Académique Documents
Professionnel Documents
Culture Documents
A.
1 2
FOR OFFICIAL USE BY THE POLICE STATION WHERE THE APPLICATION IS CAPTURED
DATE RECEIVED
B.
1 2 3 4 5
Province Area Police station Component code Firearm applications register reference No C.
1
SAPS 86
NO
YEAR
Persal number
Date
4 6
Persal number
Date
9 12
10
Officer code
13
11
14
Persal number
15
Date
16
17
Officer code
18
Page 1 of 12
SAPS 271 D.
1
(Indicate with an X)
Period of validity Five years Two years Ten years Ten years Ten years Ten years Five years Two years Two years Two years Two years Two years
Licence to possess a firearm for self-defence Licence to possess a restricted firearm for self-defence Licence to possess a firearm for occasional hunting and/or sport-shooting Licence to possess a firearm for dedicated hunting and/or dedicated sport-shooting Licence to possess a firearm in a private collection Licence to possess a firearm, in a public collection Licence to possess a firearm for business purposes: Business in hunting Licence to possess a firearm for business purposes: Other business purposes Licence to possess a firearm for business purposes: For use in theatrical, film and TV productions Licence to possess a firearm for business purposes: As a security business Licence to possess a firearm for business purposes: For training purposes Licence to possess a firearm for business purposes: As a game rancher
E.
TYPE OF FIREARM
1
Shotgun
Handgun
Combination
with an X)
Action
Automatic
Manual
1.2
1.4
Calibre code
F.
1
1.2
A Private owner
B Firearm dealer
C Company
D Imported firearm
E Estate
SAPS 271
3
4 6 7 8
Initials
9 10
Postal Code
Postal address
11
Postal Code ( ( ) )
12 12.3 14 15
12.1
Home
12.2 13
Work Fax
Are there any additional firearm licence holders for this firearm? (Indicate
with an X)
YES
NO
16
17
18 19 20 21
Postal Code
23
Business address
24
Postal Code )
25 26 27 28 29 30 31
25.1
Work
25.2
Fax
SA citizen
32 33
Postal Code
Postal address
34
Postal Code
35
SAP 350 (A) DETAILS Firearm received from Name Identification number or FAR number Address
36 37 38
39
Postal code
40
Date received
Page 3 of 12
SAPS 271
41
TYPE C (Companies)
42 43 44 45
Postal Code
47
Business address
48
Postal Code )
49 50 51 52 53 54 55
49.1
Work
49.2
Fax
SA citizen
56 57
Postal Code
Postal address
58
Postal Code
59
60 61 62
63
TYPE E (Estate)
64
with an X)
65
Administratorship
Curatorship
67
Trust Initials
66 68 69 70
Identity number of the owner of the firearm Name and surname of executor, administrator, curator, trustee or liquidator
71 72
with an X)
SA citizen Work ( ( ) ) -
Identity number of executor, administrator, curator, trustee or liquidator Telephone number Cellphone number Physical address
73.1
73 73.3 75
Home
Fax
76 77
Postal Code
Postal address
78
Postal Code
Page 4 of 12
SAPS 271
79
Postal Code
81
82 83
Name and surname of current owner/authorized person Identification number of current owner/authorized person Designation
85
84
Date
86
87
Place
PARTICULARS OF APPLICANT (Com plete only the section that has bearing on you.)
