Form H: Application to remove an animal from authorised premises
Use this form to take an animal from authorised premises, under Clause 32 of the Exhibited Animals Protection Regulation 2010. If more space is required,
attach a page.
Applicant (current
Authorised premises
Authority no.
authority holder)
(Trading name and address)
(Licence/Approval/
Permit)
Species
Use scientific name if common name is
ambiguous
No.
Adult
Y/N
Age (if
sub-adult)
Time since
last removal
if < 2 days
Housing and
method of
display*
Arrangements
for the safety
of the public
Method of
transport
* e.g. Description of enclosure; whether taken from bag or travel container; type and frequency of handling; types of behaviours required
Destination(s)
Venue name and street address
Departure
date
Name:
Position:
Conditions of Approval:
The animal(s) is (are) removed and exhibited in
the manner described above, in accordance with
the Standards for Exhibiting Animals during
Temporary Removals in NSW, and where
applicable, in accordance with the Code of
Practice for the Welfare of animals in Film and
Theatrical Performances.
Return
date
Date(s) of
display(s)
Duration
Staff numbers,
of display experience &
qualifications
Signed:
FOR OFFICE USE ONLY
Approved
/
Type of event
(See list in
standards)
Date:
Grounds for Refusal:
Refused
Signed for Director-General / Date
Fax the completed form to: 02 6391 3740
A copy of this form will be returned to the applicant when a decision
has been made.
For more information, contact Animal Welfare on 02 6391 3276.
Privacy: The information collected in this form will be stored
securely and used only for the purposes for which is has been
collected. See our full privacy policy at
http://www.trade.nsw.gov.au/legal/privacy
INT12/9630