOCK LETTERS in dark pen only.

2. LICENCE CLASS

2.2 What is your Genuine Reason for having a firearm licence?

A B C H

2.1 Select the category of firearm(s) you are applying to be licenced to use and possess?

2.3 What calibre of ammunition will you be using?

AF2009-1 Approved form under ACT Firearms Act 1996 s271

ADULT FIREARM LICENCE

APPLICATION

ACT Firearms Act 1996 - Part 7

1.1 APPLICANT DETAILS

Surname

Given Name(s)

Previous Surname

Previous Given Name(s)

1.2 Have you been known by any other names?

If yes, please provide details:

1.3 RESIDENTIAL DETAILS

Street Name

Suburb

Street Number

Post Code State

1.4 POSTAL ADDRESS (if different from above)

1.5 CONTACT DETAILS

Home Work

Mobile Fax

Street Name

Suburb

Street Number

Post Code State

Yes No

E-mail

Date of Birth

mm yyyy

Employer

The applicant to

complete.

Genuine Reasons

(Continued)

Primary Production,

Vertebrate Pest Animal

Control,

Business or

Employment,

Occupational

Requirements relating

to rural purposes,

Animal Welfare.

If there is insufficient

space to complete a

question, please provide

additional details at the

end of this application.

The applicant to

complete.

It is the responsibility of

the applicant to provide

evidence each year of

participation in club

shooting competitions, if

your genuine reason is

Sport or Target

Shooting. Failure to do

so may result in the re-

fusal of your application.

If there is insufficient

space to complete a

question, please provide

additional details at the

end of this application.

For applicants

applying for a

Category H firearms

licence with a

genuine reason of

Sport or Target

Shooting

For applicants

applying for a

Category A,B

firearms licence

with a genuine

reason of Sport or

Target Shooting or

Recreational

Hunting/Vermin

Control

3.1 Are you a member of an approved shooting club

that conducts competitions or activities requiring the

use of a firearm for which the licence is sought?

If yes please provide the following details and complete 3.3, 3.4 & 3.5:

Membership number

Club Name

3.2 Are you an active member of an approved shooting or

hunting club that conducts competitions or activities

requiring the use of a firearm for which the licence is

sought?

If yes please provide the following details and complete 3.3, 3.4 & 3.5:

3.3 How often do you attend the club?

3.4 Have you participated in any approved club competitions or

hunting activities since your last application?

If yes please provide name, location and date of the competitions and/or hunting activities you

participated in during the previous year.

2. LICENCE CLASS (continued)

3. CLUB ASSOCIATIONS

AFP 3001 (1/09) Pg 2 of 6

Membership number

Club Name

What state was this licence issue

Yes No

You must provide proof of the successful completion of an approved firearms safety training

2.7 If you answered yes to either 2.5 or 2.6, please provide the reason(s) why.

2.8 Have you completed the relevant firearms safety training?

(All applicants that have not held a previous ACT Firearms Licence)

2.5 Have you ever been refused a firearms licence?

2.6 Have you ever had a firearms licence cancelled or suspended?

If yes, what was your previous firearms licence Number?

2.4 Have you ever held a firearms licence in the ACT or another state or territory in Australia?

If no, move to 2.5.

Yes No

What category of firearm(s) were you licenced for?

C D H

Yes No

NSW VIC TAS QLD NT SA WA ACT

What state was this licence issued in?

AF2009-1 Approved form under ACT Firearms Act 1996 s271

If no, go to 3.2

If no, go to 4.1

ADULT FIREARM LICENCE

APPLICATION

ACT Firearms Act 1996 - Part 7

AFP 3001 (1/09)

Pg 3 of 6

Club official to

complete

In completing this section

the club official certifies

that the club information

given by the applicant is

true and correct as

recorded in the

appropriate club records.

3. CLUB ASSOCIATIONS (Continued)

The applicant to

complete

This information is used

to assess your suitability

for a firearms licence.

If there is insufficient

space to complete a

question, please provide

additional details at the

end of this application.

4. PERSONAL HISTORY

3.5 Club Official Details

Surname

Given Name(s)

Position held with in the club

Signature of Club Official

Club Stamp

4.1 Do you have any physical and/or mental disability which may render you unfit

to use or be in possession of a firearm?

If yes, please provide details:

4.2 Have you ever suffered or received treatment for any of the following:

Mental and or emotional illness?

Illicit drug use or dependence?

Excessive alcohol consumption?

Fits, blackouts or dizziness?

Serious head injuries?

Any other condition not previously mentioned?