with an X)
A B C D
Competency certificate to trade in firearms Competency certificate to manufacture firearms Competency certificate to conduct business as a gunsmith Competency certificate to possess a firearm Handgun Rifle
(Indicate with an X)
Shotgun
1.5 1.6
Expiry date
2 2.1
DETAILS OF FIREARMS IN YOUR POSSESSION AND FOR WHICH YOU HAVE A LICENCE, PERMIT OR AUTHORIZATION Type Calibre Make Barrel Serial No Frame/receiver Serial No Licence/permit authorization No
Page 5 of 12
SAPS 271
PRIVATE PERSON
with an X)
5.1 6 7 9 10 13
SA citizen
Identity number of private person Surname Full names Date of birth Residential address 11
Initials
Age
12
Gender
Male
Female
14 15
Postal Code
Postal address
16
Postal Code
17 18 20 21
Type of residence (eg shack, flat, caravan, cottage, house, hostel or homeless) Trade or profession Name of employer/company Business address
22 19
If self-employed, specify
Postal Code ) )
23 23.3 25
23.1
Home
23.2 24
Work Fax
( (
26
with an X)
27
Married
Divorced
Widow
Widower
Page 6 of 12
SAPS 271
28
29
with an X)
29.1 30 31 32
SA ID
Passport -
33
34
35 36 37 38
Postal Code
40
Business address
41
Postal Code )
42 43 44 45 46 47 48 49 50
42.1
Work
42.2
Fax
Number of firearms already registered to the business Number of persons employed by the business to handle firearms Responsible person (Name and surname) Type of identification (Indicate
with an X)
SA citizen
51 52
Postal Code
Postal address
53
Postal Code
54
55 56 57 58
Are you a member of an accredited association? (Indicate State name of accredited association FAR number of accredited association Membership number
with an X)
YES
NO
59 60
61
Page 7 of 12
SAPS 271
62
HAVE YOU EVER BEEN CONVICTED OF AN OFFENCE COMMITTED INSIDE OR OUTSIDE THE BORDERS OF THE RSA?
(Indicate with an X)
YES
62.1 62.3 62.4 62.5 62.7 62.8
NO
(1)
CAS/Case number
(2)
62.6
CAS/Case number
63
(Indicate with an X)
CAS/Case number
(2)
63.5
CAS/Case number
64
(Indicate with an X)
Police station
CAS/Case number
CAS/Case number
Circumstances Details of firearm WAS A CASE OF NEGLIGENCE OPENED AND INVESTIGATED REGARDING THE STOLEN/LOST FIREARM? (Indicate YES NO
(1) with an X)
65
(2)
65.6 65.8
66
HAVE YOU EVER BEEN DECLARED UNFIT TO POSSESS A FIREARM? (Indicate YES NO
(1)
Police station Charge Date from Police station Charge Date from
CAS/Case number
66.10
Period
67
(Indicate with an X)
67.1 67.3
Police station
Circumstances
Page 8 of 12
SAPS 271
67.5 67.7
Police station
(2)
67.6 67.8
68
with an X)
68.1
Handgun
Rifle
69
with an X)
NO
(Indicate with an X)
69.1
Floor
70
DECLARATION BY APPLICANT 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. H.
PHOTO
Fingerprint designation
Signature
5 6
Date Place
Page 9 of 12
SAPS 271
8
8.1
PARTICULARS OF WITNESS
9.2
9.1
Signature of witness
PARTICULARS OF INTERPRETER
(This section must be completed only if the applicant cannot read or write or does not understand the content of this form.)
1 2 3
Postal Code
Postal address
6
Postal Code
7 8 10 11
7.1
Home
7.2 9
Work Fax
( (
) )
to
12
Date
13
14
Place
Signature of interpreter
15 16
2 3 4
Page 10 of 12
SAPS 271
Date Place
Signature of parent/guardian
*** NOTIFICATION OF CHANGE OF ADDRESS *** The Registrar must be informed of all changes of address/circumstances within 30 days of such changes occurring K.
1 2
with an X)
rural area
farm
smallholding
3 3.1 3.2
If the applicant resides in a rural area/on a farm or smallholding, state the following Distance to nearest neighbours Distance to nearest police station metre/kilometre metre/kilometre
Does the applicant reside near/not near a high-risk/crime-rated area? If the applicant resides near a crime-rated area submit motivation
Does the applicant reside or work in a dangerous area or a high-risk area? If yes, submit motivation.
with an X)
dedicated hunter
dedicated sportsperson
private collector
public collector
6.1
L.
1.1
Page 11 of 12
SAPS 271
1.2
Date
Place
Page 12 of 12