Form H: Removal on an animal from authorised premises ...



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| |FORM I: MONTHLY ITINERARY |

| |FOR MOBILE EXHIBITORS & ANIMAL DISPLAY ESTABLISHMENTS USING APPROVED STANDARD OPERATING PROCEDURES FOR TEMPORARY REMOVALS |

(To be used for providing the Animal Welfare Unit of the Department of Primary Industries with an itinerary of each planned display at least 7 days prior to the proposed mobile display or temporary removal in accordance with Clause 5(i) of the Standards for Exhibiting Animals at Mobile Establishments in New South Wales and Clause 5 (5) of the Standards for Exhibiting Animals During Temporary Removals in New South Wales)

FORMS MUST BE TYPED OR WORD PROCESSED

|Authority Holder:       |Authority Number:       |Month:       |

|Display Date & Duration |

|Include start & finish, eg. 11am – 11:30am |

FORM I: MONTHLY ITINERARY

SPECIES GROUPS

Include each different combination of species to be exhibited in a Species Group box below. Note the fields in each box are expandable and a new line within each field can be started by pressing enter.

When completing a row on page 1 of the form include the relevant species group number in the ‘Species Name & Scientific Name’ column for that date.

|SPECIES GROUP |List Species Names & |No. of Animals |Adult |

| |Scientific Names | |(Y/N) |

|1 |      |      |      |

|SPECIES GROUP |List Species Names & |No. of Animals |Adult |

| |Scientific Names | |(Y/N) |

|2 |      |      |      |

|SPECIES GROUP |List Species Names & |No. of Animals |Adult |

| |Scientific Names | |(Y/N) |

|3 |      |      |      |

|SPECIES GROUP |List Species Names & |No. of Animals |Adult |

| |Scientific Names | |(Y/N) |

|4 |      |      |      |

|SPECIES GROUP |List Species Names & |No. of Animals |Adult |

| |Scientific Names | |(Y/N) |

|5 |      |      |      |

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