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FORM I
[See sub-rule (2) of rule 3]

Application for permission to acquire, receive, keep specified animal, animal article, etc. or put under process of taxidermy or make animal article
To
The ______________________________
_________________________________
_________________________________
Sir,
1. , _________________ residing at _________, Taluk __________, District ________, and holding License No ________ ,granted under section 44(4) of the Wild Life (Protection) Act, 1972 (53 of 1972), request that I may be granted permission to acquire/receive/keep in my control/custody/possession specified animal/animal article/trophy/uncured trophy/meat derived from specified animal and/or put under process of taxidermy/make animal article containing part/whole of such animal.
2. furnish below the particulars in relation to such specified animal/animal article/trophy/ uncured trophy/meat:
(1) Species of animal _________________________________________________
(2) Number ________________________________________________________
(3) Description (including sex, if possible) ____________________________________
(4) Source from which to be obtained _________________________________________
(i) Address and Licence No. if any ________________________
(ii) Whether declaration made/permission/licence obtained under sections 40, 43 or 44 of the Wild Life (Protection) Act, 1972, and if so the particulars:
_______________________________
(5) Particulars of certificate of ownership __________________________
(6) Identification mark, if any ________________________________
(7) Premises in which intended to be kept ______________________________
(8) Purpose for which to be acquired/received/kept in control/custody/possession:
   ________________________________________________
(9) If  to be put under process of taxidermy or to make animal articles,-
(a) Number of trophies/articles to be made _________________________
(b) Description of such trophies/articles ____________________________
(c) To whom they will be returned _______________________________
(d) Probable date by which they will be so returned __________________
3. I hereby declare that to the best of my knowledge and belief the information furnished herein is true and complete __________________
Signature of the applicant
Strike out whichever is not applicable.

 



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