Authority Letter for carrying Arms for Renewal of Arms Licence

(Under Chapter II, Section 3 (1) of Arms Act 1959)
From,

Name::

  

Father's Name:

  

Address:

  
 
 

Police Station:

  
To,
District Magistrate,  
District:  
Dear Sir,
   
I hereby authorize the following person to carry Arms for Renewal of my Arms Licence and bring them back. He is also authorised to sign all renewal documents on my behalf:
   
Name:  
Father's Name:  
Address:  
   
Police Station:  
   
Licence No:  
Validity:  
Weapon No and Type::  
 

I am fully aware that this authority letter is being issued to him entirely of my own risk and responsibility.
 

Specimen Signatures are Attested below.
   
1)  
   
2)  
Yours Sincerely,
 
 
(Signature)
Dated: