INDIVIDUAL APPLICATION FOR LICENSE TO OWN AND POSSESS FIREARMS
(To be filled out by FEO Personnel only)
LICENSE CONTROL No.:
TYPE OF LICENSE:
TYPE 1
OTHER LICENSE/S:
Sports Shooter
TYPE 2
(To be filled out by Applicant completely and legibly)
TYPE 3
TYPE 4
Antique Firearm Collector
PERSONAL INFORMATION
TYPE 5
Gun Collector
DATE :
Day
Month
Year
Last Name:
First Name:
Qualifier:
Middle Name:
E-Mail Address:
Place of Birth:
Day
Date of Birth:
Month
Year
Gender: M
TIN:
+ 6 3
Mobile No.:
Telephone No.: (
Primary Address:
F
-
Unit No./Bldg:
Street/Brgy:
City/Municipality:
Region:
Postal Code:
Next of Kin:
Last Name
First Name
Middle Name
Mobile No.:
Qualification:
Telephone No.: (
+ 6 3
Businessman
Elected Official
Reserve AFP
Professional
Govt Official
Ret. Govt Official
Private Employee
PNP/AFP/Other LEAs
Govt Employee
Ret. PNP/AFP/Other LEAs
Ret. Govt Employee Others _________________
CERTIFICATION AND UNDERTAKING
I hereby certify that, pursuant to the provisions of Republic Act 10591, all statements
provided herein are true and correct. Further, I certify that I have not been convicted of any crime
involving moral turpitude, nor I have been convicted or is currently an accused in a pending
criminal case for a crime that is punishable with a penalty of more than two (2) years. Any
misdeclaration/falsity stated in this application shall be a basis for the cancellation of my license
and the revocation of the registration/s of my firearm/s and its/their eventual confiscation without
prejudice to the filing of criminal and or civil case against me.
2 X 2
I.D. Photo
(White Background)
Original Photo Only
No Xerox
No Scanned
_____________________________________
Signature above printed name
SUBSCRIBED AND SWORN to before me this _______ day of _______ 20____
applicant exhibited to me his/her competent evidence of identity issued by
_______________________, bearing ID No. ______________ on ____________ 20_____.
Doc. No.:________
Page No.:________
Book No.: _______
Series of 20______
_______________________________
NOTARY PUBLIC
FEO Series of 2014rszmgb
RIGHT THUMBMARK
(Roll thumbprint from left to right)