INSTRUCTIONS Surrendering Person Complete Part A and Part B of this form. Firearms Dealer Complete Part C of this form. Forward the original form to Firearms Branch with a PD306 – Application for a Permit to Acquire a Firearm, if the firearm is being registered OR Present the original form with the firearm to SAPOL members if the firearm is surrendered to police. A copy may be retained by the dealer for local records. Receiving SAPOL Officer Complete Part D. Verify the firearm details from the item and FCS. Lodge the items with PPMS and record the PPMS number. Ensure the item holds the correct release authority e.g. destruction. Scan and email to Firearms Branch. Email: SAPOL.FirearmsBranch@police.sa.gov.au Attach original to the firearm for completion by Armoury OR to the gel blaster firearm for local destruction policy. Armoury Complete Part E and file locally
Lodging Instructions to PPMS
All firearms should be considered loaded until proven safe Always point the firearm in a safe directions Keep your finger OFF the trigger Do not accept batteries and accessories for gel blasters Refer to the ‘Safe Handling of Firearms Manual’ for safe receipt and storage practices.
PART A: TO BE COMPLETED BY THE SURRENDERING PERSON (OR RECEIVING DEALER)
I wish to remain anonymous in accordance with the General Amnesty, s64 Firearms Act 2015	OR
I,
(Full Name)
of
(Full Address)
Contact Telephone:	Home:	( )	Work:	( )	Mobile:
Firearms Licence Number: (if applicable)	Not Licenced
hereby surrender unconditionally to the South Australia Police, this firearm and I will not make any claim whatsoever in relation to this firearm. (may be anonymous) hereby surrender this firearm for the purpose of the firearm being de-activated and subsequently returned to me. hereby surrender this firearm for the purpose of seeking to become the registered owner of the firearm (PD306 – Application for a Permit to Acquire a Firearm also required). hereby surrender this firearm for the purpose of entering into a private commercial arrangement to sell the firearm to a licensed firearms dealer.
Make of Firearm:
Type:
Serial Number:	Calibre: (if applicable)
Signature:	Date:	/ /
PART B: GENERAL AMNESTY DETAILS (Optional for person surrendering items under Amnesty)
What is the reason for the Amnesty surrender?
The ability to register the firearm	A sense of responsibility
Firearm is no longer wanted	Other reason
To avoid being charged with an offence
PART B: GENERAL AMNESTY DETAILS - Continued (Optional for person surrendering items under Amnesty)
What is the reason for not surrendering earlier?
Firearm is new to surrender	Did not have the time or opportunity
Was not aware of the amnesty	Other reason
How was the firearm obtained?
In possession prior to the 1996 buy back	Gift / Inheritance / Family heirloom
In possession prior to the 2002 handgun reforms	Other
Have you previously surrendered any firearms?	Yes	No
How long has the firearm been in your possession?	years
Gender:	Male	Female	Non-Binary	Other
Age:	18 - 24	25 - 34	35 - 44	45 - 54	55 - 64	65+
How did you hear of the Amnesty?
Newspaper	Digital media	Word of mouth
Magazine or newsletter	Other reason
PART C: TO BE COMPLETED BY THE AUTHORISED FIREARMS DEALER
Dealer Licence Number:
Surrendered to Police?	Yes	No
Held pending PD306 – Application for a Permit to Acquire a Firearm:	Yes	No
If ‘Yes’, Licence No. of person acquiring:
Signature:	Date:	/ /
PART D: TO BE COMPLETED BY THE SAPOL RECEIVING OFFICER
Details confirmed with FCS?	Yes	No	If ‘No’, record details in comments.
PPMS Number:	/	Item:
Scanned and emailed to Firearms Branch:	Yes	No
Surrendered by Owner?	Yes	No	If ‘No’ – give explanation why the person surrendering is not the owner.
Comments:
Name:	Rank:	ID:
Location:	Signature:	Date:	/ /
PART E: SAPOL ARMOURY USE ONLY
BIN NUMBER: