FORM NO.

10
[See Rule 34 (1)]
FORM OF APPLICATION FOR REGISTRATION UNDER SECTION 34 OF THE WILDLIFE
(PROTECTION) ACT, 1972
To
Officer in charge of
Sanctuary/National Park

Sir,
1…………………………………………………………………………………………...resident of village
………………………………………………………Taluk………………………………............... District
...............................................................live within 10 Kilometres of.....................................
Sanctuary/National Park and apply for the registration of my name and address in accordance with the
provisions of section 34 of the Wildlife (Protection) Act, 1972
2. *The particulars of the arms possessed by me are as under/I am exempted from the provisions of the
Arms Act, 1959 (Central Act 54 of 1959)

Brief Quantity and

Whether Remarks (Name
description of description of
Sl. No. of Licence is for and address of
each weapon each kind of Date on which
licence and sports self retainers if any
with details of ammunition licence expires
date of issue protection or specified in the
distinguishing entitled to
display licence)
marks, register possess
numbers etc

1 2 3 4 5 6

3. I enclose treasury receipt for Rs……………………………………...being the registration fee

4. The arms licence is sent herewith for verification, endorsement and return.
Full Address of the applicant

Place and Date

Yours faithfully

Signature of the applicant

*(Strike out whichever is not applicable)