Application for a Single Use Permit to import, export or re-export wildlife or wildlife products under
Part 13A of the Environment Protection and Biodiversity Conservation Act 1999
Conservation Act 1999
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Important notes
There are severe penalties for knowingly making false or misleading statements in this application.
Many transactions relating to wildlife and wildlife products may require clearance from the Department of Agriculture and the
Australian Customs and Border Protection Service (Customs). Please contact the Department of Agriculture and Customs in your
State or Territory for information on quarantine and Customs controls.
The Legislation stipulates applications, with all completed information, must be processed within 40 business days of receipt.
Applications that are incomplete or contain insufficient information cannot be processed. Delays will occur whilst further
information is sought from the applicant.
If you need help in completing the application, please phone, fax or email the Wildlife Trade Regulation Section on the details
shown below.
If a permit is required, do not attempt to export/import without first obtaining your permit otherwise your specimens may be seized.
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Fee payable
For information on application fees please see: http://www.environment.gov.au/biodiversity/wildlife-trade/permits/fees.html.
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Payments may be made by credit card, cheque or money order. Please make cheques/money orders payable to ‘Collector of
Public Monies’.
Lodging the application
This application, and supporting documents, may be faxed or emailed using the details below in order to facilitate the processing of
the application, but permits will not be issued until the application fee has been received.
Please note that if you are paying by credit card, a faxed copy of your application and supporting documentation will be sufficient.
Supporting Documentation
Please ensure that, where applicable, you attach copies of:
 Overseas CITES (Convention on International Trade in Endangered Species of Wild Fauna and Flora) permits for each
specimen you wish to ship under a single use permit,
 Proof of legal acquisition of the specimen (e.g. state collection permit)
 Any relevant documents referred to in Question 25.
 You will also need to complete an extra subject-specific attachment if instructed to do so in Questions 18 and 22.
 You may be audited so please keep copies/records to verify sources of specimens.
Postal Address:
The Director
Wildlife Trade Regulation Section
Department of the Environment
GPO Box 787
CANBERRA ACT 2601
Fax: (02) 6274 1921
Telephone: (02) 6274 1900
Email: wildlifetrade@environment.gov.au
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Please complete if applicable:
Are you applying for ‘personal baggage’ permits for use for manufactured products being exported as personal
accompanied baggage? If so, how many do you require? _______________________________________
For information on the fee please see: http://www.environment.gov.au/biodiversity/wildlife-trade/permits/fees.html.
Credit card Details (if paying fee by credit card):
Card number:
Card holder name: (Print full name)
Card
name:
(Print fullorname)
Card:holder
either Visa,
Bankcard
Mastercard
Expiry date: month/year e.g. 12/2013
Amount $
Cardholder signature:
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Australian Address
Permit Details
COMPLETE FOR ALL PERMITS
Export Permits: For items that have been
sourced legally from within Australia.
Re-export Permits: For items that have
previously been exported from Australia or
another country.
Import Permits: For items that are being
imported from Overseas.
4. Name
Mr, Ms, Mrs, etc
First (given) name
Family name (surname)
1. Which of the following applies to this application?
5. Organisation name (if applicable)
TICK ONE ONLY
(Unless applying for both the import and export of a
travelling exhibition item)
Registered name and ABN
EXPORT of wildlife/wildlife products to another
country
Trading name (if different to above)
RE-EXPORT of wildlife/wildlife products to
another country
IMPORT of wildlife/wildlife products into
Australia
Position within organisation (if applicable)
2. How many permits do you require?
Single Use Permits
6. Street address
Address
Please ensure you have provided sufficient funds
for the number and types of permits required.
3. Have you previously been issued with a permit
Town/Suburb
to export or import wildlife or wildlife products?
State
No
Postcode
Go to next question
Yes
Number of last permit issued:
7. Postal address
Permit If same as street address, tick here
Address
Town/Suburb
State
Postcode
8. Contact details (include area code)
Telephone number – work
Telephone number - home / mobile
Fax number (include area code)
Email
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Shipment Details
Overseas Address
COMPLETE FOR ALL SINGLE USE
PERMITS
COMPLETE FOR ALL SINGLE USE PERMITS
14.Date of proposed import or export
9. Name
Mr, Ms, Mrs, etc First (given) Name
DD/MM/YYYY
/
/
Family name (surname)
15.How will the shipment be sent?
TICK ONE ONLY
10.Organisation name (if applicable)
Air
Registered name
Sea
Post
Accompanied baggage
Position within organisation (if applicable)
16.Name of Australian port of entry or exit
Show airport, seaport, city, town
11.Street address
Address
17.Name of Overseas port of entry or exit
Show airport, seaport, city, town
Town/Suburb
State
Postcode
18.What is the purpose of the import or export?
