FORM NO. D STATUTORY DECLARATION IN RELATION TO APPLICATION FOR A PERMIT TO ACQUIRE A COLLECTOR HANDGUN ANTIQUE HANDGUN COLLECTORS LICENCE
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1 FORM NO. D STATUTORY DECLARATION IN RELATION TO APPLICATION FOR A PERMIT TO ACQUIRE A COLLECTOR HANDGUN ANTIQUE HANDGUN COLLECTORS LICENCE CATEGORY 1 FIREARMS COLLECTORS LICENCE CATEGORY 2 FIREARMS COLLECTORS LICENCE NOTICE TO APPLICANT: You are also required to complete a Victoria Police Application Form for a Permit to Purchase a Firearm which can be obtained from Licensing Services or downloaded from the internet. That form, duly completed, must be provided to the Guild s Nominated Officer for endorsement with this Statutory Declaration. Form Date 16/8/06
2 2 Storage Requirements for Firearms Collectors as prescribed by the Firearms Act 1996 as amended. Firearms Collectors licences 1. The firearm must be stored - (a) on premises or a part of premises which is a permanent building with secure locks on all openings; and (b) in a room - (i) (ii) the walls of which are solid enough to be a substantial physical barrier to entry; and any window of which is covered by security bars; and (iii) any door to which is - (A) (B) (C) of a solid material, or is covered by steel sheet or reinforced by firmly fixed steel mesh; and fitted with a lock of the dead latch type or an extra hasp or barrel bolt and padlock which is of such a nature as to reduce the possibility of the door being sprung from the jamb; and hinged with concealed hinge pins or with hinge pins which are welded to prevent the pins being removed; and (c) in a container - (i) (ii) (iii) (iv) which is made of steel or any other robust material; and which must be firmly fixed to the wall or floor of the room; and the doors of which are attached with concealed or welded hinges; and which, when any firearm is stored in it, is locked with a lock which is so constructed as to prevent the doors of the container being easily sprung. 2. If more than 5 firearms are stored on the premises where the firearm is stored, the premises must be fitted with an effective alarm system (see note (d)) of a class approved by the Chief Commissioner. 3. If more than 15 antique handguns, held on Antique Handgun Collectors (and where no other handguns and longarms held on a Victorian Firearms Licence) are stored on the premises, the premises must be fitted with an effective alarm system (see note (d)) of a class approved by the Chief Commissioner. 4. The key to the container in which the firearm is stored must -
3 3 (a) be carried by the holder of the licence; or (b) be kept securely in a separate room from the container - when the container is not being accessed. 5. The firearm must not be removed from the container except by the holder of the licence. 6. Any bolt or firing pin which is required to be stored separately from the firearm it is a part of, must be stored in the same manner as is required for the storage of a firearm under a longarm licence for a Category A or B longarm. NOTE: If less than 15 Category A or B longarms are owned under a Collectors Licence and no other firearms are stored at the premises, storage can be as specified below: The firearm must be stored in a receptacle - (a) (b) (c) (d) which is constructed of hard wood or steel that is not easily penetrable; and which, if it weighs less than 150 kilograms when it is empty, must be fixed to the frame of the floor or the wall of the premises where the firearm is kept in such a manner that it is not easily removable; and which when any firearm is stored in it is locked with a lock of sturdy construction. An effective alarm is defined as an intruder alarm system, the installation, maintenance and operation of which complies with the Australian Standard AS Intruder Alarm Systems Part 1: Systems installed in Client s Premises, which in the event of an intrusion activates an audible alarm warning device; and activates an external visible alarm warning light.
4 4 LIST OF PERSONS AUTHORISED TO WITNESS DECLARATION A Justice of the Peace or Bail Justice A Notary Public A barrister or solicitor of the Supreme Court A clerk to a barrister or solicitor of the Supreme Court The Prothonotary or a Deputy Prothonotary of the Supreme Court The Registrar or a Deputy Registrar of the County Court The Principal Registrar of the Magistrates Court The Registrar or a Deputy Registrar of the Magistrates Court The Registrar of Probates or an Assistant Registrar of Probates The associate to a Judge of the Supreme Court or of the County Court The secretary of a Master of the Supreme Court or of the County Court A person registered as a patent attorney under Part XV of the Patents Act 1952 of the Commonwealth A member of the police force The Sheriff or a Deputy Sheriff A member or former member of either House of the Parliament of Victoria A member or former member of either House of the Parliament of the Commonwealth A councillor of a municipality A town clerk or shire secretary A legally qualified medical practitioner A dentist A veterinary surgeon A pharmacist A principal in the teaching service The manager of a bank A member of the Institute of Chartered Accountants in Australia or the Australian Society of Accountants or the National Institute of Accountants The secretary of a building society A minister of religion authorised to celebrate marriages A person who holds an office in the public service that is prescribed as an office to which s107a(1) Evidence Act 1958 applies A fellow of the Institute of Legal Executives (Victoria) STATUTORY DECLARATION
5 5 I, (Full name of declarant/person making the Declaration) of... (Address of declarant/person making the Declaration).. Postcode. in the State/Territory of. (Insert your occupation/s).. do solemnly and sincerely declare that: (a) (b) I am the holder of a current Firearms Collectors Licence Category 1/2 (delete whichever is not applicable) Number.. The handgun I am intending to acquire is (set out make, model, calibre, barrel length, capacity (of shots), age or approximate age, and method of ignition, ie. percussion, pinfire, cartridge, etc. (c) I have a good understanding of handgun safety. (i) (ii) (iii) I have received and read the information provided by the Guild concerning knowledge of firearms, firearms laws and firearms safety, including handgun safety, as they apply to collectors. Yes No I have attended and completed the Guild prescribed course on firearm knowledge, firearm laws, firearm safety, storage and licence requirements. Yes No I agree to attend the Guild prescribed refreshment course on firearms knowledge, firearms laws, firearm safety, storage and licence requirements on a periodic basis as determined by the Guild. Yes No (d) (e) I have in place and will continue to have in place firearm storage arrangements as set out in the notes as to storage requirements set out above. My firearms storage arrangements are as follows (describe in detail):
6 6 (f) The handgun I am intending to acquire will be of obvious and significant commemorative, historical and/or thematic value in relation to my collection for the following reasons: (i) Describe the commemorative, historical and/or thematic value of your collection (attach more sheets if further space required): (ii) Describe the commemorative, historical and/or thematic value of the handgun you are intending to acquire (attach more sheets if further space required): Declared at in the State/Territory of
7 7 this. day of (Signature of declarant/person making the Declaration) before me. (Signature of witness/person before whom the Declaration is made). (Name of witness/person before whom the Declaration is made). (Address of witness/person before whom the Declaration is made).. Postcode... (Title or qualification of witness/person before whom the Declaration is made) A list of persons before whom Statutory Declarations may be made under S107A of the Evidence Act 1958 (Victoria) may be made is attached.
8 8 CHECKLIST (TO BE COMPLETED BY THE NOMINATED OFFICER OF THE GUILD) (NOT THE APPLICANT) 1. Is the Statutory Declaration complete? 2. Is the Statutory Declaration duly made? Yes No 3. Has the Applicant successfully completed the Guild course on firearms knowledge, firearms laws, firearms safety, storage and licence requirements and agreed to attend refresher courses as determined by the Guild? Signature of Nominated Officer Date Name of Nominated Officer
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