Shotgun Application Form PDF Details

Are you looking for a more efficient way to fill-out shotgun applications? This post will provide an overview of the various forms available, as well as useful tips on how to make the most out of completing your application. Whether you are just beginning the process or have been submitting applications for years, this detailed guide is sure to be helpful in streamlining your shotgun application form and helping ensure that it's done correctly. Read on for some key information about this important step in any firearms purchase!

QuestionAnswer
Form NameShotgun Application Form
Form Length11 pages
Fillable?No
Fillable fields0
Avg. time to fill out2 min 45 sec
Other namesderbyshire firearms licensing contact number, derbyshire firearms licensing, derbyshire shotgun transfer, derbyshire firearms

Form Preview Example

FORM 201

APPLICATION FOR THE GRANT OR RENEWAL OF A FIREARM AND/OR SHOTGUN CERTIFICATE

PLEASE READ THE NOTES THAT ACCOMPANY THIS FORM CAREFULLY BEFORE COMPLETING THE APPLICATION FORM

Please use black ink and write in BLOCK CAPITALS throughout, except when signing. (Applicants must print their name, sign and date each page). If you wish to provide any further information to that mentioned in this form, you must also sign and date that information.

For what are you applying?

1.I am applying for (tick each box which applies)

Firearm certiicate

 

Grant

 

Renewal

Shotgun certiicate

 

Grant

 

Renewal

 

 

PART A: Personal details.

2.Title

3.Forename(s)

4.Surname

5.Date of birth i) Place of birth ii) Country of birth

6.Home address:

i)Postcode

ii)Telephone number

iii)Mobile number

iv)E-mail

7.Work address:

8.Previous home address(es) from the past ive years

If not applicable write N/A here

(please use a new line for each address).

Address 1

Postcode

Dates of residence

From To

Address 2

Postcode

Dates of residence

From To

Address 3

Postcode

Dates of residence

From To

i)Postcode

ii)Telephone number

iii)E-mail address

9.If you have at any time used a name other than that given in answer to questions 3 and 4 please complete below:

Previous surname(s)

Previous forename(s)

Please print, sign and date here:

Applicant’s name:

Applicant’s signature:

Date:

Page 1

10. Height:

 

Metres

 

Centimetres

 

 

or

 

 

 

 

Feet

 

Inches

11. Gender:

 

Male

 

Female

 

 

12. Personal health & medical declaration. IMPORTANT: Please read notes 5 and 6 BEFORE completion.

(A) Do you suffer from any relevant medical

conditions? Yes

 

No

 

(If yes give details):

 

 

 

 

 

(B)Have you ever received treatment for depression or any other kind of mental health

condition? Yes

 

No

 

(If yes give details)

 

 

 

 

 

13.Details of your general practitioner (GP)/ specialist

i)Name of your GP/specialist

ii)Address of the GP practice/medical centre

Postcode

iii)Telephone number of the GP practice/medical centre

iv)E-mail address of the GP practice/medical centre

FORM 201

14.Offences. IMPORTANT: Please read note 1 BEFORE completion.

Have you been convicted of any offence or received a written caution (not including parking)?

Yes

No

(If yes give details of all convictions and/or formal written cautions, binding overs and spent

convictions, including those received outside Great Britain).

Date Offence

PART B: Medical declaration and consent. The information I have given above is true and I understand that it is an offence under section 28A(7) of the Firearms Act 1968 to knowingly or recklessly make a false statement for the

purposes of procuring the grant or renewal of a certiicate; the maximum penalty for which is six months imprisonment and/or a ine.

I give the police permission to contact my general practitioner and/or specialist to obtain factual details of any medical history in respect of this

application. This authority is valid for the life of the certiicate.

I understand that my GP may share sensitive personal data with the police concerning my physical and mental health for the purpose of enabling the police to make a fully informed decision on my application, and I hereby consent to this processing of my personal data.”