Country
Commercial purpose
Go to
next
question
Non-commercial purposes:
Select relevant
reason below
12.Postal address
If same as Street address, tick here
Address
See “Guide to the Import and Export of Wildlife
Specimens for Non-commercial Purposes” at
http://www.environment.gov.au/biodiversity/
wildlife-trade/publications/noncommercialguide/index.html
Town/Suburb
State
Postcode
Country
Research
(Supplementary Form A)
13.Contact details (include country and area codes)
Education
(Supplementary Form B)
Telephone number - work
Country code Area code and number
Exhibition
(Supplementary Form C)
Telephone number - home / mobile
Country code Area code and number
Conservation breeding or propagation
(Supplementary Form D)
Fax number (include country and area codes)
Email
Complete
relevant
supplementary
form and
Go to next
question
Travelling exhibition
(Supplementary Form F)
Personal item(s) that will not be
traded (Cannot be a live plant or animal)
Go to 24
Testing (as part of an assessment of a
proposed live import list amendment)
Go to 21
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19.Are you applying to import or export a live
Specimen Identification
animal (including viable reproductive material)?
No
Go to 24
Yes
Go to next question
Please provide details at question 24 (next page) of
the specimens you are applying for. The following
notes are provided to assist with the completion of
question 24.
No
Go to 24
1) Source Codes
Yes
Go to next question
20.Is it an import?
Wild
Captive bred
Captive born
Artificially propagated
Ranched
Aquacultured
Other (please explain)
Unknown (must be justified)
21.Is the species to be imported included on
the “List of Specimens Suitable for Live
Import”? The list is available at
www.environment.gov.au/biodiversity/tra
de-use/lists/index.html
W
C
F
A
R
AQ
O
U
2) Name of Commercial Wildlife Program
A live specimen cannot be imported into
Australia unless it is included on the “List of
Specimens Suitable for Live Import”
No
Yes
A permit cannot be issued, but you
may apply to have the list amended.
Information on amending the list is at
www.environment.gov.au/biodiversi
ty/trade-use/lists/import/index.html
Go to next question
22.Does your application relate to the
export/import of a live animal belonging to the
class Mammalia (mammals), Amphibia
(amphibians), Reptilia (reptiles) or Aves
(birds)?
No
Yes
Go to next question
Complete ‘Supplementary Form G:
Live Animal Imports/Exports’, unless
completing ‘Supplementary Form E:
Non-commercial Household Pet’ and
Go to next question
23.Are you applying to import a live plant
In this form, please provide the specific name of the
program from which your specimens were derived; for
example, the NSW Kangaroo Management Program,
Insect Harvesting and Export Program (Mr X), TAS
Tree Fern Management Program.
3) Place of origin
For Australian native species, or a non-native species
sourced in Australia, name the State or Territory
where taken or grown. For non-native species
sourced outside Australia, name the country from
which the specimens were originally taken.
4) Year in which the specimens were taken or bred
Show the year when the animals/plants were taken
from the wild; or the year that the specimens were
captive bred or artificially propagated.
(including viable reproductive material)?
Yes
Permits for commercial imports of species listed
under CITES Appendix II may be issued for wild taken
or ranched specimens unless it is a “declared
specimen”. Declared specimens require an approved
Commercial Import Program. The Declared
specimens list is available at
http://www.environment.gov.au/biodiversity/wildlif
e-trade/cites/domestic-measures.html#declared
Permits for specimens derived from an animal bred in
captivity or a plant that was artificially propagated may
also be issued.
Note: An export permit cannot be issued for a
live native mammal, amphibian, reptile or bird
if it is for commercial purposes.
No
Permits for commercial exports can usually only be
issued for specimens derived from an approved
wildlife program (such as a Captive Breeding
Program, Artificial Propagation Program, Aquaculture
Program, Wildlife Trade Operation or Wildlife Trade
Management Plan).
Go to next question
5) Reference Publication
Only complete for species that are not commonly in
trade and if you have not applied for a permit for it
before. Refer to a publication where the species is
named and described.
The introduction of the specimen
must be in accordance with the
Quarantine Act 1908. Information
on the Act is at
http://www.daff.gov.au/biosecur
ity/import/icon-icd
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24. Specimen details to be included on permit. Refer to notes on previous page before entering details.
If you have more than 3 different specimens, you will need to photocopy the page before entering the details.
Scientific name - PLEASE PRINT
(for example: MACROPUS RUFUS)
Common name
(for example: Red Kangaroo)
Specimen description
(for example: live animal; live plant; meat; shells; hunting trophy)
Source Code (see note 1)
Place of origin (See note 3)
If commercial: name of the program(s) from which specimen was sourced
(see note 2)
Year (See note 4)
Reference Publication (only complete if species is not
commonly in trade) (see note 5)
Scientific name - PLEASE PRINT
(for example: MACROPUS RUFUS)
Common name
(for example: Red Kangaroo)
Specimen description
(for example: live animal; live plant; meat; shells; hunting trophy)
Source Code (see note 1)
Place of origin (See note 3)
Year (See note 4)
Reference Publication (only complete if species is not
commonly in trade) (see note 5)
Common name
(for example: Red Kangaroo)
Specimen description
(for example: live animal; live plant; meat; shells; hunting trophy)
Place of origin (See note 3)
Quantity and unit
(eg Number, kg etc)
If commercial: name of the program(s) from which specimen was sourced
(see note 2)
Scientific name - PLEASE PRINT
(for example: MACROPUS RUFUS)
Source Code (see note 1)
Quantity and unit
(eg Number, kg etc)
Quantity and unit
(eg Number, kg etc)
If commercial: name of the program(s) from which specimen was sourced
(see note 2)
Year (See note 4)
Reference Publication (only complete if species is not
commonly in trade) (see note 5)
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25.Attach copies of any other approvals or
27.Is a courier service required for delivery of
permits relating to the import or export of the
specimens.
your permit(s)?
