SAPS 271

SOUTH AFRICAN POLICE SERVICE

APPLICATION FOR LICENCE TO POSSESS A FIREARM

S ection 12, 13, 14, 15, 16, 17, 19 and 20 of the A ct, 2000 (A ct no 60 of 2000)

OFFICIAL DATE STAMP A. FOR OFFICIAL USE BY THE POLICE STATION

WHERE THE APPLICATION IS CAPTURED
1
Application reference No
2
Number of application of

DATE RECEIVED

B. FOR OFFICIAL USE BY POLICE STATION WHERE THE APPLICATION IS RECEIVED

1
Province
2
Area
3
Police station
4
Component code
5
Firearm applications register reference No SAPS 86 NO YEAR

C. FOR OFFICIAL USE BY THE CENTRAL FIREARMS REGISTER (CFR)

1
Outstanding/Additional information required

2 3
- Persal number - - Date

4 5
Signature of police official Name in block letters
6
Application for licence approved (Indicate with an X)

7 8
- Persal number - - Date

9 10 11
Signature of CFR officer Officer code Name in block letters
12 13
Application for licence refused (Indicate with an X) Reason(s) for refusal

14 15
- Persal number - - Date

16 17 18
Signature of CFR officer Officer code Name in block letters

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D. TYPE OF APPLICATION FOR A LICENCE TO POSSESS A FIREARM(S)

1 2
Main firearm licence holder Additional firearm licence holder (Indicate with an X)

3
Section Type of licence/permit Period of X
number validity
3.1
13 Licence to possess a firearm for self-defence Five years
3.2
14 Licence to possess a restricted firearm for self-defence Two years
3.3
15 Licence to possess a firearm for occasional hunting and/or sport-shooting Ten years
3.4
16 Licence to possess a firearm for dedicated hunting and/or dedicated sport-shooting Ten years
3.5
17 Licence to possess a firearm in a private collection Ten years
3. 6
19 Licence to possess a firearm, in a public collection Ten years
3.7
20 Licence to possess a firearm for business purposes: Business in hunting Five years
3.8
20 Licence to possess a firearm for business purposes: Other business purposes Two years
3. 9
20 Licence to possess a firearm for business purposes: For use in theatrical, film and TV Two years
productions
3.10
20 Licence to possess a firearm for business purposes: As a security business Two years
3.11
20 Licence to possess a firearm for business purposes: For training purposes Two years
3.12
20 Licence to possess a firearm for business purposes: As a game rancher Two years

E. DESCRIPTION OF FIREARM (Indicate with an X)

TYPE OF FIREARM

1
Rifle Shotgun Handgun Combination

Other, specify (armament/

indeterminable design
type)

DETAILS OF FIREARM (Indicate with an X)

1.1
Action Semi-automatic Automatic Manual

Other action (specify)

1.2
Names and addresses engraved in the metal

1.3 1.4
Calibre Calibre code
1.5
Make
1.6
Model

Firearm component type:

1.7 1.8
Barrel serial number Make
1.9 1.10
Frame serial number Make
1.11 1.12
Receiver serial number Make

F. PARTICULARS OF CURRENT OWNER

1
Type of owner (Indicate with an X)

1.2
A B C D E
Private owner Firearm dealer Company Imported firearm Estate

2
NATURAL PERSONS DETAILS

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3
TYPE A (Private owner)

4 5
Surname Initials
6
Full names
7
Identity number - - -
8
Residential address
9
Postal Code
10
Postal address
11
Postal Code
12 12.1 12.2
Telephone number Home ( ) Work ( )
12.3 13
Cellphone number Fax ( )
14
E-mail address
15
Are there any additional firearm licence holders for this firearm? (Indicate with an X) YES NO

16
JURISTIC PERSONS DETAILS

17
TYPE B (Firearm dealer)

18
Registered company name
19
Trading as name
20
FAR number
21
Postal address
22
Postal Code
23
Business address
24
Postal Code
25 25.1 25.2
Business telephone number Work ( ) Fax ( )
26
E-mail address
27
Responsible person (Name and surname)
28
Type of identification (Indicate with an X) SA citizen Non-SA citizen with permanent residence*
29
Identity number of responsible person - - -
30
Cellphone number
31
Physical address
32
Postal Code
33
Postal address
34
Postal Code

35
SAP 350 (A) DETAILS
Firearm received from
36
Name
37
Identification number or FAR number
38
Address

39 40
Postal code Date received - -
* In case of a non-SA citizen proof of permanent residence must be submitted.

