Trade in protected species: application for registration of scientific institution

CITES Form A5 (2014.02.04)

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Convention on international trade in endangered species of wild fauna and flora (CITES)

The scientific institution must meet the following conditions in order to be registered and to use a CITES Scientific Certificate:

  • A collection of animal and plant specimens recorded in a catalogue is maintained;
  • Specimens are exchanged with other CITES-registered institutions (if the other institution is not registered by CITES, CITES Export and/or Import Permits must be used). Please refer to 'CITES Registers' for the list of CITES registered scientific institutions.
  • Specimens are herbarium or other preserved, dried or embedded museum specimens, live plant material, or frozen museum specimens that are currently part of the institution's collection; and
  • Exchange of specimens is for scientific purposes.
  • If you need assistance in completing this form, the CITES Management Authority Office can be contacted by email or by telephone at 1-855-869-8670.

Important Notes

  • Send your completed application by email, regular mail or fax (send application only once):
CITES Permitting Office
Canadian Wildlife Service
Environment Canada
351 St-Joseph Blvd
Gatineau, Quebec K1A 0H3
Email : cites@ec.gc.ca
Fax: 1-855-869-8671
  • All applicable sections must be filled out. Incomplete application forms will not be accepted. Additional information or documents may be requested from the applicant in order to process the application.
  • The applicant must sign the application form. The applicant must be a resident of Canada or a representative of a scientific institution with an office in Canada and must be knowledgeable of the contents of the shipments made by the institution.
  • If the application is approved, confirmation of registration of the scientific institution including the permit and instructions will be sent by mail to the applicant. If you would like to receive your permit by courier, please provide a pre-paid envelope or your courier account number. The permit will be sent to the address provided in Section 2, unless otherwise specified by the applicant.
  • Import and export of animals and plants and their parts and derivatives is also controlled by the Plant Protection Act and the Health of Animals Act implemented by the Canadian Food Inspection Agency (CFIA). Please refer to their site or contact their regional offices by phone.

Section 1. Application type

Check one of the following:

New Application

Renewal of Scientific Registration

Number of the CITES registered
scientific institution:
_______________________________________________________
Expiry Date:
_______________________________________________________
Expected date of permit reception
(approximate if necessary):
_______________________________________________________
Year / Month / Day

I would like my permit sent by:

mailcourier (cost incurred by applicant)

If you would like your permit sent by courier, please provide:

Pre-paid envelope; or
Courier account number:
_______________________________________________________

Section 2. Name and address

Applicant (Canadian scientific institution)

Name of researcher:
_______________________________________________________
Title of researcher:
_______________________________________________________
Name of research supervisor or
sponsor:
_______________________________________________________
Name of the scientific institution:
_______________________________________________________
Street and number:
_______________________________________________________
Post Office Box:
_______________________________________________________
City:
_______________________________________________________
Province/Territory:
_______________________________________________________
Postal Code:
_______________________________________________________
Country:
_______________________________________________________
Website:
_______________________________________________________
Email:
_______________________________________________________
Work Phone:
_______________________________________________________
Cell Phone:
_______________________________________________________
Fax:
_______________________________________________________

Section 3. Research and exchange of specimens

Description of research institution:

 

 

 

Description of research:
Attach a summary of the type of research done, including methodology.

 

 

 

 

 

Please check all that apply with respect to your institution:
□ collections of animal or plant specimens, and records ancillary to them, permanently housed and professionally curated
□ accessible to all qualified users, including those from other institutions
□ all accessions properly recorded in a permanent catalogue
□ permanent records maintained for loans and transfers to other institutions
□ specimens acquired primarily for purposes of research that is to be reported in scientific publications
□ specimens prepared and collections arranged in a manner that ensures their utility
□ accurate data maintained on specimen labels, permanent catalogues and other records
□ acquisition and possession of specimens accord with the federal/provincial/territorial laws in which the scientific institution is located
□ all specimens of species included in Appendix I to CITES permanently and centrally housed under the direct control of the scientific institution, and managed in a manner to preclude the use of such specimens for decoration, trophies or other purposes incompatible with the principles of the Convention

Expected number of shipments of the specimens to be exchanged within the next three years:

 

 

Section 4. CITES registered scientific institutions for exchange of specimens

Attach additional sheets if necessary.

Name of the scientific institution:
_______________________________________________________
CITES Registration Number:
_______________________________________________________
Street and number:
_______________________________________________________
Post Office Box:
_______________________________________________________
City:
_______________________________________________________
Country:
_______________________________________________________
Postal Code:
_______________________________________________________
Name of the scientific institution:
_______________________________________________________
CITES Registration Number:
_______________________________________________________
Street and number:
_______________________________________________________
Post Office Box:
_______________________________________________________
City:
_______________________________________________________
Country:
_______________________________________________________
Postal Code:
_______________________________________________________
Name of the scientific institution:
_______________________________________________________
CITES Registration Number:
_______________________________________________________
Street and number:
_______________________________________________________
Post Office Box:
_______________________________________________________
City:
_______________________________________________________
Country:
_______________________________________________________
Postal Code:
_______________________________________________________
Name of the scientific institution:
_______________________________________________________
CITES Registration Number:
_______________________________________________________
Street and number:
_______________________________________________________
Post Office Box:
_______________________________________________________
City:
_______________________________________________________
Country:
_______________________________________________________
Postal Code:
_______________________________________________________

Section 5. Type of specimens

Identify the categories of specimens in which the institution is specialising and will be exchanging.
Attach additional sheets if necessary.

Type of Specimens
Category Classification of Specimen
(order, family, genus, or species)
Common Name Description
1 blank blank □ herbarium specimen
□ other preserved, dried or embedded museum specimen
□ live plant material
□ frozen museum specimen
□ other, specify:

2 blank blank □ herbarium specimen
□ other preserved, dried or embedded museum specimen
□ live plant material
□ frozen museum specimen
□ other, specify:

3 blank blank □ herbarium specimen
□ other preserved, dried or embedded museum specimen
□ live plant material
□ frozen museum specimen
□ other, specify:

4 blank blank □ herbarium specimen
□ other preserved, dried or embedded museum specimen
□ live plant material
□ frozen museum specimen
□ other, specify:

5 blank blank □ herbarium specimen
□ other preserved, dried or embedded museum specimen
□ live plant material
□ frozen museum specimen
□ other, specify:

6 blank blank □ herbarium specimen
□ other preserved, dried or embedded museum specimen
□ live plant material
□ frozen museum specimen
□ other, specify:

Section 6. Origin and legality of CITES specimens

Describe the methods used by the institution to ensure that specimens in the collection to be exchanged were legally acquired:

 

 

 

 

Section 7. Current location of the specimen

Please check the appropriate box:

□ In Canada
□ Outside Canada
□ Detained by:
□ Canada Customs
□ Foreign Customs

Provide the Customs file number and copies of letters exchanged with Customs.

The undersigned hereby certifies that all information given in this application is true and correct.

Signature of applicant: _______________________________________________________
Date: _______________________________________________________
Year / Month / Day

Checklist
□ Did you sign the application?
□ Did you answer all relevant questions?
□ Did you attach copies of requested documents?

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