Application For Renewal Of Individual Firearm License - Philippine National Police
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1
2APPLICATION FOR RENEWAL OF INDIVIDUAL FIREARM LICENSE
(Requirement & Instruction to applicant: Please see page 2)
ADMIN CONTROL
DATE:
I
-
/
/
Day
Month
Year
Chief, Philippine National Police
(Attn: Chief, FED)
Kind of License applied for
Camp Crame, Quezon City
RL
SP
SCR
SRL
May I respectfully request for the renewal of my firearm license. My personal details, firearms data and compliance to
other requirements in connection with my license to possess firearm are stated below.
WITH CHANGES
NO CHANGES
Owner (Agency)
Last Name:
First Name:
Middle Name:
2” x 2”
Address:
(Colored PHOTO w/
white background)
E-mail Address:
Affix signature
Tel. No.:
On the left side
Date of Birth
/
/
Of the picture
Day
Month
Year
Place of Birth
TIN No.:
-
-
Qualification:
Businessman/Overseas
Private Employee/Individual
Elected Official
PNP/AFP/BJMP/BFP
Specify:
__________________
_____________________
_____________
Rank _________ Branch_______
Professional
Government Employee
Gov’ Official
Ret .PNP/AFP/BJMP/BFP
Specify:
__________________
_____________________
_____________
Rank _________ Branch_______
Others
Retired Gov’t Emp Official
Retired Private
Reservist
Emp./Official
Specify:
__________________
_____________________
_____________
Rank _________ Branch_______
FIREARMS INFORMATION
Source of Firearm (Dealer/Transfer/Amnesty)
Kind
Make
Model
Serial No.
Caliber
RECEIVED BY:
U N D E R T A K I N G
I HEREBY CERTIFY that all statements are true and correct. I further certify that I have no criminal
conviction or pending criminal administrative case before any court of law or administrative body as of this
date. Neither is the firearm described herein involved in any case before any court of law or administrative
________________________________
body as of this date.
Name/Signature
______________________________________________
DATE:
Licensee’s Signature over Printed Name
SUBCRIBER AND SWORN to before me this ________ day of _____________________20____
applicant exhibited to me his/her Residence Certificate No. A ____________________on ________20____
_________________________
NOTARY PUBLIC
RECEIVED BY:
(TO BE FILLED-UP BY AUTHORIZED PROCESSOR)
This will serve as your claim stub. Present this stub in claiming the firearm license card.
NAME OF LICENSEE ___________________________________________________________________
________________________________
Family Name
First Name
Middle Name
Name/Signature
FIREARMS DESCRIPTION _______________________________________________________________
Kind
Make
Model
Serial No.
Caliber
DATE:
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