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Cable.) Name of property Owner / Occupier: Property name (if applicable) Flat / Unit Number Street Number Lot Number / / Street Name Street Type (RD, ST, AVE, etc) Town / Suburb State Postcode Page 2 VP304A.indd 2 31/10/13 4:06 PM Attach Medical Report here if applicable Attach longarms safety course certificate here (All new applicants must attend a longarms safety course) Part 4 - Medical History (All applicants must complete this part) Have you in the past 5 years been t.

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