Form V
(See rule 3)

APPLICATION FOR NEW LICENCE/RENEWAL OF LICENCE TO ENGAGE
IN THE BUSINESS OF PRIVATE SECURITY AGENCY

To

The undersigned hereby applies for obtaining a licence to run the business of operating services in the area of Private Security Agencies;

1. Full name of the applicant
2. Nationality of the applicant
3. Son/Wife/Daughter of
4. Residential Address
5. Address, where the applicant desires to start his Agency
6. Name of the Private Security Agency
   (NOTE: Registration Number of the Agency also be indicated)
7. Name and Address of Proprietor, Partner, Majority shareholder, Director and Chairman of the Agency.
   (NOTE: Nationality of each Partner, Majority Shareholder, Director and Chairman of the Agency be indicated)
8. Name and extent of facilities available
9. Qualification of staff engaged for imparting instructions:
   Name _____________________________
   Age ___________________
   Designation _____________________
10. Equipments which will be used for security services:
    • DFMD
    • HHMD
    • Mine Detector
    • Other Detectors
    • Wireless Telephones
    • Alarm Devices
    • Arms
    • Armory

NOTE: Strike off the equipment(s) not to be used for security services.