Signature:

Print name:

Date:

Please print, sign and date here:

Applicant’s name:

Applicant’s signature:

Date:

Page 2

FORM 201

APPLICATION FOR THE GRANT OR RENEWAL OF A FIREARM CERTIFICATE

(If applying for a SHOTGUN certiicate only go to part D)

PART C: Firearm details (if applicable). Please write in BLOCK CAPITALS

15.Details of irearms currently held. IMPORTANT: Please read note 8 BEFORE completion

If none write NONE here

Calibre

Metric/

Imperial

Type

Make and Model e.g.

Winchester

Serial No

Reason e.g. Target shooting

 

 

16.Details of irearms to be acquired (if known). IMPORTANT: Please read note 8 BEFORE completion

If none write NONE here

Calibre

Metric/

Imperial

Type

Reason e.g. Target shooting

Please print, sign and date here:

Applicant’s name:

Applicant’s signature:

Date:

Page 3

FORM 201

17.Details of the maximum amount of ammunition to be possessed

Calibre Metric/

Imperial

Quantity

Calibre Metric/

Imperial

Quantity

Calibre Metric/

Imperial

Quantity

18. i) Details of current (or in the case of a grant, proposed) security arrangements. NB: it is not necessary to have all of the below.

Tick all that are relevant:

British standard cabinet or equivalent

Cabinet bolted to the fabric of the building

Storage out of sight of casual visitors

Stored at other address(es) (give details)

Shared security (give details of whom the security is shared with)

Ammunition storage (give details)

ii)Give details of any other relevant security arrangements below e.g. gun room, address of alternate security location etc

Please print, sign and date here:

Applicant’s name:

Applicant’s signature:

Date:

Page 4

FORM 201

APPLICATION FOR THE GRANT OR RENEWAL OF A SHOTGUN CERTIFICATE

PART D: Shotgun details (if applicable). Please write in BLOCK CAPITALS

19. Details of shotguns currently held, If none, write NONE here

Calibre/bore or gauge

Action/Type

Make and Model

Serial No

20. i) Details of current (or in the case of grants, proposed) security arrangements. NB: it is not necessary to have all of the below.

Tick all that are relevant:

British standard cabinet or equivalent

Cabinet bolted to the fabric of the building

Storage out of sight of casual visitors

Stored at other address (es) (give details)

Shared security (give details of whom the security is shared with)

ii)Give details of any other relevant security arrangements below e.g. gun room, address of alternate security location etc

Please print, sign and date here:

Applicant’s name:

Applicant’s signature:

Date:

Page 5

FORM 201

21.Would you like your shotgun certiicate to expire at the same time as your irearm certiicate?

Yes

No

If YES, give details of your current irearm certiicate if applicable. See note 7.

Police force issuing your irearm certiicate:

Firearm certiicate number:

Signature:

Print name:

Date:

Please print, sign and date here:

Applicant’s name:

Applicant’s signature:

Date:

Page 6

FORM 201

PART E: Continuation sheet.

Please use this space for any additional information relating to parts A-D of this form: Please write in BLOCK CAPITALS

Please print, sign and date here:

Applicant’s name:

Applicant’s signature:

Date:

Page 7

FORM 201

DECLARATION

I hereby apply for a

irearm

shotgun

certiicate (tick as appropriate). The information I have provided on this form is true and I understand

that it is an offence under section 28A(7) of the Firearms Act to knowingly or recklessly make a false statement for the purpose of procuring the grant or renewal of a certiicate; the maximum penalty for which is six months’ imprisonment and/or a ine. I understand that I will be subject to a check of police

records and that my details will be held electronically.

Signature:

Print name:

Date:

I have enclosed FOUR identical photographs of a current likeness of me, the applicant. See note 2 and

3 for details of the photographic requirements.

If the applicant is under 18 years of age the following must be completed

Parent

Signature:

Print name:

Date:

or Guardian

Page 8

FORM 201

APPLICATION FOR THE GRANT OR RENEWAL OF A FIREARM AND/OR SHOTGUN CERTIFICATE

PART F: (i) Referee details. Please write in BLOCK CAPITALS

Firearm and/or shotgun certificates.

