Application for temporary movement of animals or plants (live, parts or products)

CITES - Form A4 (2014.02.04)

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

Download the PDF version (63 KB)

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):
Convention on International Trade in Endangered Specie (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.
  • A period of 40 days (or 80 days for requests relating to polar bears) may be required to review an application before the CITES permit is issued. Please note that this reviewing period begins once all required documents and information has been received by our office.
  • If the application is approved, the certificate and certified copies will be sent by mail to the applicant. If you would like to receive your certificate by courier, please provide a pre-paid envelope or your courier account number. The certificate will be sent to the address provided in Section 3A, 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 a Temporary Movement Certificate (Canadian)

Number of the CITES Certificate:
_______________________________________________________
Expiry Date:
_______________________________________________________

Replacement of a Temporary Movement Certificate (Canadian)

Number of the CITES Certificate:
_______________________________________________________
Expiry Date:
_______________________________________________________
Reason for replacement:
_______________________________________________________
Expected date of Certificate reception
(approximate if necessary):
_______________________________________________________
Year / Month / Day

I would like my Certificate sent by:

mailcourier (cost incurred by applicant)

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

Pre-paid envelope; or
Courier account number:
_______________________________________________________

Section 2. Trade type

Check one of the following (separate applications must be made for each type of trade):

separate applications
No. Date of Entry to Canada Canadian Port of Entry Date of Exit from Canada Canadian Port of Exit Destination Country
1 blank blank blank blank blank
2 blank blank blank blank blank
3 blank blank blank blank blank
4 blank blank blank blank blank
XXCaptionTextXX
No. Date of Exit from Canada Canadian Port of Exit Destination Country Date of Entry to Canada Canadian Port of Entry
1 blank blank blank blank blank
2 blank blank blank blank blank
3 blank blank blank blank blank
4 blank blank blank blank blank

Section 3. Name and address

A - Applicant (Canadian importer or exporter)

Name of person:
_______________________________________________________
Name of business or organization
(if applicable):
_______________________________________________________
Type of business or organization:
□ museum
□ zoo
□ circus
□ other
If other, specify:
_______________________
Street and number:
_______________________________________________________
Post Office Box:
_______________________________________________________
City:
_______________________________________________________
Province/Territory:
_______________________________________________________
Postal Code:
_______________________________________________________
Country:
_______________________________________________________
Website:
_______________________________________________________
Email:
_______________________________________________________
Home Phone:
_______________________________________________________
Work Phone:
_______________________________________________________
Cell Phone:
_______________________________________________________
Fax:
_______________________________________________________

B - Broker (e.g., shipping company)

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

Attention importers/exporter with a single shipment:

C - Consignee/supplier (Foreign country importer or exporter)

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

Attention importers/exporters with multiple shipments and/or multiple destinations: Please complete Section 3 - C for each destination. Use additional sheets if necessary.

Section 4. Purpose

Note that all the live animals/plants and animal/plant parts or products identified in this application must be exported/imported for Travelling Exhibition purposes only. Specimens traded for a purpose other than Travelling Exhibition must be applied for using a different application.

Check the box that best describes your situation:

Circuses (Q)

Other live animal exhibitions (Q)
Specify type:

 

Live plant exhibitions (Q)

Other travelling exhibitions (Q)
Specify type:

 

Section 5. Description of specimens

  • Names: avoid use of trade names or general terms that do not adequately describe the species. Identification at the higher taxon level (e.g., Primates spp., Felidae spp.) is not acceptable.
  • Description: for animal part or product, you must specify what part (e.g. feather, egg, skin) or what product (e.g. piano, handbag, belt)
  • Quantity: do not use general terms such as "box" or "case". If a re-export, use the same unit of measurement as indicated on previously issued permits.
  • Use additional sheets if necessary.
Description of Specimens
Item
No.
Scientific Name
(genus, species, sub-species)
Common Name and House Name (if applicable- for live animals) Description Quantity
(specify units, e.g., kg, cm, etc.)
Distinctive Markings
(serial, registration,
band, tattoos, microchip numbers, etc.)
1 blank blank Live specimen:
□ male □ female

Animal/Plant Part, specify:

Number of specimens used:
Date manufactured:

Name of manufacturer:

blank blank
2 blank blank Live specimen:
□ male □ female

Animal/Plant Part, specify:

Number of specimens used:
Date manufactured:

Name of manufacturer:

blank blank
3 blank blank Live specimen:
□ male □ female

Animal/Plant Part, specify:

Number of specimens used:
Date manufactured:

Name of manufacturer:

blank blank

Section 6. Origin and legality

This section must be completed for each specimen or item unless the information is identical for all specimens or items. Note that in each case you will have to choose one of the following origin: A- from the wild, B- from captive breeding or C- unknown.
In case of re-export, please complete one per supplier. Photocopy this section as needed.

Item Number:


A - Complete this section if the live specimen or part/product came from the wild:

Location of capture or removal:
_______________________________________________________
Date of capture or removal:
_______________________________________________________
Approximate age:
_______________________________________________________

For Plants: □ seedling □ juvenile □ mature (flowering/fruiting)

Note: Attach a copy of any permits required to capture or remove the specimen.

B - Complete the following section if the live specimen or part/product came from captive breeding or artificial propagation (zoo, breeding facility, nursery, greenhouse, farm, etc.):

Acquisition Date:
_______________________________________________________
Name of Establishment:
_______________________________________________________
Is the establishment registered by CITES?
□ Yes
If yes, the registration number:
_______________________________________________________
□ No
Street and number:
_______________________________________________________
Post Office Box:
_______________________________________________________
City:
_______________________________________________________
Province/Territory/Region:
_______________________________________________________
Postal Code:
_______________________________________________________
Country:
_______________________________________________________
Website:
_______________________________________________________
Email:
_______________________________________________________
Home Phone:
_______________________________________________________
Work Phone:
_______________________________________________________
Cell Phone:
_______________________________________________________
Fax:
_______________________________________________________

Complete the genealogy of the live animal (name and identification #) at the minimum to the 2nd generation (F2) born in captivity.

Genealogy of the live animal
blank Specimen:
Sex: □ male □ female
Date of birth:
Specimen:
Sex: □ male □ female
Date of birth:
F1 Mother:
Date of birth:
Father:
Date of birth:

F2 Mother:
Date of birth:

Father:
Date of birth:
Mother:
Date of birth:

Father:
Date of birth:

Note: Attach a copy of a letter or birth certificate from the breeder indicating the birth date of the specimen and parents (F1 and F2).

C - Complete the following section if origin of live specimen or part/product is unknown:

Acquisition Date:
_______________________________________________________
Context of acquisition
(purchase, gift, etc.):
_______________________________________________________
Country of acquisition:
_______________________________________________________

Has a CITES permit (Canadian or foreign) already been issued for this live specimen or part/product?

□ No
□ Yes (Attach a copy of the permit)

Permit number:
_______________________________________________________

Section 7. Transport of live animals/plants

Describe the method of transport (duration, cage, container, etc.):

 

 

 

 

Describe the facility where the animal/plant will be kept during your stay:

 

 

 


For Animals only, describe the security measures that will be in place to prevent escape and ensure public safety:

 

 

 


Section 8. 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 questions relevant to your specimen or product?
□ Did you attach copies of requested documents?

Report a problem or mistake on this page
Please select all that apply:

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