Approved Club Declaration (Queensland Applicant)

QUEENSLAND POLICE SERVICE
Approved Club Declaration (Queensland Applicant)
Weapons Act 1990 Section 18B06/20 1 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
Surname
Given Name(s)
Email
Date Of Birth
Day
Month
Year
Applicant’s current Cairns Target Shooting Pistol Club membership no.
Membership Financial Year of Expiry
Complete the Following ONLY if you are a New Concealable Firearms License Applicant

(If you are only renewing your existing license and are not a new applicant scroll down and click submit)
Joining Date of the Pistol Club: This is the date your initial invoice for full membership was paid.
Month
Year
Day
Month
Membership Financial Year of Expiry
Existing Club Members License Renewal only:

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

Enter the dates of your 3 most recent approved shoots that you have signed off on your shoot card and upload your card / participation record. These MUST be within the previous 6 months of submitting this application.
File Upload REQUIRED

Cancelof
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.
Todays Date
Day
Month
Year
Should be Empty:

Date Of Birth