Include (where appropriate):
State/Territory holding, collection, import
and export permits, CITES permits
26.Do you wish to nominate an agent to act on
Go to next question
Yes
Enclose a pre-paid courier bag
OFFENCE DECLARATION
your behalf? If you answer yes, the permit
will be sent to your agent.
To answer this question, please answer ‘Yes’ or
‘No’ in the section provided
No
Go to next question
Yes
Provide agent details and
authorisation below.
Note that the applicant retains
responsibility for the application and that
the applicant (not agent) must sign the
declaration at question 29 and on any
relevant supplementary forms.
Name of agent
Address of agent
Telephone number of agent
(
No
)
Signature of agent
28.Has the applicant been convicted of, or is
the applicant subject to proceedings for:
Yes / No
(a) offences under the Environment
Protection and Biodiversity
Conservation Act 1999 or
Regulations;
(b) offences under any law of the
Commonwealth about the protection,
conservation or management of native
species or ecological communities;
(c) offences under section 6 of the
Crimes Act 1914 in relation to an
offence referred to in paragraph (a) or
(b)1;
(d) offences under a law of a State or
Territory about the protection,
conservation or management of native
species or ecological communities;
(e) offences in relation to a law referred to
in paragraph (d), under a provision of
a law of a State or Territory that is
equivalent to provision mentioned in
paragraph (c), or to section 11.1, 11.4
or 11.5 of the Criminal Code 2,3.
Note 1. Section 6 of the Crimes Act 1914 relates to
accessories to an offence,
Note 2. Section 11.1 of the Criminal Code relates to
attempt; section 11.4 of the Code relates to incitement
to commit an offence; and section 11.5 to conspiracy
to commit an offence.
Under section 11.6 of the Code, a reference in a law of
the Commonwealth to an offence includes the
offences created by sections 11.1, 11.4 and 11.5. For
offences of complicity and common purpose, and the
commission of an offence by means of an innocent
agency, see sections 11.2, and 11.3 of the Code.
Date signed
I further state that I have provided the abovenamed agent with the particulars of the
transaction and that the information provided by
me is true and correct in every detail.
Note 3 The provisions of Part V11C of the Crimes Act
1914 includes provisions that, in certain
circumstances, relieve persons from the requirement
to disclose spent convictions and require persons
aware of such convictions to disregard them.
Name of applicant (or Authorised person
if applicant is an organisation)
If the answer to any of the above parts of question 27
is ‘Yes’, please provide details of the offence, date,
penalty imposed
Signature of applicant or Authorised person
Date signed
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29.Please check the following before signing the
30.Declaration
declaration:
I declare that:
If you are paying by credit card, you
have completed the payment details on
page 2; otherwise the fee is enclosed.
You have attached all relevant
authorities and consents that indicate
compliance with other Commonwealth,
State and Territory requirements
related to the proposed export or
import.

the particulars provided by me in this
application are true and correct in every
detail; and

in the case of live animals and plants, that
they will be prepared and shipped in
accordance with the current edition of the:
“IATA (International Air Transport
Association) Live Animals regulations” in the
case of live animals to be transported by air;
or “CITES (Convention on International
Trade in Endangered Species of Wild Fauna
and Flora) guidelines for transport and
preparation for shipment of live wild animals
and plants” in all other cases; and

in the case where the specimen is for
personal use it will not be used for
commercial purpose including sale, lease,
hire or exchange and shall remain as my
personal property; and

all Commonwealth and State/Territory
requirements in relation to the specimen(s)
have been/ will be met (question 24 refers).
You have attached all relevant
authorities and consents from the
governments of other countries that
entitle you to import or export wildlife
across their respective borders.
You have attached any relevant
documents listed on Page 1.
You have attached all supplementary
forms as requested in questions 18 and
22, and any relevant documents listed
on those supplementary forms.
Names of supplementary forms:
Supplementary Form A - Research
Supplementary Form B - Education
Supplementary Form C - Exhibition
Supplementary Form D - Conservation
Breeding or Propagation
Supplementary Form E - Household Pet
Supplementary Form F - Travelling
Exhibition
Supplementary Form G - Live Animal
Imports/Exports
Please Note:
GIVING FALSE OR MISLEADING
INFORMATION IS A SERIOUS
OFFENCE
(Criminal Code – Division 137)
Name of applicant (or authorised person
if applicant is an organisation)
Signature of applicant or authorised person
Date signed
Information provided in this application form
may be exchanged with other
Commonwealth and State agencies for the
purposes of administering the EPBC Act
and relevant State legislation.
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