Application for permit to export live animals

If you need assistance in completing this form, the Convention on International Trade in Endangered Specie (CITES) Management Authority Office can be contacted by email or by telephone at 1-855-869-8670.

Important Instructions for the Applicant
Please read carefully - Be sure to fill-in all related questions on the application form. An incomplete application may cause delays in processing.

Type of application

New Application

Replacement

Reason for replacement:
__________________________________
Expected date for the
reception of the CITES permit:
__________________________________

How should the CITES permit be sent to you?

Regular mailCourier service

For the permit to be sent by courier, indicate the courier company name and your account number:

Courier company name:
_______________________________________________________
Courier account number:
_______________________________________________________

Part 1: Contact information

1.1 Applicant information (canadian exporter)

Name:
_______________________________________________________
Name of business or organization
(if applicable):
_______________________________________________________
Address (number and street):
_______________________________________________________
Post Office Box:
_______________________________________________________
City:
_______________________________________________________
Province/Territory:
_______________________________________________________
Postal Code:
_______________________________________________________
Country:
_______________________________________________________
Email:
_______________________________________________________
Home Phone:
_______________________________________________________
Work Phone:
_______________________________________________________
Cell Phone:
_______________________________________________________
Fax:
_______________________________________________________

To which address should the permit be sent?

Applicant's addressOther address (please specify below)

Address (number and street):
_______________________________________________________
Post Office Box:
_______________________________________________________
City:
_______________________________________________________
Province/Territory/State:
_______________________________________________________
Country:
_______________________________________________________
Postal Code:
_______________________________________________________

1.2 - Broker information (if applicabale)

Name:
_______________________________________________________
Name of business or organization
(if applicable):
_______________________________________________________
Address (number and street):
_______________________________________________________
City:
_______________________________________________________
Province/Territory/State:
_______________________________________________________
Country:
_______________________________________________________
Postal/Zip Code:
_______________________________________________________
Email address:
_______________________________________________________
Daytime phone:
_______________________________________________________
Work Phone:
_______________________________________________________
Alternate Phone:
_______________________________________________________
Fax:
_______________________________________________________

1.3 - Consignee information (the foreign importer)

Name:
_______________________________________________________
Name of business or organization
(if applicable):
_______________________________________________________
Address (number and street):
_______________________________________________________
City:
_______________________________________________________
Province/Territory/State:
_______________________________________________________
Country:
_______________________________________________________
Postal/Zip Code:
_______________________________________________________
Email address:
_______________________________________________________
Daytime phone::
_______________________________________________________
Work Phone:
_______________________________________________________
Alternate Phone:
_______________________________________________________
Fax:
_______________________________________________________

Part 2: Purpose of export

Will the animal(s) be sold when received in the country of import?

YesNo

Will the animal(s) be used in an educational program?
If yes, provide a document with the name and address, as well as a description or outline of the program.

YesNo

Will the animal(s) be used for an exhibition?
If yes, provide a document with the name and address, as well as the purpose of this exhibition.

YesNo

Will the animal(s) be introduced or re-introduced into the wild?
If yes, provide a document with the name and address as well as a summary of the program under which this will be done.

YesNo

Is the animal(s) destined for a zoo?

YesNo

Will the animal(s) be used for breeding?

YesNo

Part 3: Animal descriptions

3.1 Animal Description
Live Animal
Number
House name
(e.g. Felix):
Common species name
(e.g. Serval)
Scientific species name
(e.g. Leptailurus serval):
Gender Unique identification marks (list all applicable) Birth/hatch date
OR
Age:
1 blank blank blank □ Male □ Female □ Uknoown blank blank
2 blank blank blank □ Male □ Female □ Uknoown blank blank
3 blank blank blank □ Male □ Female □ Uknoown blank blank
4 blank blank blank □ Male □ Female □ Uknoown blank blank
5 blank blank blank □ Male □ Female □ Uknoown blank blank
Acquisition
Live Animal Number Possession or acquisition date: How or where was the animal acquired? If the animal was obtained from a CITES registered breeder, please provide:

