AFRICAN POLICE SERVICE - gov · - STAATSKOERANT, 26 MAART 2004 No. 26156 125 SAPS 517(a) SOUTH AFRICAN POLICE SERVICE APPLICATION FOR A FURTHER COMPETENCY CERTIFICATE Seclion 9(6)(a)

STAATSKOERANT, 26 MAART 2004 No. 26156 125 - SAPS 517(a)

SOUTH AFRICAN POLICE SERVICE

APPLICATION FOR A FURTHER COMPETENCY CERTIFICATE Seclion 9(6)(a) of the Firearms Control Acl. 2000 (Act No 60 of 2OM))

OFFICIAL DATE STAMP

I DATE RECENED

I I I .... I I I Name in block letters I

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

................................................................. Signature of CFR officer '' Officer code " Name in block letters

................................................................. l6 Signature of CFR officer " Officer code '' Name in block letters

Page 1 of 6

126 No. 261 56 GOVERNMENT GAZETTE, 26 MARCH 2004 - SAPS 51 7(a)

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1 NATURAL PERSON’S DETAILS I G i l d e n t i t i c a t i o n (Indicate with an X) I

* Proof of permanent residence must be submitted, if an applicant is not a SA citizen.

Page 2 of 6

STAATSKOERANT, 26 MAART 2004 No. 26156 127

SAPS 517(a)

I OTHERINFORMATION 1

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1:!8 No. 26156 GOVERNMENT GAZETTE, 26 MARCH 2004 - SAPS 517(a)

f5

15.1

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15.5

15.7

16 DECLARATION BY APPLICANT

1 am aware that it is an offence in terms of section 120 (9)(f) of the Firearms Control Act, 2000 (Act No 60 of 2000), to make a false statement in this application.

Note:

The requirements of the photo:

- The photograph must be in colour and may not exceed the border. - The photo must be the size of a standard passport photograph. - The photo must be a full front view of the head and shoulders of the

- The background of the photo must be plain. - The applicant may not be wearing a hat or sunglasses on the

- The applicant's name and identification number must be written

applicant.

photograph.

on the back of the photograph before it is affixed on the application form.

- The applicant must sign in black ink. - The signature may not exceed the border.

- The fingerprint should not be rolled and must be a fiat impression. - The whole finger must be pressed down on the sheet.

2

5 f i Name of applicant in block letters

I I Name of police official in block letters ' Rank of police official in block letters

8 PARTICULARS OF POLICE OFFICIAL DEALING WITH APPLICATION

9 PARTICULARS OF WITNESS

Name of witness in block letters

9 2 1 - 1

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

Fingerprint designation

3

I. I Rank of witness in block letters

8.7.

Persal number of police official

8.4 ................................................................. Signature of police official

9.2 1 Persal number of witness

9.4 ................................................................. Signature of witness

Page 4 of 6

261 5 6 4

STAATSKOERANT, 26 MAART 2004 No. 26156 129 - SAPS 51 7(a)

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

: Signature of interpreter

Rank of police official in block letten(if applicable)

16 I Penal number of police ofkial(if applicable)

6

.................................................................. Signature of parenffguardian

03-1 19282-5

Page5of 6

261 5 6 5

1301 NO. 26156 GOVERNMENT GAZETTE, 26 MARCH 2004

SAPS 517(a)

3 1 I LI Name of Designated Firearms Offtcer in block letters

5w Rank of Designated Firearms Officer in block letters

’ II Signature of Designated Firearms Officer

... ..... . .. .-. ... ..,.. .... .. .

B

Persal number of Designated Firearms Officer

Page6of 6

STAATSKOERANT, 26 MAART 2004 No. 261 56 131

SAPS 51 7(b)


APPLICATION FOR A DUPLICATE LICENCE, PERMIT,.CERTlFlCATES OR AUTHORIZATION FOR LOST, STOLEN AND DEFACED LICENCES

Section 29(2), 44(2), 58(2), 72(2) and 82(2) of the Firearms Control Act, 2000 (Act No 60 of 2000)

DATE RECEIVED

i

1.1

1.2

1.3

I .4

2

2.1

2.2

2.3

2.4

2.5

2.6

2.7

2.8

continue

Page 1 of 5

132: No. 26156 GOVERNMENT GAZETE, 26 MARCH 2004

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SAPS 517(b)

10 DETAILS OF FIREARM

In case of a licence, temporary authorization to possess a firearm or an imporkxport permit the following particulars must be submitted

Page2of 5

STAATSKOERANT, 26 MAART 2004 No. 26156 133 - SAPS 517(b)

Firearm component type:

I NATURAL PERSON’S DETAILS I 1.1

1.2

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I S

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JURISTIC PERSON’S DETAILS

I OTHER BODIES 1

1 RESPONSIBLE P!&XIN’S DETAILS I ~~~~

Page 3 of 5

134 No. 261 56 GOVERNMENT GAZETTE, 26 MARCH 2004 - SAPS 517(b)

Note:


- The photograph must be in colour and may not exceed the border. - The photo must be the she of a standard passport photograph. - The photo must be a full front view of the head and shoulders of the



applicant.

photograph.

on the back of the photograph before it is affuted on the application form.

