RETURN FORM – Wildlife Basic or Advanced Licence

1 April 20…… to 31 March 20…… Name: ……………………………………………… Wildlife Licence No. ……………………

/
ACQUISITIONS DURING THIS PERIOD
/
DISPOSALS DURING THIS PERIOD
/
STOCK HELD AT 31 MARCH
Species Common Name
Refer to your Species Code list / Species
Code / ALIVE AT
1 APRIL / BRED / Imports / Other / ESCAPES / DEATHS / Exports / OTHER / Alive / DEAD
Preserved / Mounted
+ / + / + / - / - / - / - / =
Eg. Carpet Python / 2969 / 2 / + / 1 / + / + / 2 / - / - / 1 / - / - / = / 4
+ / + / + / - / - / - / - / =
+ / + / + / - / - / - / - / =
+ / + / + / - / - / - / - / =
+ / + / + / - / - / - / - / =
+ / + / + / - / - / - / - / =
+ / + / + / - / - / - / - / =
+ / + / + / - / - / - / - / =
+ / + / + / - / - / - / - / =
+ / + / + / - / - / - / - / =
Signature:.....…...... …......
Date: ………… / ………… /20 ………….
(Returns must be provided to DELWP by 14 April). / ü DO:
§  Show only transactions conducted during the specified period .
§  Only include those species for which a wildlife licence is required.
§  Check your figures to make sure they add up.
§  Use the correct species name and code.
YOU MUST KEEP A COPY OF THIS FORM. / û DON’T:
§  Separate species into sexes or age groups.
§  Include pest or exotic animals.
§  Include as BRED, anything born before 1 April.
§  Include as OTHER, anything acquired or disposed of before 1 April.
§  Forget to sign and date your form.

Send to: Wildlife Licensing, 475 Mickleham Rd, Attwood VIC 3049 Please direct any questions to the DELWP Customer Service Centre on 136 186