Name of establishment:
If the animal was obtained from a CITES registered breeder, please provide:

CITES registration number:
*If you have selected OTHER, describe the circumstances of the acquisition:
1 blank □ Business □ Zoo □ breeding operation □ Individual □ Other* blank blank blank
2 blank □ Business □ Zoo □ breeding operation □ Individual □ Other* blank blank blank
3 blank □ Business □ Zoo □ breeding operation □ Individual □ Other* blank blank blank
4 blank □ Business □ Zoo □ breeding operation □ Individual □ Other* blank blank blank
5 blank □ Business □ Zoo □ breeding operation □ Individual □ Other* blank blank blank

Part 4: Transport of live animals

Check the appropriate box and describe in detail the manner in which the animal(s) will be transported:

By airBy seaOver land

_______________________________________________________

Part 5: Current location of the animal(s)

In which country is the animal(s) located?

_______________________________________________________

If the animal(s) is detained, please indicate where it is detained.

□ Canada Customs
□ Foreign Customs

Provide the Customs file number as well as all copies of the documents pertaining to the detention:

_______________________________________________________

□ I understand that it is my responsibility to be informed of all other requirements with regard to possession, care and transport of my animal(s) and have or will obtain any additional authorizations or permits required by other jurisdictions, federal government agencies, or foreign countries.

I hereby certify that I am authorized to submit this application and that the information submitted is complete and accurate to the best of my knowledge.

(sign with dark ink) _______________________________________________________
Date: dd/mm/yyyy
_______________________________________________________

Appendix A: Genealogy of the specimen

Complete Section 1 to inform us of the breeding operation your live animal came from.
Complete Section 2 only if your live animal came from your own breeding operation.

Section 1:

Captive breeding operation
Live Animal
Number
Name of establishment: Is the establishment registered with CITES? CITES registration number: Address (number and street): City: Province/
Territory:
Country: Postal Code:
1 blank □ Yes □ No blank blank blank blank blank blank
2 blank □ Yes □ No blank blank blank blank blank blank
3 blank □ Yes □ No blank blank blank blank blank blank
4 blank □ Yes □ No blank blank blank blank blank blank
5 blank □ Yes □ No blank blank blank blank blank blank
Captive breeding operation continued
Live Animal
Number
Email address: Website: Day time phone: Alternate phone: Fax:
1 blank blank blank blank blank
2 blank blank blank blank blank
3 blank blank blank blank blank
4 blank blank blank blank blank
5 blank blank blank blank blank

Section 2:

Complete the genealogy of the live animal born in captivity in your facility as accurately and as comprehensively as possible, indicating the name and/or the identification number when available. Put a star (*) beside any animal that was purchased or obtained from another facility. Do not complete the previous generation for a live animal that was obtained from another facility.

First Generation
Live Animal Number Live animal (name/id): Date of birth:
1 □ Male □ Female blank
2 □ Male □ Female blank
3 □ Male □ Female blank
4 □ Male □ Female blank
5 □ Male □ Female blank
Second Generation
Item Number Mother (name/id): Mother Date of birth: Father (name/id): Father Date of birth:
1 blank blank blank blank
2 blank blank blank blank
3 blank blank blank blank
4 blank blank blank blank
5 blank blank blank blank
Third Generation
Item Number Mother

Mother (name/id):
Mother

Mother Date of birth:
Mother

Father (name/id):
Mother

Father Date of birth:
Father

Mother (name/id):
Father

Mother Date of birth:
Father

Father (name/id):
Father

Father Date of birth:
1 blank blank blank blank blank blank blank blank
2 blank blank blank blank blank blank blank blank
3 blank blank blank blank blank blank blank blank
4 blank blank blank blank blank blank blank blank
5 blank blank blank blank blank blank blank blank

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