Club Authority to Acquire Firearm

CLUB AUTHORITY TO ACQUIRE FIREARM REQUEST

Form - QP0518A
Mareeba Pistol Club Form # QP0518A
NAME
First Name & Surname
Email
example@example.com
Is a Financial Member of the Mareeba Pistol Club Inc. until 30th June*
Type year of membership expiry
Member's Concealable Firearms License No.
Exp Date

DayMonthYear
Date
Mareeba Pistol Club Membership No.
Same as SSAA Membership Number
Make
Manufacturer of Firearm
Model
Model number or name
Type of Action
Revolver, Semi Auto, Break action, air pistol etc
Class
Enter corresponding letter: (A) an air pistol; (B) a centre-fire pistol with a calibre of not more than .38 inch or a black-powder pistol; (service matches, 25 yard, WA1500, ISSF Centrefire ECTA ) (C) a centre-fire pistol with a calibre of more than .38 inch but not more than .45 inch; ( mainly single action matches at our club ) (D) a rim-fire pistol.
Calibre
22LR, 9mm, 38 Special etc
Magazine Capacity
Max 10 allowed
Barrel Length
Enter in millimetres
Please tick option that applies:

Barrel Length is greater than 100mm (Not Semi Automatic)Barrel Length is greater than 120mm (Semi Automatic)
Date

DayMonthYear
Date
Please click on the "Submit' button below.

A member of the executive committee will confirm your membership and email you back a signed copy of the form, ready for submission with your PTA.
Should be Empty:

CLUB AUTHORITY TO ACQUIRE FIREARM REQUEST