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 your SSAA, or Shooters Union number when you joined)*
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
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