- The applicant must sign in black ink. - The signature may not exceed the border. - The whole finger must be pressed down on the sheet. - The fingerprint should not be rolled and must be a flat impression.

2

PHOTO

. . . . . . . . . . . . . ,,..,̂ . . . . . . . . . . . . . . . . ~,.. . . . . . . . . . . . . . . . ., ,1 ..... ,,, . . . . . . Signature


I( Name of applicant in block letters

I

G R S OF POLICE OFFICIAL DEALING WITH APPLICATION 1

*.' Id Name of police official in block letters

II Rank of police official in block letters

E A R S OF WITNESS

% Name of witness in block letters

9.1 I- Rank of witness in block letters

8.2

Persal number of police official

0.4

............................................................... Signature of police official

9.2 1 Persal number of witness

9.4

Signature of witness

Paye4of 5


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e

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1 3

15

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SAPS 517(b)

1 Signature of interpreter

I I Rank of police official in block letters (if applicable)

16 I I I I I I - I 1 Persal number of police official (if applicable)

9 Name of police official in block letters

e Rank of police official in block letters

I - In ................... j:j_ ......................... < < ~ [ ~ ~ @ j ....... !.........X.. ..... :.. ..... 1 :f’”(.:,:.:’,:,:,~..’.

6

.................................................................. I Signature of police official Persal number of police official

Page 5 of 5

136 No. 26156 GOVERNMENT GAZETTE, 26 MARCH 2004 - SAPS 517(c)


APPLICATION FOR LICENCE ISSUED TO PARTICULAR CATEGORIES OF PERSONS - DEALERS, MANUFACTURERS OR GUNSMITHS

Section 34.48 and 62 of the Firearms Control Act. 2000 (Act No 60 of 2000)

I ' Application reference No I I I I 1 I I [ I

L . 1 DATE RECEIVED

I t I I .........

' Sianature of miice official 'I ' Name in block letters

................................................................. ' Signature of CFR officer '' -' Officer code l1 Name in block letters I

I.. ................................................................................................................................................................................................ I

I I I ................................................................. I l6 Signature of CFR officer ' I Officer code '* Name in block letters

Page 1 of 6

STAATSKOERANT, 26 MAART 2004 No. 26156 137 - :SAPS 517(c)

' I Details of competency certificate

FSpecify;ype of licence which is being applied for (Indicate with an X )

6.1

6.2

6.3

6.4

6.5

' EL PERSON'S DETAILS I

9

'I4 PERSON'S DETAILS 1

2o IRESPONSlBLE PERSON'S DETAILS 1 21

22

23

2.4

2!5

Page 2 of 6

7 38 No. 261 56 GOVERNMENT GAZETTE, 26 MARCH 2004 - SAPS 517(c)

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F N A T T U R E S OF RESPONSIBLE PERSON I 32

. . . . . . . . . . . . . . . . . . .. . . . . . . . , . . . . . . . . . . . . . . . . . .. . Signature of responsible person

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Signature of responsible person

Page3of 6


SAPS 517(c)

41

42

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

L. .................................................................................................................................................................................................. ..................................................................................................................................................................................................

Date of commencement of business

43 I DECLARATION BY APPLICANT I I am aware that it is an offence in terms of Section 120 (9)(f) of the Firearms Control Act, 2000 (Act No 60 of 2000), to make a false statement in this application.

Note:


- The photograph must be in colour and may not exceed the border. - The photo must be the size of a standard passport photograph. - The photo must be a full front view of the head and shoulders of the



applicant.

photograph.

on the back of the photograph before it is affixed on the application form.

- The applicant must sign in black ink. - The signature may not exceed the border. - The whole finger must be pressed down on the sheet. - The fingerprint should not be rolled and must be a flat impression.

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

I. I Name of applicant in block letters

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

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


Page 4 of 6

140 No. 261 56 GOVERNMENT GAZETTE, 26 MARCH 2004

SAPS Eil7(c)

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F i OF POLICE OFFICIAL DEALING WITH APPLICATION I I I 8.2

Name of police official in block letters Persai number of police official

I I Rank of police official in block letters

0.4

................................................................. Signature of police official

PARTICULARS OF WITNESS

I Name of witness m block letters

I Rank of witness ir; block ietters

9.2 I I I I I I I - I J Persal number of witness

9.4

................................................................. Signature of witness

.............................................. Signature of interpreter

1 Rank of police official in block letters(if applicable)

................. li

z:.:. .. .:.:...<.:.:*:::<; c,:::w-...:.:,y..: ..... *,&&gg

15 I Persal number of police official (if applicable)

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

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

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

Ptge 5 of 6

STAATSKOERANT, 26 MAART 2004 No. 261 56 141

SAPS 51 7(c)

1

5 ~;;;~:;::*>*~.~$: :::$B&g$;:,:$ 2.: ........... :.:. ..: ...... .? .... :(.:<.: .... I I 1 - 1 I 1 - 1 I 1 Name of Designated Firearms Officer/Staiion Commissioner in block letters

