APPLICATION FOR AIRSOFT/AIRGUN REGISTRATION

REGONAL CIVIL SECURITY GROUP 10 No. ________________

Camp Alagar, Lapasan, Cagayan de Oro City Date:

PERSONAL DATA:
Complete Name:
Date of Birth: Place of Birth:
Residential Address:
Citizenship: Sex: Status:
Length of stay in present address: Tel 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 air soft described herein involved in any
case before any court of law or administrative body as of this date.

___________________ 1x1
Applicant’s Signature
I D Photo
SUBSCRIBED AND SWORN to before me this _____ day of ______________ , 20___.
Applicant exhibited tome his/her Community Tax Certificate no. _______________ issued in
____________________________________ on _____________________________20___.
Doc No. __________
Page No. _________
Book No. _________ _________________________
Right Thumb mark
Series of _________ Notary Public
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(For FED Use Only)
Paid thru SBR No. ___________ P _____
Verified by: ___________________
Encoded by: __________________
RECOMMEND APPROVAL CONCURRED  Approved  Disapproved

PMAJ GILBERT LEE MENDOVA III

Officer-In-Charge, RCSU 10

MAF2018
 Republic of the Philippines
NATIONAL POLICE COMMISSION
PHILIPPINE NATIONAL POLICE, CIVIL SECURITY GROUP
REGIONAL CIVIL SECURITY UNIT 10
Camp 1Lt Vicente Alagar, Cagayan de Oro City

AS Reg No. ____________________

CERTIFICATE OF REGISTRATION
THIS IS TO CERTIFY that the bearer, whose personal data, picture and thumb
mark appear below, is the registered holder of the following described AirSoft/ Airgun
(Rifle/Pistol).
TYPE OR PRINT:

Last Name :
First Name :
Middle Name :
Address : 2X2
PHOTO

Occupation:
Tel. No.:
Date of Birth : / /
Place of Birth :

TIN: Right Thumb Mark

AIRSOFT/AIRGUN INFORMATION
SOURCE OF AIRSOFT KIND MAKE/MODEL SERIAL NO. CAL./POWER FACTOR

___________________ PMAJ GILBERT LEE MENDOVA III

Date Registered Officer-In-Charge, RCSU 10

____________________________
Signature over Printed Name of Owner

SBR# :
DATE :
AMOUNT :

MAF2018
 Republic of the Philippines
NATIONAL POLICE COMMISSION
PHILIPPINE NATIONAL POLICE, CIVIL SECURITY GROUP
REGIONAL CIVIL SECURITY UNIT 10
Camp 1Lt Vicente Alagar, Cagayan de Oro City

STENCIL AND BALLISTICS CERTIFICATE

Instruction: One (1) form is good for one (1) firearm only. This certificate is to be
prepared in three copies.
Print or type entries legibly.

DESCRIPTION OF FIREARM
Kind of Firearm Caliber

Make and Model Serial Number

STENCIL OF FIREARM
Serial Number Make and Model Other Markings

STENCIL TAKEN BY:

PSMS Mike Alejandro P Fabre

RCSU10 RSPNCO/FES

MAF2018