SAPS 519(a)
SOUTH AFRICAN POLICE SERVICE
APPLICATION FOR ACCREDITATION FOR BUSINESS PURPOSES
S ection 8 of the Firearm s C ontrol A ct, 2000 (A ct N o 60 of 2000)
OFFICIAL DATE STAMP A. FOR OFFICIAL USE BY THE POLICE STATION
WHERE THE APPLICATION IS CAPTURED
1
Application reference No
DATE RECEIVED
B. FOR OFFICIAL USE BY POLICE STATION WHERE THE APPLICATION IS RECEIVED
1
Province
2
Area
3
Police station
4
Component code
5
Firearm applications register reference No SAPS 86 NO YEAR
C. FOR OFFICIAL USE BY THE CENTRAL FIREARMS REGISTER (CFR)
1
Outstanding/Additional information required
2 3
- Persal number - - Date
4 5
Signature of police official Name in block letters
6
Application for accreditation approved (Indicate with an X)
7 8
- Persal number - - Date
9 10 11
Signature of deciding officer Officer code Name in block letters
12 13
Application for accreditation refused (Indicate with an X) Reason(s) for refusal
14 15
- Persal number - - Date
16 17 18
Signature of deciding officer Officer code Name in block letters
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SAPS 519(a)
D. TYPE OF ACCREDITATION (Indicate with an X)
1
As a shooting range
2
To provide training in the use of firearms
3
To provide firearms for the use in theatrical, film or television productions
4
To conduct business in hunting
5
To provide an in-house security service
6
As a museum
7
As a public collector in firearms and ammunition
8
As a game rancher
9
For other business purposes (specify the
purpose)
E. PARTICULARS OF APPLICANT
1
NATURAL PERSON’S DETAILS
2
Type of identification (Indicate with an X)
2.1
SA citizen Non-SA citizen with permanent residence*
3
Identity number - - -
4 5
Surname Initials
6
Full names
7 8 9
Date of birth - - Age Gender Male Female
10
Residential address
11
Postal Code
12
Postal address
13
Postal Code
14 15
Trade or profession If self-employed, specify
16
Name of employer/company
17
Business address
18
Postal Code
19 19.1 19.2
Telephone number Home ( ) Work ( )
19.3 20
Cellphone number Fax ( )
21
E-mail address
22
Marital status (Indicate with an X)
23
Single Married Divorced Widow Widower
Other (specify)
24
PARTICULARS OF APPLICANT’S SPOUSE/PARTNER (If applicable)
24.1
Type of identification (Indicate with an X)
24.1.1
SA ID Passport
24.2
Identity number of spouse/partner - - -
24.3
Passport number of spouse/partner
24.4
Name and surname
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SAPS 519(a)
*In the case of a non-SA citizen proof of permanent residence must be submitted.
25
JURISTIC PERSON’S DETAILS
26
OTHER BODIES (eg body corporate, close corporation or com pany)
27
Registered company name
28
Trading as name
29
Company registration or CC number
30
Postal address
31
Postal Code
32
Business address
33
Postal Code
34 34.1 34.2
Business telephone number Work ( ) Fax ( )
35
E-mail address
36
RESPONSIBLE PERSON’S DETAILS
37
Responsible person (full name and surname)
38
Type of identification (Indicate with an X) SA ID Passport number
39
Identity number of responsible person - - -
40
Passport number of responsible person
41
Cellphone number
42
Physical address
43
Postal Code
44
Postal address
45
Postal Code
46
PROOF SIGNATURES OF RESPONSIBLE PERSON
47 48
Signature of responsible person Signature of responsible person
49
PARTICULARS OF OTHER PERSONS IN CONTROL OF/OR RESPONSIBLE FOR THE MANAGEMENT OF THE ORGANIZATION
50
Identity number Full names Surname Capacity
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SAPS 519(a)
51
PARAGRAPH 52 - 55 MUST BE COMPLETED FOR ALL TYPES OF ACCREDITATION
52
MOTIVATION OF PURPOSE AND SCOPE FOR WHICH ACCREDITATION IS REQUIRED
53
DESCRIPTION OF THE MAIN PURPOSE OF THE BUSINESS
54
DESCRIPTION OF SECURITY MEASURES PERTAINING TO THE STORAGE, TRANSPORT AND SAFEKEEPING OF FIREARMS TO BE
USED
55
DESCRIPTION OF HOW REGISTERS WILL BE KEPT
56
COMPLETE ONLY IN THE CASE OF AN APPLICATION FOR ACCREDITATION TO PROVIDE IN-HOUSE SECURITY SERVICES
57
SCOPE OF WHAT IS TO BE PROTECTED
58
NUMBER OF PERSONS WHO WILL BE ISSUED WITH FIREARMS
59
COMPLETE ONLY IN THE CASE OF AN APPLICATION FOR ACCREDITATION AS A MUSEUM
60
DESCRIPTION OF ACCESS CONTROL
61
DESCRIPTION OF DISPLAY MECHANISMS
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SAPS 519(a)
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SAPS 519(a)
62
COMPLETE ONLY IN THE CASE OF AN APPLICATION FOR ACCREDITATION AS A PUBLIC COLLECTOR
63
PARTICULARS OF AN ACCREDITED MUSEUM WHERE THE FIREARM COLLECTION WILL BE DISPLAYED
63.1
Name
63.2
Accreditation registration number
64
DECLARATION BY APPLICANT
I am aware that it is an offence in terms of section 120 (9)(f) of the Firearms Control Act, 2000 (Act No 60 of 2000), to make a false statement in
this application.
F. SIGNATURE OF APPLICANT (S ign only if applicable)
1 3
2 Date - -
Fingerprint
designation
Name of applicant in block letters
5
Place
Right index fingerprint of applicant
6
Signature of applicant
7
PARTICULARS OF POLICE OFFICIAL DEALING WITH APPLICATION
7.1 7.2
-
Name of police official in block letters Persal number of police official
7.3 7.4
Rank of police official in block letters Signature of police official
G. PARTICULARS OF INTERPRETER
(This section must be completed only if the applicant cannot read or write, or does not understand the content of this form.)
1
Name and surname of interpreter
2
Identity/Passport number of interpreter
3
Residential address
4
Postal Code
5
Postal address
6
Postal Code
7 7.1 7.2
Telephone number Home ( ) Work ( )
8 9
Cellphone number Fax ( )
10
E-mail address
11
Interpreted from (language) to
12
Date - -
13 14
Place
Signature of interpreter
15 16
-
Rank of police official in block letters (if applicable) Persal number of police official (if applicable)
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SAPS 519(a)
H. FOR OFFICIAL USE BY THE DESIGNATED FIREARMS OFFICER/STATION COMMISSIONER
1
RECOMMENDATION REGARDING THE APPLICATION
Recommended Not recommended
2
Motivation
3
Recommended conditions
3 5
Date - -
Name of Designated Firearms Officer/Station Commissioner in block letters
6 7
Place
Rank of Designated Firearms Officer/Station Commissioner in block letters
8 9
-
Signature of Designated Firearms Officer/Station Commissioner Persal number of Designated Firearms Officer/Station
Commissioner
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