Nominated Land/Club Form

LINCOLNSHIRE POLICE

NOMINATED LAND/CLUB FORM

IN ORDER TO ESTABLISH A LAND REGISTER AND REDUCE THE DELAY IN THE PROCESSING OF RENEWAL AND VARIATION APPLICATIONS IT IS REQUESTED THAT THIS DOCUMENT BE COMPLETED. THIS IS NOT A LEGAL REQUIREMENT.

To be completed by the owner/agent/occupier/tenant* of the land on which shooting is proposed.

Title (e.g. Mr, Mrs, Ms) / Surname
Forenames
Address
Telephone Number
Acreage / Hectares
Name of Land
Weapon Type(s) Authorised
I am the above named person and I am the owner/agent/occupier/tenant* in respect of the land named above over which I have given
Permission to shoot with the type(s) of weapon I have indicated.
Signature / Date

TO BE COMPLETED BY COMMITTEE MEMBER OF APPROVED CLUB

Name: / is an active full time member
of the (enter name of club)
His/her membership number is / and expires
Signature / Date

*Delete as necessary