APPLICATION FOR AIRSOFT REGISTRATION

Chief, Philippines National Police No.

________________________
(Attention: Chief, FED)
Camp Crame, Quezon City Date:
______________________

PERSONAL DATA:
Complete Name:
__________________________________________________________________________________
Date of Birth: ________________________________ Place of Birth:
_________________________________________
Residential Address:
_______________________________________________________________________________
Citizenship: _______________________ Sex: _______________ Marital Status:
______________________________
Length of stay in present address: __________________________________ Telephone No.
______________________
Provincial Address:
________________________________________________________________________________
Provincial / Other Address:
__________________________________________________________________________
Name of Spouse:
_________________________________________________________________________________
Next of Kin (If Single) :
_____________________________________________________________________________
Name & Ages of Children (if any):
____________________________________________________________________

EMPLOYMENT:
Profession: ___________________________________________ Position:
___________________________________
Name of Company/ Office:
__________________________________________________________________________
Address: __________________________________________________________ Telephone No.
_________________
Length of Service: __________________________________________________

CRIMINAL RECORD:
Accused/Convicted of any crime? ( ) Yes ( ) No
If yes:
When and where filed:
_____________________________________________________________________
Nature of Offense and Outcome:
_____________________________________________________________
Name and address of three (3) non-relative Character References:

________________________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

AIRSOFT DATA:
Kind Make Serial Number Caliber/Power Factor

SOURCE: ( ) Dealer _______________________ ( ) Transfer ________________________

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I HEREBY CERTIFY that all statements are true and correct. I further certify that I
have no criminal conviction or pending criminal / administrative case before any court of law
or administrative body as of this date. Neither is the airsoft described herein involved in any 1 x 1
case before any court of law or administrative body as of this date.
I D Photo

_______________________
 Applicant’s Signature

SUBSCRIBED AND SWORN to before me this _______ day of ______________, 20___

Applicant exhibited to me his/her Community Tax Certificate No. ____________________ issued in
____________________________________ on ___________________________________20___.

Doc. No. __________

Page No. _________
Book No. _________ _________________________ Right
Thumbmark
Series of _________ Notary Public
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(For FED Use Only)

Paid thru SBR No. _____________________ P _______________

Verified by: __________________________
Encoded by: _________________________

RECOMMENDED APPROVAL CONCURRED Approved

Disapproved

______________________ _______________________ _____________________

Chief,FA Licensing Branch Deputy Chief, FED Chief, FED