DANGEROUS WILD ANIMALS ACT 1976
APPLICATION FORM FOR GRANT OR RENEWAL OF A DANGEROUS WILD ANIMALS
LICENCE
PLEASE READ GUIDANCE NOTES SUPPLIED BEFORE COMPLETING FORMS
A.
PERSONAL DETAILS
Full Name
………………………………………………………………………………………..
Home Address
………………………………………………………………………………………..
………………………………………………………………………………………..
………………………………………………………………………………………..
Post Code
………………………………………………………………………………………..
Tel No
……………………………………Mobile…………………………………………..
Email
………………………………………………………………………………………..
Date of Birth
………………………………………Age……………………………………………
Place of Birth
………………………………………………………………………………………..
Do you intend to carry out the day to day management of the business YES / NO
B.
BUSINESS DETAILS
Full Name of Business
………………………………………………………………………............
Address of Registered
Or Principle Office
………………………………………………………………………............
……………………………………………………………………………….
………………………………………………………………………............
Post Code
………………………Email…………………………………………………
Tel No
……………………………………………………………………………….
C.
LICENCE DETAILS
Tick one box only
Grant
Renewal
If Renewal – Licence No.
………………………………………………………………………...
If not a Renewal:
Have you previously held a Dangerous Wild Animal
Licence in this area or any other in the U.K.?
If Yes Area:
YES / NO
………………………………………………………..........
Dates and duration of licence :
……………………………………………………………...
Reason no longer licensed:
……………………………………………………………...
If not a Renewal:
Have you previously been refused a Dangerous
Wild Animal Licence in this area or any other of the U.K.? YES / NO
If Yes Area:
D.
……………………………………………………………...
Reason for refusal:
……………………………………………………………...
Date(s) of refusal:
……………………………………………………………...
PREMISES DETAILS
Address of accommodation where animal(s) is / are to be kept.
…………………………………………………………………………………………………………………..
…………………………………………………………………………………………………………………..
………………………………………………………..Post Code…………………………………………….
Tel
no………………………………………………..Email…………………………………………………........
Description and dimensions of accommodation to be used
…………………………………………………………………………………………………………………..
………………………………………………………………………………………………………………….
…………………………………………………………………………………………………………………..
.
E.
ANIMAL DETAILS
Species, sex and number of animals to be kept
…………………………………………………………………………………………………………………..
…………………………………………………………………………………………………………………..
…………………………………………………………………………………………………………………..
Is it intended to breed or attempt to breed with animals?
F.
YES / NO
KEEPER(S) DETAILS
Name(s) of person(s) proposed by the applicant to act as keeper(s) of the animal(s) on his or her
behalf
…………………………………………………………………………………………………………………..
…………………………………………………………………………………………………………………..
…………………………………………………………………………………………………………………..
G.
INSURANCE DETAILS
Details of the Insurance Policy to cover liability
Name of Company
……………………………………………………………………………….
Address of Company
……………………………………………………………………………….
……………………………………………………………………………….
……………………………………………………………………………….
Policy No…………………………Expiry Date…………………………Amount £………………………...
DECLARATION
I hereby declare that I am over 18 years of age and not disqualified by being convicted of
any offence at any time under the Protection of Animal Act 1911 to 1964, the Protection of
Animals (Scotland) Act 1912, The Protection of Animals Act 1934, the Pet Animals Act
1951, the Animal Boarding Establishments Act 1963, the Riding Establishments Act 1964
and 1970 or the Breed of Dogs Act 1973.
I require the licence to operate from the ………..........day of ……………….20……………
A remittance of £…………………….is enclosed for the licensing fee.
Signature of applicant
Dated
……………………………………………………………………………….
……………………………………………………………………………….
Data Protection Act 1998 privacy notice – Personal information of any kind, including sensitive
information like convictions, supplied by applicants on a licence application form or associated
documents may be stored on a computer and/or paper file system by the authority (Moray Council
and/or Moray Licensing Board) as part of the licensing process. Wherever possible the authority
will take steps to preserve privacy e.g. by the use of case reference numbers rather than names.
Information may be shared with and received from: Other council departments; other
councils/authorities; government departments; the police; the fire and rescue service; and other
relevant parties e.g. community councils or courts.
Information may be shared by: any method. Public-sector organisations can share data privately
and securely by sending emails via the UK Government Connect Secure Extranet (GCSX). In
addition they can communicate with other authorities Europe wide via the EC’s secure Internal
market Information (IMI) system.
Information may be used for: Vetting and background enquiries; regulatory functions;
enforcement; protection of public funds; auditing; detection and prevention of crime (including data
matching exercises for this purpose); and promoting equalities.
Information may be made available to the public for the purposes of: public consultation; to
advertise applications; through public licensing meetings; and to populate public registers.
Applicant’s Consent: By signing the form the applicant consents to the Council / Licensing Board
processing information in these ways.