See notes 10 and 11

1. Title

2. Surname

3. Forename(s)

4. Date of birth

 

5. Occupation

6.Home address

Postcode

7. Home telephone number

i) Work telephone number

ii) Mobile number

iii) Home e-mail

iv) Work e-mail

8.In what capacity do you know the applicant?

9.I have seen the details given by

(insert full name of applicant) which are true to the best of my knowledge. I have known the applicant

for

years and know of no reason why she/he should not be granted or have renewed

ashotgun or irearm certiicate as applicable. I have signed and dated the reverse of one of the photographs submitted with the application and declare that it is a current true likeness. I also

understand it is an offence under section 28A(7) of the Firearms Act to knowingly or recklessly make a false declaration for the purpose of procuring for another the grant or renewal of a certiicate.

Signature of referee:

Print name:

Date:

Please print, sign and date here:

Applicant’s name:

Applicant’s signature:

Date:

Page 9

FORM 201

APPLICATION FOR THE GRANT OR RENEWAL OF A FIREARM CERTIFICATE

PART F: (ii) Referee details. Please write in BLOCK CAPITALS

Referee (ii) is ONLY required for a firearm certificate. See note 10.

1. Title

2. Surname

3. Forename(s)

4. Date of birth

 

5. Occupation

6.Home address

Postcode

7. Home telephone number

i) Work telephone number

ii) Mobile number

iii) Home e-mail

iv) Work e-mail

8.In what capacity do you know the applicant?

9.I have seen the details given by

(insert full name of applicant) which are true to the best of my knowledge. I have known the applicant

for years and know of no reason why she/he should not be granted or renewed a irearm

certiicate as applicable. I have signed and dated the reverse of one of the photographs submitted with

the application and declare that it is a current true likeness. I also understand it is an offence under

section 28A(7) of the Firearms Act to knowingly or recklessly make a false declaration for the purpose of procuring for another the grant or renewal of a certiicate.

Signature of referee:

Print name:

Date:

Please print, sign and date here:

Applicant’s name:

Applicant’s signature:

Date:

Page 10

PART G: Equality (Please tick the appropriate boxes)

EQUALITY INFORMATION

1. Do you have a disability?

Yes

No

Prefer not to say

2.What is your ethnic group? A. White

English

Welsh

Scottish

Northern Irish

British

Irish

Gypsy or Irish Traveller

Any other white background, write in:

B. Mixed / multiple ethnic groups

White and Black Caribbean

White and Black AfricanWhite and Asian

Any other mixed / multiple ethnic

background, write in:

C. Asian or Asian British

Indian

Pakistani

Bangladeshi

Chinese

Any other Asian background, write in:

D. Black / African / Caribbean / Black British

African

Caribbean

Any other Black / African / Caribbean

background, write in:

E. Other ethnic group

Arab

Any other ethnic group, write in

F. Prefer not to say

 

 

 

FORM 201

3. Gender

male

female

Prefer not to say

 

 

 

 

4. What is your age group?

 

 

 

 

 

 

 

Age group

 

 

Tick

 

 

 

 

 

 

66 and above

 

 

 

 

 

 

 

 

 

61–65

 

 

 

 

 

 

 

 

 

56–60

 

 

 

 

51–55

 

 

 

 

 

 

 

 

 

46–50

 

 

 

 

41–45

 

 

 

 

36–40

 

 

 

 

31–35

 

 

 

 

 

 

 

 

 

26–30

 

 

 

 

21–25

 

 

 

 

 

 

 

 

 

18-25

 

 

 

 

 

 

 

 

 

Under 18

 

 

 

 

 

 

 

 

 

Prefer not to say

 

 

 

 

Page 11

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4. To move onward, your next step requires typing in a couple of blank fields. These include Height, Gender, Metres, Centimetres, Feet, Male, Inches, Female, Personal health medical, A Do you suffer from any relevant, If yes give details, FORM, Offences IMPORTANT Please read, Have you been convicted of any, and Yes, which you'll find essential to carrying on with this process.

Offences IMPORTANT Please read, Male, and If yes give details inside derbyshire firearms licensing

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