Wildlife Conservation Act 1950, Section 23C Reg 56E (1)(a)
Conservation and Land Management Regulations 2002 Regs 4 and 8 (1)
CP and CE
Application to Take Protected Flora from Conservation
Estate for Commercial Purposes
Completed forms should be returned to:
Department of Parks and Wildlife
Locked Bag 30 Bentley Delivery Centre WA 6983
Or faxed to (08) 9219 8242 or emailed.
Further information on the licensing requirements
is available from DPaW Wildlife Licensing Section
Phone: (08) 9219 9836
Email: wildlifelicensing@dpaw.wa.gov.au
IF SUCCESSFUL, THE APPLICANT WILL BE ISSUED WITH A REGULATION 4 AUTHORITY AND A
COMMERCIAL PURPOSES (CP) LICENCE WHICH RELATE TO EACH OTHER AND THE PROJECT.
ALL PERSONS TAKING FLORA IN THE CONSERVATION ESTATE FOR THE PROJECT MUST HOLD A CP
LICENCE RELATING SPECIFICALLY TO THE REGULATION 4 AUTHORITY; ANY OTHER CURRENT CP
LICENCES THAT AN APPLICANT MAY HOLD ARE NOT VALID TO BE USED ON CONSERVATION ESTATE
FOR THE PROJECT.
APPLICATIONS MAY ONLY BE CONSIDERED WHERE THE ACTIVITY WILL ASSIST IN THE PRESERVATION
OR PROTECTION OF THE FLORA OF THE CONSERVATION ESTATE.
PLEASE ALLOW THIRTY (30) WORKING DAYS TO PROCESS COMPLETE AND CORRECT APPLICATIONS.
Applicant:
Surname
Dr/Mr/Mrs/Miss/Ms
Other Names
Personal Address (residential)
Postcode
Address (postal)
Postcode
Address Change Yes/No
(please state previous address)
Day Phone No.
Associated Research Institution/Company (if applicable)
Date of Birth:
/
Previous Permit No.:
CE……………..
Expiry Date:
/
/
Email Address:
/
@
Commercial Purposes licences:
 Application/s for CP licences attached (tick) Note: all persons taking flora require a CP licence (see above for
more details)
Names of other participants:
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Application to Take Protected Flora from Conservation Estate for Commercial Purposes
Details of conservation estate (Identify each):
Name of CALM managed land
(eg. National Park, Nature Reserve, Marine Park, etc)
DPaW District
Applicants are required to submit a map of the proposed collection sites with this application.
 Map attached (tick)
Purpose of collection:
a) Detail the primary purpose of collection (continue on separate paper if not enough space below):
 Further supporting documents attached (tick) e.g. project proposal, revegetation plan.
b) Details of the location where the flora will be used:
Name of Local Government
Authority (eg. Shire)
Location details of where planting will take place (must
be specific- eg. Lot number; can provide GPS
coordinates to support)
Land Owner/Occupier (Private Property)
OR Land Manager (Crown Land)
Applicants are required to submit a map of the site where the flora will be used.
 Map attached (tick)
Details of the proposed collection:
a) Will the collection of flora from conservation estate be:

Situation 1- the primary source of collection; in which case a complete list of species will need to be
provided- refer to section b (tick)
OR

Situation 2- used as a source of collection only if the last resort; in which case five (5) working days
before collection the applicant will have to contact the relevant DPaW district, provide them with details of
the species and quantities of flora proposed to be taken and demonstrate that collection from the
conservation estate is the only option under the current circumstances (tick)
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Application to Take Protected Flora from Conservation Estate for Commercial Purposes
b) Flora to be collected- MUST be completed if you have selected Situation 1 above (continue on separate
paper if not enough space below):
Species
Priority
Code
(1-4)
Part of plant to be taken and total quantity
(eg. seed, 150g)
Method of Collection
c) Will the collection sites be marked? Please detail:
d) Will vehicles be required to be used within the conservation estate? Please detail (eg. make, type,
registration number, company markings, etc):
Potential alternative sources of flora outside the conservation estate: It must be demonstrated that
there are no alternative sources of flora available outside of the conservation estate, or why other sources are not
suitable.
a) Detail if there is any flora available on Unallocated Crown Land (UCL):
b) Detail if there is any flora available on Shire managed lands:
c) Detail if there is any flora available on State Forest:
d) Detail if there is any flora available on Private Property:
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Application to Take Protected Flora from Conservation Estate for Commercial Purposes
Provide justification for the taking of flora from conservation estate: Detail how your proposed
activities will increase DPaW’s knowledge of protected flora, benefit the conservation estate of interest, or assist the
long-term survival of flora species.
Period for which licence will be required/duration of activity (Note: exact dates must be specified; if
long-term project please note that the maximum period that a licence can be issued for is 12 months):
Starting Date:
Finishing Date:
(state ‘ASAP’ if starting date will be once
the permit has been issued, but not within
the next 30 working days)
Expected overall finish date of project:
Applicant’s declaration:
I AGREE THAT:
If approved I will comply with the provisions of the Wildlife Conservation Act and Regulations and the
Conservation and Land Management Act and Regulations, and all conditions (including those added specifically
for this activity) applicable to the issue of this authority and licence.
/
Signature of Applicant
/
Date
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