New Form
New Form
New Form
F-A-01
Licence No.
(ISO 9001:2000 Certified)
PART – A Identity of applicant
Mr. Ms.
1. Name
2. Father’s/Husband’s
/ Mother’s Name :
3. (a) Place of Birth : (b). Nationality :
4. Date of Birth in Christian era : In Figures (dd mm yyyy) : (with documentary proof)
Fax: E-mail:_____________________________________________________
6. Permanent Address :
Attention – please enclose : (1) Four passport size photographs, One to be pasted on the form and other three to be attested on the reverse by
a Gazetted officer;
(2) Attested photocopy of the address proof
i) Ration card / voter’s I-card / passport / Electricity Bill / Water Bill / Telephone Bill / Driving Licence / Property (House) Tax / Tax Return
& PAN Card; or
ii) Posting certificate indicating the residential address of the applicant / recommendation from the commanding / supervisory Gazetted
Officer in case of armed forces personnel, Police and para-military forces only; and
(3) Proof of date of Birth (Please attach any one mentioned below):
Copy of Matriculation Certificate indicating the Date of birth duly attested by a Gazetted officer; or
Copy of the Birth certificate issued by a Municipality Authority or district office of the Registrar of Births & Deaths duly
attested by a Gazetted officer; or
Affidavit sworn before a Magistrate/Notary stating date and place of birth by illiterate or semi-illiterate applicants (specimen
language of the affidavit may be taken from the Delhi Police web site http://www.delhipolice.nic.in or from the Reception
counter of the Licensing Branch, at Police Station Defence Colony, New Delhi; or
Any other proof (Passport / Driving License / PAN Card / Service I-Card for Government employees issued by the Government
Department having Date of Birth / Army Discharge Certificate etc. please specify) ___________________________
DCP/Licensing, 1st Floor, P.S. Defence Colony, New Delhi-110049 (E-MAIL : dcp-license@delpol.nic.in)
13. If any of the entry in Col. No. 9 to 12 is ‘YES’, then give details here by writing the particular column no.:
Col. No. Detail
_______________________________________________________________________________________________
Note :- Against col. No. 15 & 16, the applicant should clearly mention the purpose(s) for which the licence is required – such as : use, requisition,
possession, carrying, manufacture, sale, transfer, repair, convert, proof–test, import, export, transport, self protection, sport, display, destruction of wild
animals which do injury to human beings / cattle, protection of crops and cattle, target practice / shooting, temporary possession as bonafide traveler
visiting India etc.
DECLARATION : I hereby declare that the above particulars given in the application are true, complete and correct to the best of my knowledge
and belief. I understand that in the event of any information being found false or incorrect at any stage, I am liable to be proceeded against and
action, taken under the relevant provisions of Arms Act, 1959, the Arms Rules, 1962, and other central enactments or the law for the time being
in force.
Place :
WARNING : Suppression of any factual information or furnishing of any false or wrong information in the application form in violation of Rule
51- A will render the applicant liable for punishment under Section 30 of the Arms Act, 1959 and revocation of license as per Section 17 (3) of
the Arms Act, 1959.