1
2SCHEDULE – III
Form No. F-A-01
Application form for Fresh Arms License
Write in English and CAPITALS. Use only Blue/Black Ball Point Pen. One character in one Box.
Paste passport
Do not write outside the boxes. SAMPLE How to fill the Form :
B
R
I
J
M
O
H A N
Tick inside the appropriate Box only. Male
Female
size photograph
here
DELHI POLICE
DELHI POLICE
Date of Application
CITIZENS FIRST
CITIZENS FIRST
Licence No.
(ISO 9001:2000 Certified)
–
PART
A Identity of applicant
Mr.
Ms.
1. Name
2. Father’s/Husband’s
/ Mother’s Name :
3. (a) Place of Birth :
(b). Nationality :
4. Date of Birth in Christian era : In Figures (dd mm yyyy) :
(with documentary proof)
In words (capital letters): …………………………………………………………………………………………………..
5. Present Address :
Residing since :
Nearest Police Station of Present address:
Telephone: Office:
Residence:
Mobile:
Fax:
E-mail:_____________________________________________________
6. Permanent Address :
Nearest Police Station of permanent address :
7. Occupation (Professional/Business/Govt. service/Private service/Doctor etc.):
8. Office address:
PART
B Other information of applicant
–
Whether the applicant has been :
b) Whether the applicant’s Licence was ever :
9.
a) Convicted :
Yes
No
Suspended
Yes
No
If yes give the offence(s), the detail and the date of sentence at Col. 13
Cancelled
Yes
No
b) Ordered to execute a bond under Chapter VIII of CrPC (2 of 1974) for
Revoked
Yes
No
keeping the peace or for good behaviour :
Yes
No
If yes, when and by whom and on what account, give details at col. 13
If yes, when and for which period, give details at Col. 13
c) Whether any other member of the applicant’s family is in possession of
c) Prohibited under the Arms Act 1959, or any other law
an arms license: Yes
No
from possessing arms and ammunition : Yes
No
11. Whether the applicant a) is an exemptee : Yes
No
If yes, give details at Col. 13
If yes, give description and serial no (s) of the arms held, at col. 13
10. a) Whether the applicant applied for a licence
b) has a safe place to keep the arms : Yes
No
earlier anywhere in India : Yes
No
12. Whether arrested or involved in any criminal case : Yes
No
If yes, when, to whom and with what result. Give details at Col. 13
If yes, give details at Col. 13
Attention
– please enclose : (1) Four passport size photographs, One to be pasted on the form and other three to be attested on the reverse by
a Gazetted officer;
(2) Attested photocopy of the address proof
i) Ration card / voter’s I-card / passport / Electricity Bill / Water Bill / Telephone Bill / Driving Licence / Property (House) Tax / Tax Return
& PAN Card; or
ii) Posting certificate indicating the residential address of the applicant / recommendation from the commanding / supervisory Gazetted
Officer in case of armed forces personnel, Police and para-military forces only; and
(3) Proof of date of Birth (Please attach any one mentioned below):
Copy of Matriculation Certificate indicating the Date of birth duly attested by a Gazetted officer; or
Copy of the Birth certificate issued by a Municipality Authority or district office of the Registrar of Births & Deaths duly
attested by a Gazetted officer; or
Affidavit sworn before a Magistrate/Notary stating date and place of birth by illiterate or semi-illiterate applicants (specimen
language of the affidavit may be taken from the Delhi Police web site http://www.delhipolice.nic.in or from the Reception
counter of the Licensing Branch, at Police Station Defence Colony, New Delhi; or
Any other proof (Passport / Driving License / PAN Card / Service I-Card for Government employees issued by the Government
Department having Date of Birth / Army Discharge Certificate etc. please specify) ___________________________
st
DCP/Licensing, 1
Floor, P.S. Defence Colony, New Delhi-110049 (E-MAIL : dcp-license@delpol.nic.in)
SCHEDULE – III
Form No. F-A-01
Application form for Fresh Arms License
Write in English and CAPITALS. Use only Blue/Black Ball Point Pen. One character in one Box.
Paste passport
Do not write outside the boxes. SAMPLE How to fill the Form :
B
R
I
J
M
O
H A N
Tick inside the appropriate Box only. Male
Female
size photograph
here
DELHI POLICE
DELHI POLICE
Date of Application
CITIZENS FIRST
CITIZENS FIRST
Licence No.
(ISO 9001:2000 Certified)
–
PART
A Identity of applicant
Mr.
Ms.
1. Name
2. Father’s/Husband’s
/ Mother’s Name :
3. (a) Place of Birth :
(b). Nationality :
4. Date of Birth in Christian era : In Figures (dd mm yyyy) :
(with documentary proof)
In words (capital letters): …………………………………………………………………………………………………..
