[PDF] FIREARMS REGISTRY - Application for a Minors Firearm Permit P637

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Vers 1.8 October 2019

B. RESIDENTIAL ADDRESS - minor

Application for a Minor's Firearm Permit

P637

NSW POLICE FORCE - FIREARMS REGISTRY

This is an

interactive

form. Please complete the sections, print & sign this form and submit w�ith the Minor's Firearm Permit

Legitimate Reason form to the

Firearms Registry, Locked Bag 5102, Parramatta NSW 2124.

Fields in

RED are mandatory. The applicant must be a minimum of 12 years of age, but no older than 18� years of age.

This application requires the consent of the parent or legal guardian of� the applicant. Consent is provided on the Minor's

Firearm Permit Legitimate Reason form,

which must accompany this application

If you wish to make application for a Minors Safety Training Permit (AB� or C) and a Minors Target Pistol Permit (H), you may do

so on the one application, but you will need to pay two fees.

ABN 43 408 613 180

Day Time

Phone No

If you have been known by another name, please provide details below (L�ast Name, Given Names)

Last Name

NSW

Drivers

Licence No.

A. NOMINATED PERMIT HOLDER - minor

Date of Birth

Gender

C. POSTAL ADDRESS - If the same as your residential address please mark this box Email

AddressMobilePhone No

You may select:

1. A Firearms Safety Training Permit for

Categories A & B,

or

2. A Firearms Safety Training Permit for

Category C (

supported by evidence of physical need or

3. A Minor's Target Pistol Permit for category H,

or

4. Both a Minor's Target Pistol H

and a Firearms Safety Training Permit AB or C.

If you apply for both the Target Pistol and the Firearms Safety Training� Permit, two fees will apply.

An application for a Category C Permit

for clay target shooting must be accompanied by proof of membership of a club

affiliated with the Australian Clay Target Association or other body app�roved by the Commissioner of Police and must also be

supported by evidence from a medical practitioner of the physical reason for needing a pump action or self-loading shotgu�n

for Clay Target Shooting. Please see the Legitimate Reason form for the �specific requirements relating to a Category C Minors

Permit.

Fees:

Should you wish to apply for a Minor's Safety Training Permit and a Mino�r's Target Pistol Permit, a separate fee of $75.00

is required for each permit. D. PERMIT TYPEThis application is for a (please select)

First and

Middle Names

Vers 1.8 October 2019

F. DECLARATION - must be completed by the applicant (the minor)

· I understand that it is a serious offence under the Firearms Act 1996 to� make a statement or provide information that I know is

false or misleading & I certify that all the information contained �in this application is true and correct in every detail

· I authorise the release of my personal information to any third party th�e Commissioner deems appropriate and for the purposes

of any relevant Authority verifying the details of this application�.

· I agree to the NSW Police Force undertaking such enquiries as are necess�ary to establish that the information I have provided in

relation to this application is true and correct.

Applicants SignatureDate

E. PERSONAL HISTORY - You MUST complete this section - select one box for each question IF YOU ANSWERED YES TO ANY OF THE ABOVE QUESTIONS, PLEASE PROVIDE DETAIL�S AS AN ATTACHMENT c) Been subject to a firearms/weapons prohibition order?

a) Been refused or prohibited from holding a firearms licence or permit� or had a firearms licence or permit

suspended, cancelled or revoked?

d) Have you ever attempted suicide or self harm, or in the past 12 mont�hs been referred or treated for alcoholism,

drug dependence, or a mental or nervous disorder or illness?

e) Within the last 10 years, been convicted of an offence involving fir�earms or weapons, prohibited drugs/plants/

prescribed restricted substances, fraud/dishonesty/stealing, terrori�sm, violence, assaults against law

enforcement officers, robbery, organised criminal groups and recruit�ment, riot, affray or an offence of a

sexual nature or are you presently subject to a good behaviour bond �in relation to one of those offences?

Have you in NSW or elsewhere;

b) Been recorded as a registrable person or corresponding registrable p�erson under the Child Protection

(Offenders Registration) Act 2000

f) Within the last 10 years been the subject of a Apprehended Violence �Order (other than an order which was

revoked) or an injunction ordered by the Family Court, or presently� subject to an Interim Apprehended

Violence Order?

YES/NO

G. FEE

Please attach a cheque or money order made payable to the 'NSW Police Fo�rce' or complete the credit card authority below.

Remember, one permit is $75 and if you make application for two permits,� then you must pay two fees = $150

Please debit my forCard Number

Cardholder

Name

Cardholder

Signature

YearExpiry Month

OFFICE USE ONLY

Receipt No.

AmountDate$

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