If you answered yes to any of 4.2 please provide details:

4.3 Have you in the last 10 years been convicted of an offence?

If yes please provide details:

4.4 Have you in the last 10 years entered into a recognisance to keep the peace

or to be of good behaviour?

If yes please provide details:

Yes No

Date

dd mm yyyy

AF2009-1 Approved form under ACT Firearms Act 1996 s271

ADULT FIREARM LICENCE

APPLICATION

ACT Firearms Act 1996 - Part 7

AFP 3001 (1/09) Pg 4 of 6

The applicant to

complete

This information is used

to assess your suitability

for a firearms licence.

If there is insufficient

space to complete a

question, please provide

additional details at the

end of this application.

4. PERSONAL HISTORY (Continued)

AF2009-1 Approved form under ACT Firearms Act 1996 s271

4.5 Are you an Australian citizen?

4.6 If no, when did you arrive in Australia?

4.8 Are you a permanent resident of Australia?

4.7 What is your country of birth?

Yes No

dd mm yyyy

Yes No

4.9 Are you in Australia on a Visa?

4.10 What type of Visa do you hold?

4.11 What is the expiry date of your Visa?

4.13 Have you ever been refused entry into or deported from Australia?

If yes please provide details:

4.12 Have you ever been refused a Visa?

If yes please provide details:

4.14 Do you have a passport?

If yes, what is the passport number?

What is the country of issue?

4.15 Do you have a firearms licence issued by another country?

If yes, what is the firearms licence number?

What is the country of issue?

Yes No

dd mm yyyy

Yes No

If no, go to 4.13

If no, go to 4.15

If no, go to 5.1

If yes, go to 5.1

ADULT FIREARM LICENCE

APPLICATION

ACT Firearms Act 1996 - Part 7

Australian Capital Territory

Firearms Registry

ADULT FIREARMS LICENCE APPLICATION

You are required to provide 100 points of identity with your application for a

new licence under this Act.

1. APPLICANT DETAILS Please Use

BLOCK LETTERS in dark pen only.

To be completed by

The applicant for this

Licence.

Family Name

.............................................................................................................................................................................

Upon completion of this form please submit it in person at the ACT Firearms Registry.

AFP 3001 (1/09) Pg 5 of 6

The applicant to

complete.

Firearms and

ammunition must

be stored at an

address with in

the ACT.

5. STORAGE

6. APPLICANT DECLARATION

The applicant to

complete.

5.1 How will your firearms be stored?

5.2 How will your ammunition be stored?

5.3 What address (in the ACT) do you wish to nominate as the registered address to store your

firearm(s) and ammunition?

Signature of person making the declaration

6.1 APPLICANT DECLARATION

DECLARATION

I declare that the answers I have given on this application are true and correct to the best of my knowledge.

I understand that it is an offence to deliberately make a false or misleading statement. I agree to abide by

the ACT Firearms Act 1996. I also consent to Police making any enquiries necessary to assess this

application.

dd mm yyyy

ADDITIONAL INFORMATION

AF2009-1 Approved form under ACT Firearms Act 1996 s271

ACT Firearms Registry

GPO Box 401, Canberra ACT 2601

Phone: 02 62567777 Fax: 02 62567758

Email: actfirearmsregis[email protected]

ADULT FIREARM LICENCE

APPLICATION

ACT Firearms Act 1996 - Part 7

Australian Capital Territory

Firearms Registry

ADULT FIREARMS LICENCE APPLICATION

You are required to provide 100 points of identity with your application for a

new licence under this Act.

1. APPLICANT DETAILS Please Use

BLOCK LETTERS in dark pen only.

To be completed by

The applicant for this

Licence.

Family Name

AFP 3001 (1/09) Pg 6 of 6

ACT Firearms Registry Use Only.

Signature of Approving Officer

dd mm yyyy

Licence Issue Date — No

earlier than 28 days from the

day after the application date.

NOT APPROVED APPROVED

Licence Conditions

Date of Application

Amount $

Receipt Number

Receipt

Date

ID Verification

Passport Drivers Licence ACT Firearms Licence

dd mm yyyy

ID Type

Printed Name and Badge Number

Licence Issuer

Signature of Issuing Officer

Printed Name and Badge Number

Licence Receiver

Signature of Receiver

Printed Name

dd mm yyyy

Agent Applicant

dd mm yyyy

Approval Date

AF2009-1 Approved form under ACT Firearms Act 1996 s271

Primary ID Number

Secondary ID

ADULT FIREARM LICENCE

APPLICATION

ACT Firearms Act 1996 - Part 7