SCHEDULE- I FORM A-1 (for Individuals) an Arms Licence in Form If, I and TV =: Form of Application for Application Form A-1 for grant of new arms DISTRICT MAGISTRATE JHANST 14 | orricemusiness A. PERSONAL DETAML = See ee eae E F {YT armicarrnaone AVEENDDT : =o 3 [2 [pacennaroos DRDO {| 3. | cenoer MALE suse Diet —— a £6 [osreormmn oer984 2] 6. | Panno: 2OODOOCTSEL i 1] [eee {EAR DRM RESIDENCE, MANSY, PIN 284003 | TELEPHONE NUMBER BrMeSebe ‘svotesenco | : ofiee Reve | [90] more 8318164645 | 10 | NEAREST POLICE STATION HANA nAWABAD JHANS! K1,1427 ASHIANA LUCKNOW 2] 11 | pamacaner i LwoKNOW UTTAR PRADESH Tia | neanesrrouicesrarion | Need ASWAWK 1 [7 [occurarion GOVERNMENT SERVICES } i i 5 Note ~ Nearest Police Station means the police station weet Jurisdiction the place given in the address Bene OTS ara oan ore 9 Pere afrge & re F ARSE, Sse ‘Thursday 17 March 2022 ai@ (), ae ‘particar ‘Whether the applicant has been — Convicted ordered to execute a bond under ‘Chapter VIII of Code of Criminal Procedure, 1973 (2 of 1974) for keeping the peace or for good behavior No a W. @) ene applicant applicd before: itso, when, fo whom and feith shat resalt ©) the applicant's cence was ever Suspended or canceled / revoked = © anyother member ofthe applicant's facil sin possesion of 289 AF cence, eo particulars No @ én applicant has safe place 0 Ke earns and No. © | adaiional particulars the Uceace egeired fr crop protection under rule33SCHEDULE- IIL FORM A-1 (for Individuals) Form of Application for an Arms Licence in Form Il, II and IV Application Form A-1 for grant of new arms gant DISTRICT MAGISTRATE JHANSI Boeuraigszi22 7. | PResenr ADDRESS S] A [aveicavraane | ETAL SHURA 3 TPARENTISPOUS SANTOSH KUMAR [3 | cenver MALE 3 r State Distt Ae lama a TTTAR PRADESH FANPUROETAT 5 | S_| pare or sient 0/09/1985 27 e._ | ranno OOOO j i i 853-A, TYPE V, RAILWAY OFFICER COLONY, CIVIL LINES: HANS! UTTAR PRADESH Eg, |revernone numer Fs Otee Residence } [90 | Mose (6398826919 5140 [wearesrrouicestanion | nawabad HOUSE NO 254, MANGLA VIHAR, NEW PAC LINE. 11 | peRManenr KANPURINAGAR) UTTAR PRADESH. 12 | Neanesr POLICE STATION chaker 13 | occurarion (GOVERNMENT SERVICES DRM OFFICE JH 14 | orricemusiness aecesteneas DRM OFFICE JHANS! = Note ~ Néress Patice Siation means the police station under whose jurisdiction the place given in the address ia m —_ Wednesday 23 March 2022ther the applicant has been — Convicted [ordered to execute a bond wnder (p) |Stapter VII of Code of Criminal Procedure, 1973 (2 of 1974) for keeping the peace or for good behavior No (c) | pronibitea under the Arms Act, 1959, or any other law from having eke arms oF ammunition NO 7. | Water che applicant applied for a licence efores if so, when, © whom and with what result No ve apo ©) Viespetued or enclaves = No any oter member of the applicant's (C) | tamity is in possession of any arms licence, iso, particulars No che applicant has safe place to keep the arms and No (@) | Addisons particulars if the licence is required for crop protection under rule 33 No