Regulations > Performing Animals Protection Regulations, 2016 > Annexure A > Written Application : Granting of a Licence

N776 Annexure A

WRITTEN APPLICATION: GRANTING OF A LICENCE

DIRECTORATE: VETERINARY PUBLIC HEALTH

DEPARTMENT OF AGRICULTURE, FORESTRY AND FISHERIES

Delpen Building, c/o Annie Botha and Union Streets, Riviera, 0084

Enquiries: Tel: 012 319 7647/7575. E-mail: [email protected]

FEES PAYABLE FOR PERFORMING ANIMALS LICENCE SERVICES

No.	Purpose	Amount payable per application
1.	Application fee for PAPA license issue (Reg. 2(1))	R430 per application
2.	Fee for re-issue/lost/stolen/damaged PAPA license	R430 per application
3.	Application fee for appeal process (Reg. 8(d))	R4 402 per application

[Table 1 : Fees payable substituted by regulation 2 of Notice No. 130, GG 42230, dated 15 February 2019]

Bank account details:

Name of account : DAFF : PERF ANIM PROTECT ACT, 1935

Name of bank : Standard bank

Type of Account : Business Cheque

Account No: 010285032

Branch : Pretoria

Branch : 010045

For official purposes only
Receipt number:
Date application received:
Date application completed:
Licence issued:	Yes	No
Date approved:
Licence number:
Expiry date:

Purpose of Application:		Application for:	Complete where applicable
	To exhibit	Existing licence number
		Existing licence number
	To train	Expiry date
		Expiry date
	To use animals for safeguarding	Previous licence numbers related to either the facility or the applicant (if applicable)


New Application	Yes	No	Amendment of an Existing Licence	Yes	No

Re-application	Yes	No

1. Details of the applicant

The applicant is the owner

the manager

trainer

(please tick where applicable

For a facility, both owner and manager information is required.

Name of Applicant	Owner/trainer		Manager:
Identity Number
Business or Company Name (if applicable)

Address of Applicant
Postal Address


		Postal Code
Province
Telephone Number
Cell phone Number
Email address
Fax Number


Are you affiliated with an industry body?	Yes	No
If yes, indicate the name of the body:

2. Please provide details of the primary facility for housing animals:

Name of the facility
Postal Address


		Postal Code

Physical Address


		Postal Code
Province
Telephone Number
Fax Number
Email address
District/Local Municipality
GPS co-ordinates or What3Word	S " E " ................................................................................

3. Please provide details of secondary facilities that may be used during the year:

(Where this information is available, note that movement notifications are applicable for all movements to facilities that are not recorded on the license)

Name of facility	Address	Date of use

4.	Please indicate species and breed of animals to be trained / exhibited / used for safeguarding, and where applicable, whether the animals were born in captivity or not.

(if insufficient space, a separate list may be attached)

FOR TRAINING
Species and breed	Number	Born in captivity		Caught in wild

		Y	N


		Y		N


		Y		N

FOR EXHIBITION / FILM INDUSTRY
Species and breed	Number	Born in captivity		Caught in wild

		Y	N


		Y		N


		Y		N

FOR SAFEGUARDING
Species and breed	Number	Born in captivity		Caught in wild

		Y	N


		Y		N


		Y		N

5.	Experience and training of the trainer with regard to the training / exhibition / use of animals for safeguarding with full particulars of species of animals and duration and nature of experience.

Name of trainer :

Specify Applicable qualification :

Year obtained :

Experience :

6.	Approximate duration of each exhibition / training / safeguarding (per species) and the number of working hours per day or per week.

(May attach a work program)

Species	Duration of exhibition (hours per day/week)	Duration of training (hours per day/week)	Duration of safeguarding (hours per day/week)

7.	Has the owner of the business or any employees been convicted of cruelty to animals in the Republic of South Africa or elsewhere?

Please tick

		If yes, please give full particulars of the person's name, charge, date, place and outcome of trial
Yes	No

8. Full particulars of the responsible private / facility veterinarian.

Name of veterinarian:

SAVC Registration no:

Telephone numbers:

Fax number:

Email address:

Physical address:

Declaration : I declare that

1.	I will visit the facility at least twice per year at an interval of at least 4 months apart.

2.	I undertake to inform the officer of any suspicious mortalities, illnesses and welfare problems within 24hours of becoming aware of them.

3.	I will inform the officer if my services are terminated by the facility for any reason whatsoever

4.	I will make available clinical records to the officer on request even after the termination of the client/vet relationship.

Signature:

Official practice stamp:

1 Addendums may be used should there be insufficient space (if there are additional trainers)

9. Copy of the applicant's ID attached

Yes

10. Proof of Payment attached

Yes

I ……………………………………………….....................................…(Full name) the undersigned, hereby apply for a licence to exhibit / train animals / use animals for safeguarding* in terms of the Performing Animals Protection Amendment Act , 2016 (Act No 4 of 2016) and declare that the above particulars are to the best of my knowledge and belief, true, correct and complete and that any misleading or incorrect information supplied by myself in support of this application will, upon the discovery thereof, result in the immediate suspension of my licence.

I give my consent for the facility veterinarian to divulge applicable information about the abovementioned facility /facilities and animals to the officer.

I further declare that I have the means to feed, care for and house all the above mentioned animals and maintain the facilities, transport and other equipment to meet all the animal welfare needs.

(* Delete whichever is not applicable)

Signature of Applicant
Place
Date

For official purposes only

Officer:_____________________________________________

Designation:_________________________________________

Signature:___________________________________________

Date:__________________________________ Official stamp

Comments:

____________________________________________________________________________________

Approved

Not approved

.................................................................................................................................(please tear)

For official purposes only

Receipt number: ________________________________________________________________

Date application received: ________________________________________________________

Signature of receiving official: ____________________________________________________

Official stamp:

Performing Animals Protection Act, 1935 (Act No. 24 of 1935)

Regulations

Performing Animals Protection Regulations, 2016

Annexure A

Written Application : Granting of a Licence