Department of Primary Industries, Parks, Water and Environment
PERMIT APPLICATION FORM
To Apply for the ‘Taking’ of Native Fauna
(Issued under the Threatened Species Protection Act 1995 and/or National Parks and Reserve Management Act
2002 and/or Crown Lands Act 1976 and/or Nature Conservation Act 2002)
NOTE: Applications involving scientific research or associated work must use the Scientific Permit
Application – Wildlife available at http://www.dpipwe.tas.gov.au/inter.nsf/WebPages/SJON-572UUU?open
Surname
Full Given Names
Title
Organisation/Institution
Address
(no P.O.
boxes)
Contact
Details
Phone
Fax
Email
Full names, organisations & addresses of all those involved that will require to be named on the permit.
Short title of project (for development proposals, quote the name (including author and date) of the relevant
report. Include the proposal application number if known).
Proposed start date
End date
Provide a brief description of the proposed activity, collection methods to be used, and expert advice that
has been provided (~150 words). (Where a document already exists which provides a description send a copy of
it along with the application form instead). In all cases where destruction of native fauna or significant habitat
is proposed, any proposed mitigation measures must also be provided.
*For the purposes of this applications ‘take’ includes kill, injure, catch, damage, destroy or collect a listed or protected species
or any product (including nests) derived there from.
Fauna species or product to be ‘taken’, including scientific names and the estimated number (or reasons
why this cannot be estimated). Attach a list if insufficient space. For applications where destruction of
threatened species is requested you must also provide an estimate of the species population size, area
occupied and distribution (eg clumped, scattered) and what proportion of the population will be affected for
the area where the destruction is proposed.
Attach a legible map (showing scale, map sheet number and easting/northing and datum grids and/or the PID)
and/or describe in detail each ‘take’ location/s. For each ‘take’ location you must provide the land tenure
(national park, private land, etc), grid references (easting and northing and/or PID) and the species to be
‘taken’ from the location. Grid references can be obtained from maps or the LIST.
Provide a description of what the material taken will be used for, and the quantity and type of material to
be used. If animals are to be removed from site of capture, where are they taken and for how long? Will
other species or sensitive locations be affected as a result of methods used?
Location/s where the material taken will be used or lodged (eg museum)
Have you previously been issued with a permit to ‘Take’ Native Fauna requiring, as one of the conditions
that a report be submitted? The report must be completed and submitted to the relevant officer before
further permits will be issued.
Report submitted?
Yes
Signature of Applicant
No
Date
Please Read Carefully: The Department retains the authority to reject any permit application and also to apply conditions to
any permit issued. Allow 4 weeks for processing of applications. Permission must be sought from the relevant land manager(s)
to access land. Fees for permits may apply.
Removal of wildlife from Tasmania requires an export permit from the Department of Primary Industries, Parks, Water and
Environment.
Permit Applications can be faxed, e-mailed or posted to:
For threatened species permits associated with developments:
Conservation Assessment Section, Resource Management and Conservation Division
ConservationAssessments@dpipwe.tas.gov.au
Phone 03 6165 4381, Fax 03 6223 8603
Department of Primary Industries, Parks, Water and Environment GPO Box 44 Hobart, TAS 7001
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Personal information will be collected from you for the purpose of managing Tasmania’s fauna and will be used by DPIPWE for assessing,
considering, advising upon, managing and/or determining the relevant application and may be used for other purposes permitted by the
Crown Lands Act 1976, National Parks and Reserves Management Act 2002, Nature Conservation Act 2002, Threatened Species
Protection Act 1995 and regulations made under these Acts.
You are required to provide this information by the Crown Lands Act 1976, National Parks and Reserves Management Act 2002, Nature
Conservation Act 2002, Threatened Species Protection Act 1995 and regulations made under these Acts. Failure to provide this
information may result in your application not being able to be processed or the service not being able to be provided
Your personal information will be used for the primary purpose for which it is collected, and may be disclosed to contractors and agents of
the Resource Management and Conservation Division, law enforcement agencies, courts and other organisations authorised to collect it
Your basic personal information may be disclosed to other public sector bodies where necessary, for the efficient storage and use of the
information
Personal information will be managed in accordance with the Personal Information Protection Act 2004 and may be accessed by the
individual to whom it relates on request to DPIPWE. You may be charged a fee for this service.