Data Protection Rights: Individuals have the rights to: ask what the Council uses the information
for; be provided with a copy of the information; be given details of the purposes for which the
Council uses the information; know about persons/organisations to whom the information is
disclosed; ask for incorrect data to be corrected.
GUIDANCE NOTES
The Application Form
The application form is split into 7 sections
A.
B.
C.
D.
E.
F.
G.
Personal Details
Business Details
Licence Details
Premises Details
Animal Details
Keeper(s) Details
Insurance Details
You must answer all of the questions as fully as you can as failure to do so may result in your
application being returned to you. Your application will not be processed until you have provided all
the necessary information.
A.
PERSONAL DETAILS
You require to complete this section if you are an individual person applying for a Dangerous
Wild Animals Licence. It is essential that your full details are supplied on the application form so
that necessary Police checks can be undertaken swiftly and so your application can be
progressed as quickly as possible.
B.
BUSINESS DETAILS
You require to complete this section if the premises is run by a company or partnership rather
than an individual person.
C.
LICENCE DETAILS
A Dangerous Wild Animal Licence generally lasts for a maximum of 1 year although the
Licensing Authority have the discretion to grant it for a shorter period. Once it expires
you can apply to renew it for a further 1 year.


Grant of a Licence (1 year) – If you have never held a Dangerous Wild Animal
Licence before or you do not currently have such a licence you need to apply for
the Grant of a licence. The fee for a grant is £.
Renewal of Licence (1 year) – If you currently hold a Dangerous Wild Animal
Licence which has not expired but is due to expire then you need to apply for a
Renewal of the licence. The fee for a renewal is £. The old licence remains in
force until the renewal is granted, but only if application is made before the expiry
date.
If you are applying for the grant of a licence you are asked questions on the form as to
whether you have previously held a licence in the United Kingdom or whether you have
been refused such a licence previously. Please note it is very important that you
complete these questions fully.
D.
PREMISES DETAILS
You are required to supply the full postal address and telephone number of the
premises to which the licence is to relate. Please also include the details of the
accommodation being provided for the animal(s)
E.
ANIMAL DETAILS
Please give details of all the animals in which it is proposed to keep at the premises
please detail type, sex and number.
F.
KEEPER(S) DETAILS
Please provide the full name(s) of all person(s) who will be acting as keeper(s) of the
animals on behalf of the applicant.
G.
INSURANCE DETAILS
Please provide details of the insurance policy held to cover liability, please include the
name and address of the company, the policy number, expiry date and the amount of
cover.
LICENCE CONDITIONS APPLICABLE TO KEEPING A DANGEROUS WILD ANIMAL
Conditions subject to which the licence is granted
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
That the animal(s) specified in the licence shall be kept by no other than the licence
holder or, the person(s) named in the licence and designated by the licence holder to
act as keeper(s) of the animal(s) on his or her behalf.
That the applicant make the terms of the licence known to each person acting as a
keeper on his or her behalf.
That the applicant shall not increase the number of animals authorised by the licence
to be in his possession without the consent of the authority.
That the applicant possesses a valid insurance policy against liability for any injury
caused by any animal specified in the licence.
The applicant must not be disqualified for the time being under any of the following
enactments:a) The Dangerous Wild Animals Act 1976
b) The Protection of Animals Acts 1911 to 1964
c) The Protection of Animals (Scotland) Acts 1912 to 1964
d) The Pet Animals Act 1951
e) The Animal Boarding Establishments Act 1963
f) The Riding Establishments Acts 1964 to 1970
g) The Breeding of Dogs Act 1973
That each animal specified in the licence shall at all times be held in accommodation
which secures that it will not escape and, which is suitable as regards construction,
size, temperature, lighting, ventilation, drainage and cleanliness and which is suitable
in the provision of adequate exercise space
That each animal specified in the licence be adequately supplied with suitable food
and drink, be provided with suitable bedding material, be adequately exercised and
(so far as is necessary) be visited at suitable intervals.
Appropriate steps will, at all such times, be taken for the protection of any animal
concerned in case of fire or other emergency.
All reasonable precautions will be taken at all times to prevent and control the spread
of infectious diseases.
That immediate notification shall be made by the applicant or authorised keeper to
the Police and to the Council in the event of any animal, to which the licence relates,
escaping and being at large.
That a notice be displayed at all times on any accommodation holding any animal
specified in the licence, indicating that the occupant is a "Dangerous Wild Animal".
That no animal, to which the licence refers, shall be kept at premises outside this
District for a continuous period exceeding 72 hours unless previous notice of this
intention has been given to both this Authority and the Authority in whose area those
premises are situated and permission to do so has been obtained from both
Authorities.
PENALTY
Any person guilty of an offence under any provision of this Act shall be liable on
summary conviction to a fine not exceeding £400.00