Form A - 3: Form of Application For Renewal of Arms Licensee

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FORM A - 3

Recent
(For Individuals) passport Size
Form of Application for Renewal of Arms photograph of
Licensee the licensee
(See rule 24) with (White
Background)

IDENTITY OF THE APPLICANT


1 UIN (18 digit)
2 Name

3 Parent/Spouse Name

4 Date of Birth in Christian era D D M M Y Y Y Y

(a) Date of Birth in figures


Male
(b) Sex Female

5 Aadhaar No. :-
Pan Card No. :-
Challan Details :- Amount Challan No.- Challan Date

6 Present Address

7 Permanent Address

(a) Mobile No.


(b) E-mail.
(c) Nearest Police Station

8 Occupation.

9 Office/Business Address

License Particulars and Weapon Endorsements


10 License Number
11 Date of expiry
12 Period For Renewal
13 Area Validity
14 Arms Last Inspection Date
15 Weapons Endorsed Weapon 1 Weapon 2 Weapon 3
(a) Type [Rifle/Shot Gun/Hand
Gun (Revolver/Pistol)]
(b) Bore/Caliber

(C) Weapon Number


Cartridges/ One Time One Year
Gun Powder/
16 Ammunition allowed
Percussion Caps
OTHER PARTICULARS OF THE LICENSEE
17 Whether the licensee, since the last renewal/issuance of license has been –
Y N If yes, details thereof –
(a) Convicted – Offence
Sentence
Date of sentence
DD/MM/YYYY
(b) Ordered to execute a bond Y N If yes, details thereof –
under Chapter VIII of Code of
Criminal Procedure, 1973 (2 Date
of 1974) for keeping the DD/MM/YYYY
peace or for good behavior - Period for which bound
(C) Prohibited under the Arms Y N
Act, 1959, or any other law If yes, details thereof –
from having the arms/ Date
ammunition DD/MM/YYYY
Period for which prohibited
18 Whether -
(a) The applicant’s license since If yes, details thereof –
last renewal/ issuance was Y N Name of the
ever suspended or Cancelled / licensing authority
revoked Reasons
If yes, details thereof –

Name
Any other member of the License No.
applicant’s family is in
(b) possession of any arms Y N Weapons endorsed
license, if so, particulars
thereof 1.

2.

3.
The applicant has a safe Y N If yes, details thereof –
(c) place to keep the arms and
ammunition
the applicant has undergone Y N If yes, details thereof –
prescribed
(d) training as specified under rule
10
(whenever made applicable by the
Central Government)

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 the Arms Act, 1959, the Arms
Rules, 2016, and laws for the time being in force.

Signature /Thumb - impression of applicant


Place ………………………………

Date : ………/…………/20……….

Note :-
The exemptee sports persons shall attach a list of the arms and ammunition held by them in a separate sheet
against columns 11 and 12.
Warning :
Suppression of any factual information or furnishing of any false or wrong information in the Application Form in
violation of arms rules will render the applicant liable for punishment under Section 30 of the Arms Act, 1959.

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