The Wild Life Protection Act, 1945

Application for an Exemption under Section 22 of the Wild Life Protection Act for being in Possession of the whole or any part of a Protected Animal or Protected Bird

Please read the following before completing this form:-

  1. This form must be completed in full
  1. This form will be submitted to the Minister responsible for the Environment.
  1. This form shall be returned to the National Environment and Planning Agency (NEPA) at 10 Caledonia Avenue, Kingston 5, c/o Manager, Biodiversity Branch.

NB. The Minister may order the confiscation of such animal/bird if the application is not granted.

All birds in Jamaica except the birds in the 2nd schedule to the Act are protected.

A copy of the Schedule to the Wild Life Protection Act with a list of all protected animals is attached to this form.

Section A

General Information

  1. ______

Name of Applicant

  1. ______

Address of Applicant

  1. ______

Telephone Number (Applicant)

  1. ______

Fax Number

  1. ______

E-mail Address

  1. ______

Type of Facility (e.g. Residence, Zoo & Attraction)

  1. ______

Name of Owner or Operator of the Facility

  1. ______

Name and Address of Facility

  1. ______

Telephone Number (Facility)

  1. ______

Name and Address of Supervisor of animal/bird care

Section B

Information on the Facility and Animal(s)/Bird(s)

1.0Facility (Tick as appropriate and indicate the purpose(s) of applying for the exemption)

Conservation______

Scientific ______

Historic______

Educational______

Recreational______

Other (state)______

2.0List Animals/Bird for which exemption is being applied.

SPECIES OF ANIMAL/BIRD / AGE(IF ALIVE) / SEX (IF ALIVE) / NAME OF PARTS (IF NOT ALIVE) / SIZE
(m) / WEIGHT
(kg/grams)
COMMON NAME / SCIENTIFIC NAME

2.1Description of animals/birds (indicate any distinguishing features).

______

______

______

______

______

______

______

2.2Quantity & Weight

SPECIES AND PARTS / TOTAL NO. /

TOTAL WEIGHT (kg/grams)

2.3Indicate whether the protected animal or bird has been captive bred, ranched or taken from the wild and state circumstances for each category:-

______

______

______

______

2.4State when and how the protected animals/birds were acquired or came into your possession?

______

______

______

______

2.5If alive, what is the present health of the animal(s)/bird(s) (attach veterinary report).

______

______

SECTION C

Statement by Applicant

I hereby certify that the information contained in this application is true and complete to the best of my knowledge and belief. I understand that any misrepresentation may lead to the discontinuation of the processing of the application and the revocation of certification granted. I understand that the certification if granted may be suspended or revoked for breach of any of the conditions stipulated therein.

Signature of Applicant:______

Date______day of______200_

FOR OFFICIAL USE ONLY

Date application received: ______

Date of Inspection______

Name of Officer______

Comments:

______

All information requested is completed and attached.Yes______No_____

Submitted to the Minister on the ______day of ______200_

Certified of Exemption granted on______day of______200_

NAME OF SPECIES OR PARTS / ID NUMBER / TYPE OF ID

Certification of Exemption Number______

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