Record of Movement Prohibited Dealings NOTE: this form can only be used for movements to approved places listed in part 9c of a valid Non-indigenous Animal Biosecurity Permit. If movement is required to locations, the permit holder must apply to amend their permit, or be issued with an additional permit to allow movement. If you require more space please attach additional pages. I, Name of responsible person pursuant to the conditions of a biosecurity permit make the following record of movement: Movement Date Leaving place of origin Returning to place of origin (if known) Permit number – Please provide permit number of the non-indigenous animal intended to be moved Transport details Vehicle Registration number State of Registration Registration State of Registration (If applicable) Other transport details Destination of non-indigenous animal Name of place Street address Suburb State Postcode Phone Phone Email Purpose of movement Declaration I hereby agree that I have and will comply with the movement conditions of my permit and all information contained in this record is true and correct. Full name Signature Date Phone Phone Email A copy of the completed form must be emailed to no later than 24 hours before transportation of the permitted non-indigenous animal. This information is collected by the collecting agency identified in this form in relation to its functions under the Biosecurity Act 2015. This agency/s and the NSW Department of Industry may use and disclose this information as reasonably necessary for the purpose of performing biosecurity risk functions under, or reasonably contemplated by, the Biosecurity Act 2015.
Record of Movement Prohibited Dealings NOTE: this form can only be used for movements to approved places listed in part 9c of a valid Non-indigenous Animal Biosecurity Permit. If movement is required to locations, the permit holder must apply to amend their permit, or be issued with an additional permit to allow movement. If you require more space please attach additional pages. I, Name of responsible person pursuant to the conditions of a biosecurity permit make the following record of movement: Movement Date Leaving place of origin Returning to place of origin (if known) Permit number – Please provide permit number of the non-indigenous animal intended to be moved Transport details Vehicle Registration number State of Registration Registration (If applicable) State of Registration Other transport details Destination of non-indigenous animal Name of place Street address Suburb State Postcode Phone Phone Email Purpose of movement Declaration I hereby agree that I have and will comply with the movement conditions of my permit and all information contained in this record is true and correct. Full name Signature Date Phone Phone Email A copy of the completed form must be emailed to no later than 24 hours before transportation of the permitted non-indigenous animal. This information is collected by the collecting agency identified in this form in relation to its functions under the Biosecurity Act 2015. This agency/s and the NSW Department of Industry may use and disclose this information as reasonably necessary for the purpose of performing biosecurity risk functions under, or reasonably contemplated by, the Biosecurity Act 2015.
Record-of-Movement-Prohbited-dealing-.docx