5. Present Address :
Residing since :
Nearest Police Station of Present address:
Telephone: Office:
Residence:
Mobile:
Fax:
E-mail:_____________________________________________________
6. Permanent Address :
Nearest Police Station of permanent address :
7. Occupation (Professional/Business/Govt. service/Private service/Doctor etc.):
8. Office address:
PART
B Other information of applicant
–
Whether the applicant has been :
b) Whether the applicant’s Licence was ever :
9.
a) Convicted :
Yes
No
Suspended
Yes
No
If yes give the offence(s), the detail and the date of sentence at Col. 13
Cancelled
Yes
No
b) Ordered to execute a bond under Chapter VIII of CrPC (2 of 1974) for
Revoked
Yes
No
keeping the peace or for good behaviour :
Yes
No
If yes, when and by whom and on what account, give details at col. 13
If yes, when and for which period, give details at Col. 13
c) Whether any other member of the applicant’s family is in possession of
c) Prohibited under the Arms Act 1959, or any other law
an arms license: Yes
No
from possessing arms and ammunition : Yes
No
11. Whether the applicant a) is an exemptee : Yes
No
If yes, give details at Col. 13
If yes, give description and serial no (s) of the arms held, at col. 13
10. a) Whether the applicant applied for a licence
b) has a safe place to keep the arms : Yes
No
earlier anywhere in India : Yes
No
12. Whether arrested or involved in any criminal case : Yes
No
If yes, when, to whom and with what result. Give details at Col. 13
If yes, give details at Col. 13
Attention
– please enclose : (1) Four passport size photographs, One to be pasted on the form and other three to be attested on the reverse by
a Gazetted officer;
(2) Attested photocopy of the address proof
i) Ration card / voter’s I-card / passport / Electricity Bill / Water Bill / Telephone Bill / Driving Licence / Property (House) Tax / Tax Return
& PAN Card; or
ii) Posting certificate indicating the residential address of the applicant / recommendation from the commanding / supervisory Gazetted
Officer in case of armed forces personnel, Police and para-military forces only; and
(3) Proof of date of Birth (Please attach any one mentioned below):
Copy of Matriculation Certificate indicating the Date of birth duly attested by a Gazetted officer; or
Copy of the Birth certificate issued by a Municipality Authority or district office of the Registrar of Births & Deaths duly
attested by a Gazetted officer; or
Affidavit sworn before a Magistrate/Notary stating date and place of birth by illiterate or semi-illiterate applicants (specimen
language of the affidavit may be taken from the Delhi Police web site http://www.delhipolice.nic.in or from the Reception
counter of the Licensing Branch, at Police Station Defence Colony, New Delhi; or
Any other proof (Passport / Driving License / PAN Card / Service I-Card for Government employees issued by the Government
Department having Date of Birth / Army Discharge Certificate etc. please specify) ___________________________
st
DCP/Licensing, 1
Floor, P.S. Defence Colony, New Delhi-110049 (E-MAIL : dcp-license@delpol.nic.in)
13. If any of the entry in Col. No. 9 to 12 is ‘YES’, then give details here by writing the particular column no.:
Col. No.
Detail
11(b)
Place where arms/ammunition will be kept –
14. Type of Weapon for which licence is required :
a) NPB
PB
b) Revolver
Pistol
Rifle
Gun (SB/DB)
Others (Pl. specify) __________________
15. Need for the weapon : __________________________________________________________________________
16. Any claim for special consideration : ______________________________________________________________
_______________________________________________________________________________________________
Note :- Against col. No. 15 & 16, the applicant should clearly mention the purpose(s) for which the licence is required – such as : use, requisition,
possession, carrying, manufacture, sale, transfer, repair, convert, proof–test, import, export, transport, self protection, sport, display, destruction of wild
animals which do injury to human beings / cattle, protection of crops and cattle, target practice / shooting, temporary possession as bonafide traveler
visiting India etc.
PART – C Particulars in case of already acquired weapon(s)
17. Details of earlier weapon(s) held :
a) NPB
PB
b) Revolver
Pistol
Rifle
Gun (SB/DB)
Others (Pl. specify) ___________________
________________________________________________________________________________________________
18. Previous Arms License No., if any : ________________________________________________________________
19. Place & route of import or transport : _______________________________________________________________
20. Whether applicant is a bonafide tourist : Yes
No
if yes,
(i)
Country to which the applicant belongs :
(ii)
The probable/actual date of arrival in India :
(iii)
Whether the applicant is prohibited by the laws of
his / her country from having any arm / ammunition:
Yes
No
Note: A bonafide tourist is permitted to bring into India arms and ammunition for sports purpose and in reasonable
quantities only, subject to the conditions specified in Sec. 10 of the Arms Act, 1959 & in Rule 32 of the Arms Rules, 1962.
PART – D For applicant requiring licence for import / export / transport
If the previous sanction of the concerned authority required under Rule 50 of the Arms Rules, 1962 has been obtained, then
the copy of document in support thereof should be attached.
DECLARATION : I hereby declare that the above particulars given in the application are true, complete and correct to the best of my knowledge
and belief. I understand that in the event of any information being found false or incorrect at any stage, I am liable to be proceeded against and
action, taken under the relevant provisions of Arms Act, 1959, the Arms Rules, 1962, and other central enactments or the law for the time being
in force.
Place :
Date :
Signature or Thumb impression of the applicant
(Left Hand T.I. if male and Right Hand T.I. if female)
WARNING : Suppression of any factual information or furnishing of any false or wrong information in the application form in violation of Rule
51- A will render the applicant liable for punishment under Section 30 of the Arms Act, 1959 and revocation of license as per Section 17 (3) of
the Arms Act, 1959.