7

Rank of Designated Firearms OfficerMation Commissioner in block letters

9

.................................................................. Signature of Designated Firearms Officer/Station Commissioner

10 1 Penal number of Designated Firearms Officer/Station Commissioner

Page 6 of 6

142 No. 26156 GOVERNMENT GAZETTE, 26 MARCH 2004 - SAPS 517(d)

APPLICATION TO

OFFICIAL DATE STAMP

DATE RECEIVED


MANUFACTURE A NEW FIREARM OR AMM IUNlTlON TYPE

I Application reference ND

.............. ............................................................................................................. ............ :. .... :. ::9:*:.,.,:.:.:.: $$:;s3;;; -

.:.:.'. .... :.:.: .... ............................................................... $@???;: NO : . ., . . '.':LI '(.,.:.:'. ,:,::,

.................... <... .... x.:.:. I._ ,-... 1. -._ YEAR

I I

I I I I I I

Name in block letters I

........ ' Signature of CFR officer lo Officer code Name in block letters

................................................................. l 6 Signature of CFR officer '' Ofticer code Name in block letters

Page 1 of 6


SAF’S 51 7(d)

’ [NATURALRERSON’S DETAILS 1 2

3

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I O

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1s

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1 JURISTIC PERSON’S DETAILS 1

RESPONSIBLE PERSON’S DETAILS

’ Proof of permanent residence must be submitted. if an applicant is not a SA citizen

PageZof 6

1 4 4 No. 26156 GOVERNMENT G A Z E T E , 26 MARCH 2004

SAPS 517(d)

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E PROPOSED TYPE OF FIREARM I

1 ................................................... ~

P a g e 3 o f 6

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STAATSKOERANT, 26 MAART 2004 No. 26156 145 - SAPS 517(d)

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G O ; PROPOSED N P E OF AMMUNITION I

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

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

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

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

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

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

~~ ~

DECLARATION BY APPLICANT

I am aware that it is an offence in terms of section 120 (9)(fJ of the Firearms Control Act, 2000 (Act No 60 of2000), to make a false statement in this application.

Id Name of applicant in block letters

................................................................. Signature of applicant

03-1 1 9 2 8 2 4

Page4of 6

26 1 56--6

146 No. 26156 GOVERNMENT GAZETTE, 26 MARCH 2004

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6.1

6.3

7

7.1

7.3

1

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5

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8

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Fingerprint deslgnation

Right index I 1 fingerprint of applicant

1 F

Name of applicant in block letters

I PARTICWARS OF POLICE OFFICIAL DEALING WITH APPLICATION ~ I -

II 6.2

Name of police official in block letters I I I I I I I I - I 1

Persal number of Dolice official

Rank of police official in block letters

("LARS OF WITNESS

6.4

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Signature of police official

7.2

Name of witness in block letters

7.4

Rank of witrless in block letters

I I I I I I I I - I I Persal number of witness

Signature of witness

13

Signature of interpreter

l5 LI Rank of police official in block letters (if applicable)

16 I I I I I - I I Persal number of police official (if applicable)

Page5of 6


... I

................................................................................................................................................................................................ I

................................................................................................................................................................................................ I

1 Name of Desigllated Firearms Officer/Station Commissioner in block letters

, ~ ~ : l i i l ~ . ~ ~ ~ ~ r.P,&g33 >I.. , .............. ......... ... ..._,......

Rank of Designated Firearms Officer/Station Commissioner in block letters

8

.................................................................. Signature of Designated Firearms OfficdStation Commissioner

9

Persal number of Dwianated Firearms Officer/Station Commissioner -

Page 6 of 6

148 No. 26156 GOVERNMENT GAZElTE, 26 MARCH 2004

SAPS 517(e)


APPLICATION FOR RENEWAL OF LICENCE(S) IN TERMS OF THE PREVIOUS ACT

(Transitional provisions)

I DATE RECEIVED

I I

I] I I I 1 - I t ~~~~~~~~~,~~

3WA.. ......... :. ., ...................... .. ., ......... .,.$.:.:.'.:. I I 1 - 1 I I ........................

I I i I I I

Name in block letters I

................................................................. Sionature of decidina officer 'O Officer code " Name in block letters

DJ I I ' I - I ....... , ~ ~ . ~ ~ ~ ~ ~ ~ ~ ~ ~

......................................... .................................................. IBli..< 1 - 1 I I

................................................................. l6 Signature of deciding officer " Officer code '' Name in block letters

Page 1 of 6


SAPS 517(e)

' INATURAL PERSON'S DETAILS 1 2

3

4

5

.?

9

ii

11.3

13

14

15

16

17

18

19

20

22

24

25

26

27

29

29

30

31

32

34

I OTHER BODIES

F I B L E PERSON'S DETAILS

Page 2 of 6

Documents

AFRICAN POLICE SERVICE - gov · - STAATSKOERANT, 26 MAART 2004 No. 26156 125 SAPS 517(a) SOUTH AFRICAN POLICE SERVICE APPLICATION FOR A FURTHER COMPETENCY CERTIFICATE Seclion 9(6)(a)