iKapa Arms & Ammunition Collectors Association P.O. Box 6282, Roggebaai 8012, Tel: 021-421-3273, (FAR Number 130076) ossies@culemborg.co.za, www.ikapa.yolasite.com Association Ref / Ser. No: (Unique No. for each Certification) Date: The Head Central Firearms Registry Private Bag X811 Pretoria 0001 Certification of “Approval for Collection” of collectable ammunition and deactivated artefacts (projectiles, rifle grenades and prohibited firearm cartridges) in terms of Section 18 of the Firearms Control Act, No. 60 of 2000 (the FCA). 1. Personal Details of Member: Name: ID no: Member no: Classification (Category): Contact telephone number: 2. Approved collecting interest: Field of interest: Theme and (Please delete if not applicable) Sub-Theme: (Please delete if not applicable) 3. Description of ammunition and deactivated artefacts: As per attached schedule Ser. No. xxxx Pages 1 to xx ……………………… Initials (Member) NAACCSA STANDARD FORMAT 07 ………………………… Initials (Chairman) Issue 03 dated April 2014 Page 1 of 3 iKapa Arms & Ammunition Collectors Association P.O. Box 6282, Roggebaai 8012, Tel: 021-421-3273, (FAR Number 130076) ossies@culemborg.co.za, www.ikapa.yolasite.com 4. Confirmation of ammunition and deactivated artefact Information: I, ………………………………., solemnly declare that all information supplied in this document is true and correct and that it is an accurate reflection of my interest in and knowledge of the ammunition and deactivated artefacts described within the context of the relevant Field of Interest or Theme or both. ………………………. Signature (Member) 5 ……………………… Name (Print) ………………. Date Certification of Approval I, …………………………………., as chairman/ duly authorised Executive Committee Member of this Association, hereby certify that: The above person is a registered member of iKapa accredited collectors’ association and is in good standing with the association, The member qualifies to collect the ammunition and deactivated artefacts (projectiles, rifle grenades and prohibited firearm cartridges) described in this document, The ammunition and deactivated artefacts (projectiles, rifle grenades, and prohibited firearm cartridges) described in this document fit within the member’s approved Theme or Field of Interest; and The ammunition and deactivated artefacts (projectiles, rifle grenades and prohibited firearm cartridges) are approved for collection in terms of Section 18 of the FCA. ……………………………….. Signature (Chairman*) ……………………….. Name (Print) ………………. Date (* or duly authorised Executive Committee Member) NAACCSA STANDARD FORMAT 07 Issue 03 dated April 2014 Page 2 of 3 iKapa Arms & Ammunition Collectors Association P.O. Box 6282, Roggebaai 8012, Tel: 021-421-3273, (FAR Number 130076) ossies@culemborg.co.za, www.ikapa.yolasite.com 6. Schedule of Ammunition and deactivated artefacts (projectiles, rifle grenades and prohibited firearm cartridges). (Schedule may be on separate pages, but each page must have the serial no. and page no’s. referred to in paragraph 3). 6.1 Ammunition as envisaged in Section 18(1) of the FCA: Item No. 1 2 3 Etc. 6.2 Description (Dimension and Make , Mark , Model or Type) 7x57 Mauser 8x57 Mauser S type .303 British Mk 7 EXAMPLE Quantity Remarks 100 200 1500 Includes packets Includes Case Deactivated Artefacts envisaged in Section 18(5) of the FCA EXAMPLE Item No. Description Quantity Remarks 1 2 Anglo Boer War ‘Pom Pom’ shells British Rifle Grenades , Type 23 &36 British / SA Mortar 3 inch 15 6 By manufacturer and type By manufacturer and date 2 1942 and 1943 versions 3 Etc. ……………………… Initials (Member) NAACCSA STANDARD FORMAT 07 ………………………… Initials (Chairman) Issue 03 dated April 2014 Page 3 of 3