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41
TYPE C (Companies)

42
Registered company name
43
Trading as name
44
FAR number
45
Postal address
46
Postal Code
47
Business address
48
Postal Code
49 49.1 49.2
Business telephone number Work ( ) Fax ( )
50
E-mail address
51
Responsible person (Name and surname)
52
Type of identification (Indicate with an X) SA citizen Non-SA citizen with permanent residence*
53
Identity number of responsible person - - -
54
Cellphone number
55
Physical address
56
Postal Code
57
Postal address
58
Postal Code

59
TYPE D (Imported firearms)

60
Import permit number
61
Date issued - -
62
Expiry date - -

63
TYPE E (Estate)

64
Type of estate (Indicate with an X)

65
Executorship Administratorship Curatorship Trust

66 67
Surname Initials
68
Full names
69
Identity number of the owner of the firearm - - -
70
Name and surname of executor, administrator, curator, trustee or liquidator

71
Type of identification (Indicate with an X) Non-SA citizen with permanent residence* SA citizen
72
Identity number of executor, administrator, curator,
- - -
trustee or liquidator
73 73.1 73..2
Telephone number Home ( ) Work ( )
73.3 74
Cellphone number Fax ( )
75
Physical address
76
Postal Code
77
Postal address
78
Postal Code
* In case of a non-SA citizen proof of permanent residence must be submitted

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79
Physical address where firearm(s) is kept
80
Postal Code

81
DECLARATION BY PERSON WHO IS LAWFULLY IN POSSESSION OF THE FIREARM(S)

I hereby declare that the above firearm(s) is/are legally in my possession and that I propose to sell or supply it to the applicant once the
necessary licence(s) has/have been obtained and that the particulars of the firearm(s) are correct and accurate.

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.

82
Name and surname of current owner/authorized person
83
Identification number of current owner/authorized
- - -
person

84 85
Designation Date - -

86 87
Place
Signature of current owner/authorized person

G. PARTICULARS OF APPLICANT (Com plete only the section that has bearing on you.)

1
PARTICULARS OF EXISTING COMPETENCY CERTIFICATE (Indicate with an X)

1.1
A Competency certificate to trade in firearms
1.2
B Competency certificate to manufacture firearms
1.3
C Competency certificate to conduct business as a gunsmith
1.4
D Competency certificate to possess a firearm (Indicate with an X)

Handgun Rifle Shotgun

1.5
Competency certificate number
1.6 1.7
Date of issue - - Expiry date - -

2
DETAILS OF FIREARMS IN YOUR POSSESSION AND FOR WHICH YOU HAVE A LICENCE, PERMIT OR AUTHORIZATION
2.1
Type Calibre Make Barrel Serial No Frame/receiver Serial Licence/permit
No authorization No

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3
NATURAL PERSONS DETAILS

4
PRIVATE PERSON

5
Type of identification (Indicate with an X)

5.1
SA citizen Non-SA citizen with permanent residence*
6
Identity number of private person - - -
7 8
Surname Initials
9
Full names
10 11 12
Date of birth - - Age Gender Male Female
13
Residential address
14
Postal Code
15
Postal address
16
Postal Code
17
Type of residence (eg shack, flat, caravan, cottage, house, hostel or homeless)
18 19
Trade or profession If self-employed, specify
20
Name of employer/company
21
Business address
22
Postal Code
23 23.1 23.2
Telephone number Home ( ) Work ( )
23.3 24
Cellphone number Fax ( )
25
E-mail address

26
Marital status (Indicate with an X)

27
Single Married Divorced Widow Widower

Other (specify)
* In case of a non-SA citizen proof of permanent residence must be submitted

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28
PARTICULARS OF APPLICANTS SPOUSE/PARTNER

29
Type of identification (Indicate with an X)

29.1
SA ID Passport
30
Identity number of spouse - - -
31
Passport number of spouse
32
Name and surname

33
JURISTIC PERSONS DETAILS

34
OTHER BODIES (eg body corporate, close corporation or com pany)

35
Registered company name
36
Trading as name
37
FAR number
38
Postal address
39
Postal Code
40
Business address
41
Postal Code
42 42.1 42.2
Business telephone number Work ( ) Fax ( )
43
E-mail address
44
Number of firearms already registered to the business
45
Number of persons employed by the business to handle firearms
46
Responsible person (Name and surname)
47
Type of identification (Indicate with an X) SA citizen Non-SA citizen with permanent residence*
48
Identity number of responsible person - - -
49
Cellphone number
50
Physical address
51
Postal Code
52
Postal address
53
Postal Code

54
OTHER DETAILS (A pplicable to dedicated hunters, dedicated sports-persons or collectors only.)

55
Are you a member of an accredited association? (Indicate with an X) YES NO If yes, submit the following details
56
State name of accredited association
57
FAR number of accredited association
58 59
Membership number Date joined - -
60
Expiry date - -

61
Motivation of purpose for which the firearm is required (A pplicable to all types of applications)

* In case of a non-SA citizen proof of permanent residence must be submitted

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62
HAVE YOU EVER BEEN CONVICTED OF AN OFFENCE COMMITTED INSIDE OR OUTSIDE THE BORDERS OF THE RSA?
(Indicate with an X)

YES NO If yes, submit the following details

62.1 (1) 62.2
Police station CAS/Case number
62.3
Charge
62.4
Outcome
62.5 (2) 62.6
Police station CAS/Case number
62.7
Charge
62.8
Outcome

63
ARE THERE ANY CASES PENDING AGAINST YOU? (Indicate with an X)

YES NO If yes, submit the following details

63.1 (1) 63.2
Police station CAS/Case number
63.3
Offence
63.4 (2) 63.5
Police station CAS/Case number
63.6
Offence

