Page 1 of 1

Maya Xavier[CHANGE REQUEST]

Posted: 10 May 2026, 16:56
by Maya Xavier
Image
1. REQUESTEE DETAILS
  • FULL NAME: Maya Xavier
    PHONE NUMBER: 5186015
2. FIREARM DETAILS
  • Which firearm(s) are you currently licensed for?:
    Mark each box by changing [cb] to [cbc]
    • Double-Action Revolver
      Heavy Revolver
      Heavy Revolver Mk II
      Navy Revolver
      Pistol
      Pistol Mk II
      Pistol .50
      Heavy Pistol
      Combat Pistol
      SNS Pistol
      SNS Pistol Mk II
      Vintage Pistol
      WM 29 Pistol
      Flare Gun
    Which firearm(s) do you wish to be licensed for?:
    Mark each box by changing [cb] to [cbc]
    • Double-Action Revolver
      Heavy Revolver
      Heavy Revolver Mk II
      Navy Revolver
      Pistol
      Pistol Mk II
      Pistol .50
      Heavy Pistol
      Combat Pistol
      SNS Pistol
      SNS Pistol Mk II
      Vintage Pistol
      WM 29 Pistol
      Flare Gun
    If selecting a Flare Gun please additionally explain the reasoning for this:
    N/A
3. AMENDMENT PAYMENT
  • Use this section to post the receipt of you paying the Amendment Fee of $2,500 to change your firearms license.

    Proof of Payment
    ► Show Spoiler
4. DECLARATION
  • By signing and submitting this form you agree that the information provided is accurate and truthful. If the information provided is deemed to be false or inaccurate, you will be subject to receiving the criminal charges of GF07 - Fraud and GM12 - Giving False Information to a Police Officer. Your firearms license may also be revoked.

    SIGNATURE: Maya Xavier
    DATE: 10/MAY/2026
Image