Approved Club Declaration QP518A

QUEENSLAND POLICE SERVICE
Approved Club Declaration (Queensland Applicant)
Weapons Act 1990 Section 18B 06/20 2 To accompany an Application for a New or Renewal of a Concealable Firearms Licence for sports or target shooting
THIS DECLARATION IS VALID FOR 28 DAYS AFTER IT IS SIGNED BY THE APPROVED PISTOL CLUB REPRESENTATIVE/EXECUTIVE
Section 1 Applicant Details
Family Name*
Given Name(s)*
Applicant Date of Birth
Day*
Month*
Year*
Applicant’s current Mareeba Pistol Club Membership number (which is obtained through your TidyHQ login and listed as your ID number
Financial Year that your current Mareeba Pistol Club membership expires*
Complete the Following ONLY if you are New Concealable Firearms Licence Applicant

(If you are only renewing your existing licence and are not a new applicant scroll down and click submit)
Joining Date of the Pistol Club: This is the date of the Meeting when your membership application was accepted. If you do not know leave it blank.
Day
Month
Year
Existing Club Members License Renewal only:

Please upload a current copy of your Concealable H class firearms license below
New applicant only

Upload a copy/photograph of your shoot card.
Cancelof
New concealable weapons licence applicants only

Enter the dates of your 3 most recent approved shoots that you have signed off on your shoot card. These MUST be within the previous 6 months of submitting this application.
Shoot 1
Day
Month
Year
Shoot 2
Day
Month
Year
Shoot 3
Day
Month
Year
I acknowledge that I am responsible for the accuracy of the information in this document and will check and confirm the accuracy of any documents received from the Mareeba Pistol Club Inc prior to submitting to Weapons Licensing Branch.*

I have read the above acknowledgement and agree to these conditions
The information contained in this document is true and correct to the best of my knowledge and I declare it meets the requirements of section 18B of the Weapons Act 1990.
Your Email Address*
example@example.com
Approval Signature

Clear
Date

DayMonthYear
Should be Empty:

QUEENSLAND POLICE SERVICE

Approved Club Declaration (Queensland Applicant)

THIS DECLARATION IS VALID FOR 28 DAYS AFTER IT IS SIGNED BY THE APPROVED PISTOL CLUB REPRESENTATIVE/EXECUTIVE

Section 1 Applicant Details

Applicant Date of Birth

Complete the Following ONLY if you are New Concealable Firearms Licence Applicant

Joining Date of the Pistol Club: This is the date of the Meeting when your membership application was accepted. If you do not know leave it blank.

Existing Club Members License Renewal only:

New applicant only

New concealable weapons licence applicants only

Shoot 1

Shoot 2

Shoot 3