Regulations > Threatened or Protected Marine Species Regulations, 2017 > Annexures

ANNEXURE 1

PERMIT APPLICATION FORM

A.	Applicant details:

NAME OF APPLICANT: NAME OF PERSON WHO WILL CARRY OUT THE RESTRICTED ACTIVITY: (if not the same as the applicant):
IDENTITY OR PASSPORT NO: APPLICANT: PERSON WHO WILL CARRY OUT THE RESTRICTED ACTIVITY: (if not the same)
TEL NO:	CELLULAR NO:
FAX NO:
E-MAIL:
POSTAL ADDRESS:	PHYSICAL ADDRESS:

B.	Facility details:

NAME OF FACILITY:

KIND OF FACILITY:

DATE OF ESTABLISHMENT OF FACILITY:

PHYSICAL ADDRESS OF FACILITY:

C.	Kind of Permit Applied for (Tick off)

ORDINARY		STANDING		PERMANENT POSSESSION
NEW		RENEWAL		AMENDMENT

D.	If the Application applies to a Standing Permit (Tick off)

	CAPTIVE BREEDING OPERATION	SANCTUARY
	TEMPORARY HOLDING FACILITY	SCIENTIFIC INSTITUTION
	COMMERCIAL EXHIBITION FACILITY	NURSERY
	GAME FARM	WILDLIFE TRADER
	REHABILITATION FACILITY	TAXIDERMIST
	WILDLIFE TRANSLOCATOR	FREIGHT AGENT

E.	Kind of restricted activity applied for (see section G in the case of a hunt)

E.g. Possession / Hunt / Catch / Capture / Gather / growing / Breeding / Other Applicable Restricted Activity:

HUNT		CATCH	KILL
GATHER		COLLECT	PLUCK
PICK		CUT	CHOP OFF
UPROOT		DAMAGE	DESTROY
IMPORT	EXPORT	RE-EXPORT	INTRODUCE FROM THE SEA
POSSESSION / EXERCISE PHYSICAL CONTROL
GROW		BREED	PROPAGATE
CONVEY/MOVE/TRANSLOCATE
SELL		BUY	RECEIVE
GIVE		DONATE	ACCEPT AS A GIFT
RELEASE		ANGLING	DART

F.	Property where restricted activity will take place

(if not the same as provided in B):

PHYSICAL ADDRESS:	POSTAL ADDRESS:

G.	In the case of transport/export/import/sell/purchase:

NAME OF SELLER:	NAME OF PURCHASER:
PHYSICAL ADDRESS (SELLER/TRANSPORT FROM OR EXPORT FROM);	PHYSICAL ADDRESS (PURCHASER/TRANSPORT TO):

H.	Species involved:

SCIENTIFIC NAME	COMMON NAME	QUANTITY	PARTICULARS OF SPECIMEN (Such as sex, size, age, markings, derivatives etc)

I.	Additional Information for Hunt:

(i)	Hunting client and Applicant Details: (If applicable)

HUNTING CLIENT AND NAME:

PASSPORT HUMBER:

PHYSICAL ADDRESS:

(ii)	Hunting Outfitter and Professional Hunting Details: (If applicable)

HUNTING OUTFITTER	PROFESSIONAL HUNTER
NAME:	NAME:
TEL NO:	TEL NO:

(iii)

Duration of Hunting Trip

ARRIVAL DATE: (dd/mm/year)	DEPARTURE DATE: (dd/mm/year)

(iv)	Weapon and Method of Hunt

WEAPON	METHOD

J. Additional Information for Standing Permits

REGISTRATION NUMBER:

.................................................

........................

Signature of applicant

Date

K.	Official Use

NAME OF INSPECTION OFFICIAL	SIGNATURE OF INSPECTION OFFICIAL	DATE	APPROVED/REFUSED

REASONS FOR REFUSAL:

L.	Period of Validity of Permit

NAME OF INSPECTION OFFICIAL	SIGNATURE OF INSPECTION OFFICIAL	DATE	APPROVED/REFUSED

REASONS FOR REFUSAL:

National Environmental Management: Biodiversity Act, 2004 (Act No. 10 of 2004)

Regulations

Threatened or Protected Marine Species Regulations, 2017

Annexures

Annexure 1 : Permit application form