64
HAVE ANY OF YOUR FIREARM(S) EVER BEEN LOST/STOLEN? (Indicate with an X)

YES NO If yes, submit the following details

64.1 (1) 64.2
Police station CAS/Case number
64.3
Circumstances
64.7
Details of firearm
64.5 (2) 64.6
Police station CAS/Case number
64.7
Circumstances
64.8
Details of firearm

65
WAS A CASE OF NEGLIGENCE OPENED AND INVESTIGATED REGARDING THE STOLEN/LOST FIREARM? (Indicate with an X)

YES NO If yes, submit the following details

65.1 (1) 65.2
Police station CAS/Case number
65.3 65.4
Charge Outcome
65.5 (2) 65.6
Police station CAS/Case number
65.7 65.8
Charge Outcome

66
HAVE YOU EVER BEEN DECLARED UNFIT TO POSSESS A FIREARM? (Indicate with an X)

YES NO If yes, submit the following details

66.1 (1) 66.2
Police station CAS/Case number
66.3
Charge
66.4 66.5
Date from Period
66.6 (2) 66.7
Police station CAS/Case number
66.8
Charge
66.9 66.10
Date from Period

67
HAS A FIREARM IN YOUR POSSESSION BEEN CONFISCATED? (Indicate with an X)

YES NO If yes, submit the following details

67.1 (1) 67.2
Police station CAS/Case number
67.3 67.4
Circumstances Outcome

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 SAPS 271
67.5 (2) 67.6
Police station CAS/Case number
67.7 67.8
Circumstances Outcome

68
DO YOU HAVE THE PRESCRIBED SAFE? (Indicate with an X)

YES NO
68.1
IF YES, SUBMIT FULL DETAILS (Indicate with an X, with short description)

Type of safe Handgun Rifle

Strongroom

Device
69
IS SAFE MOUNTED? (Indicate with an X)

YES NO
69.1
IF YES, SUBMIT FULL DETAILS (Indicate with an X)

Wall 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. SIGNATURE OF APPLICANT (S ign only if applicable)

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
applicant.
- The background of the photo must be plain. PHOTO
- The applicant may not be wearing a hat or sunglasses on the
photograph.
- The applicants name and identification number must be written
on the back of the photograph before it is affixed on the application
form.
- The applicant must sign in black ink. 1
- 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.

4
Fingerprint
designation

2 3

Signature

5 6
Date - -
Name of applicant in block letters
7
Place

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8
PARTICULARS OF POLICE OFFICIAL DEALING WITH APPLICATION

8.1 8.2
-
Name of police official in block letters Persal number of police official

8.3 8.4

Rank of police official in block letters Signature of police official

9
PARTICULARS OF WITNESS

9.1 9.2
-
Name of witness in block letters Persal number of witness

9.3 9.4

Rank of witness in block letters Signature of witness

I. 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
Name and surname of interpreter
2
Identity/Passport number of interpreter
3
Residential address
4
Postal Code
5
Postal address
6
Postal Code
7 7.1 7.2
Telephone number Home ( ) Work ( )
8 9
Cellphone number Fax ( )
10
E-mail address
11
Interpreted from (language) to

12
Date - -

13 14
Place
Signature of interpreter

15 16
-
Rank of police official in block letters (if applicable) Persal number of police official (if applicable)

J. PARENTAL CONSENT IN CASE OF A MINOR

1
Recommended Not recommended

2
Name and surname of parent/guardian
3
Identity/Passport number of parent/guardian
4
Comments of parent/guardian

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 SAPS 271

5
Date - -

6 7
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. FOR OFFICIAL USE BY THE DESIGNATED FIREARMS OFFICER

1
REPORT OF DESIGNATED FIREARMS OFFICER IN THE CASE OF A RESTRICTED FIREARM FOR SELF-DEFENCE
2
Place where the applicant resides (indicate with an X) urban area rural area farm smallholding

other

3
If the applicant resides in a rural area/on a farm or smallholding, state the following
3.1
Distance to nearest neighbours metre/kilometre
3.2
Distance to nearest police station metre/kilometre

4
Does the applicant reside near/not near a high-risk/crime-rated area? If the applicant resides near a crime-rated area submit motivation

5
Does the applicant reside or work in a dangerous area or a high-risk area? If yes, submit motivation.

6
Is the applicant a (Indicate with an X) dedicated hunter dedicated sports- private collector public collector
person
6.1
How many firearms does the applicant possess?

1
L. RECOMMENDATION REGARDING THE APPLICATION (A pplicable to all types of applications)

Recommended Not recommended

1.1
Motivation regarding the application

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 SAPS 271
1.2
Report regarding the physical inspection of the applicants safeguarding facilities

2 3
Date - -
Name of Designated Firearms Officer/Station Commissioner in block letters

4 5
Place
Rank of Designated Firearms Officer/Station Commissioner in block letters

6 7
-
Signature of Designated Firearms Officer/Station Commissioner Persal number of Designated Firearms Officer/Station
Commissioner

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