Exhibited Animals Protection Regulation 2010 Clause 31 FORM F: APPLICATION TO ACQUIRE OR DISPOSE OF ANIMALS OF PRESCRIBED SPECIES Use this form to apply for approval to acquire or dispose of exhibited animals of Prescribed Species. Prescribed species are listed in Schedule 2 of the Exhibited Animals Protection Regulation 2010. Name It should be completed by either a) an exhibitor proposing to receive animals or b) an exhibitor seeking to dispose of animals interstate or to persons not authorised under the Exhibited Animals Protection Act 1986. Licence or Approval No. Full Street Address including Postcode Permit No. Sender Receiver ANIMALS Common Name No. of Animals Scientific Name Male Signed: Position: Name: Date: Trading Name: If approved: Fem Unkn. Total FOR OFFICE USE ONLY Trans. No.* Approved/Refused | Date Signed for Director-General Conditions of Approval / Grounds for Refusal * Record the transaction number in the Animal Record Book when the animal transaction takes place. Please note that approval is valid for 60 days only from the approved 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 the Animal Welfare Unit 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.industry.nsw.gov.au/legal/privacy INT12/9367