APPLICATION FOR A PERMIT TO IMPORT / EXPORT / CONVEY
LIVE WILD ANIMALS FROM A PUBLIC GAME AUCTION
Province
(i.e. particulars of the destination of wild animals listed on this application)
DETAILS OF BUYER
Please note:
Application forms must be completed in legible block letters.
Where the space provided is not adequate the information should be attached as an addendum.
Any additional information, which the applicant deems necessary, should be attached to this application.
Name & Surname:
Company:
Registered name of farm
Farm number:
Size of area where wild animals will be introduced
Magisterial District
Telephone (work)
Fax
Telephone (home)
ID number (Passport number in the case of non-South African
Cell phone
Postal
E-mail
Physical
Address
M
F
T
DETAILS OF ANIMALS THAT ARE TO BE TRANSLOCATED
COMMON NAME
Quantity
COMMON NAME
DETAILS OF TRANSLOCATER OF WILD ANIMALS
Address
Quantity
F
T
Company name:
M
DECLARATION
I declare that all information provided is complete and correct to the best of my knowledge; I understand that any false
Date:
information supplied could lead to my application being disqualified.
Signature: