Fire Arm Reg Form
Fire Arm Reg Form
Fire Arm Reg Form
Last Name:
First Name:
Middle Name: Qualifier:
FIREARM/S INFORMATION
SOURCE OF FIREARM KIND MAKE MODEL CALIBER SERIAL NUMBER Addres s (1or2)
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(Fill out separate sheet if necessary. For firearm/s with different address, please fill out on separate Registration Form/s.)
I hereby undertake to renew the registration of my firearm/s on or before the ex piration of the same; that, pursuant to
the provisions of Republic Act No. 10591, I voluntarily give my consent and authorize the PNP to inspect my firearm/s described
above at my residence/address as indicated in my application and, to confiscate or forfeit the same in favor of the government for
failure to renew my firearm/s registration/s within six (6) months before the date of its expiration.
_____________________________________
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