Docstoc

Form 30 Proof of Identity Declaration

Document Sample
Form 30 Proof of Identity Declaration Powered By Docstoc
					                                                                            FORM 30
                                                                       Queensland
                                                                     Weapons Act 1990
                                                                     Section 13(1)(c)(ii)
                                                 PROOF OF identity declaRatiOn                                                                   Ver. 6 — 21/09/2009
                      You are required to provide proof of identity and two new, good quality, passport-sized colour photographs                                  ∆1

                      with your application for a licence, and within three years for subsequent licence renewal or replacement.
                                                                                        Please use block leTTers in dark pen only.
1. PROOF OF identity declaRatiOn                                                        To be completed by person suPPlyIng this declaration.
 In order to establish the          Family name
 correct identity of the
 person applying for the
 licence, the Authorised          Given name(s)
 Officer needs someone
 else to complete
 the Proof of Identity        address on electoral Roll of Person Supplying this declaration
 Declaration.
                                Property name/
 The Queensland                     Lot on plan
 person who makes
 this Proof of Identity          Street number
 Declaration must:                   and name
 • NOT be related by
    birth or marriage/           Suburb/Locality
    de facto relationship;
 • have known you for
    at least one year;                         State                     Postcode
 • write on the back of
    both photographs          contact details
    ‘This is a true
    photograph of                Home                                                                 Work
    (applicant’s name)’
    and sign their usual
    signature;                   Mobile                                                                Fax
 • be over the age of 18;
 • be recorded on the
    electoral roll at their   Identification type
    current Queensland                    Queensland Weapons Act licence                        Queensland driver licence         Passport
    address for at least
    12 months; and
 • provide a CURRENT               Identification number
    Queensland driver
    licence number,                                                            (Only one licence number required)
    Weapons Act licence
    number, or passport
    number.                   I Declare ThaT I have known The aPPlIcanT for ThIs lIcence
 You are required to
 provide proof of identity    For           year(s) and I vouch for his/her identity. I have endorsed the back of each photograph. I have
 and two new, good            given my details in the section above. I understand that it is a serious offence under the weapons act 1990
 quality, passport-sized      to make a deliberately false or misleading statement.
 colour photographs
 with your application
 for a licence, and
 within three years
 for subsequent
 licence renewal or
 replacement.                  Signature of person supplying the declaration                         Day        Month           Year

2. aPPlicant/RePReSentative detailS
 To be completed by                 Family name
 the applicant for this
 licence.
                                  Given name(s)

                                        Date of birth
                                                          Day       Month                Year
                                 Weapons licence no.
                                             (if applicable)

3. aPPlicant ceRtiFicatiOn
 To be completed
 by the applicant for
 this licence.


 If the form is not
 completed correctly
 and/or appropriate
 documentation is not
 provided at the police
 station, you may incur
 a delay in processing.

                                                                     Applicant’s signature                                      (Photograph of applicant)
                                                  nOt tO exceed deFined white aRea                                                do not staple or pin


                                                                Privacy Collection Statement
   The collection of this information is authorised by the Weapons Act 1990. The information will be used for the administration and enforcement of the
   Weapons Act 1990. The QPS may disclose some or all of this information to other State and Federal Government agencies as provided for by legislation or
   in accordance with the Information Privacy Act 2009.



Form 30 Proof of Identity Declaration                                                                                                                Page 1 of 1

				
DOCUMENT INFO
Shared By:
Categories:
Stats:
views:169
posted:4/27/2010
language:English
pages:1
Description: Form 30 Proof of Identity Declaration