CTHRepealedLegislation
Wildlife Protection (Regulation of Exports and Imports) Regulations 1984
RECORD OF CHANGE IN POSSESSION OF SPECIMRECORD OF CHANGE IN POSSESSION OF SPECIMENS OR OTHER ITEMS SEIZED UNDER THE ACT
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RECORD OF CHANGE IN POSSESSION OF SPECIMENS OR OTHER ITEMS SEIZED UNDER THE ACT
<table cellspacing="0" cellpadding="0" style="border-collapse:collapse"><tbody><tr><td style="width:30.05pt; border-top:0.75pt solid #000000; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:6pt; margin-bottom:12pt; font-size:11pt"><span>1.</span></p></td><td colspan="6" style="width:315.25pt; border-top:0.75pt solid #000000; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:6pt; margin-bottom:12pt; font-size:11pt"><span>Description of specimen(s) / other item(s):</span></p></td></tr><tr><td style="width:30.05pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>2.</span></p></td><td colspan="6" style="width:315.25pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Date of seizure:</span></p></td></tr><tr><td style="width:30.05pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>3.</span></p></td><td colspan="6" style="width:315.25pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Place of seizure:</span></p></td></tr><tr><td style="width:30.05pt; border-bottom:0.75pt solid #000000; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:6pt; font-size:11pt"><span>4.</span></p></td><td colspan="6" style="width:315.25pt; border-bottom:0.75pt solid #000000; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:6pt; font-size:11pt"><span>Possession of the above specimen(s) / item(s) is transferred from:</span></p></td></tr><tr><td colspan="2" style="width:108pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:6pt; margin-bottom:30pt; font-size:11pt"><span>Name</span></p></td><td colspan="4" style="width:102.6pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:6pt; margin-bottom:30pt; font-size:11pt"><span>Rank/title</span></p></td><td style="width:123.9pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:6pt; margin-bottom:30pt; font-size:11pt"><span>Department and address</span></p></td></tr><tr><td colspan="7" style="width:356.1pt; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; margin-bottom:6pt; font-size:11pt"><span>to:</span></p></td></tr><tr><td colspan="2" style="width:108pt; border-bottom:0.75pt solid #000000; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:6pt; margin-bottom:30pt; font-size:11pt"><span>Name</span></p></td><td colspan="4" style="width:102.6pt; border-bottom:0.75pt solid #000000; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:6pt; margin-bottom:30pt; font-size:11pt"><span>Rank/title</span></p></td><td style="width:123.9pt; border-bottom:0.75pt solid #000000; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:6pt; margin-bottom:30pt; font-size:11pt"><span>Department and address</span></p></td></tr><tr><td colspan="7" style="width:356.1pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:6pt; margin-bottom:6pt; font-size:11pt"><span>for the following purpose:</span></p></td></tr><tr><td colspan="4" style="width:200.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="font-size:11pt"><span></span></p></td><td colspan="3" style="width:145.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="font-size:11pt"><span>Signature</span><span style="width:122.19pt; font-family:'Lucida Console', monospace; display:inline-block">..................</span></p></td></tr><tr><td colspan="5" style="width:200.5pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span></span></p></td><td colspan="2" style="width:144.8pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Date</span><span style="width:143.59pt; font-family:'Lucida Console', monospace; display:inline-block">.....................</span></p></td></tr><tr><td colspan="7" style="width:356.1pt; border-bottom:0.75pt solid #000000; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; margin-bottom:6pt; page-break-inside:avoid; page-break-after:avoid; font-size:11pt"><span>5.</span><span style="width:13.05pt; display:inline-block"> </span><span>The above specimen(s) / item(s) were despatched by:</span></p></td></tr><tr><td colspan="2" style="width:108pt; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:6pt; margin-bottom:30pt; page-break-inside:avoid; page-break-after:avoid; font-size:11pt"><span>Name</span></p></td><td colspan="4" style="width:102.6pt; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:6pt; margin-bottom:30pt; page-break-inside:avoid; page-break-after:avoid; font-size:11pt"><span>Rank/title</span></p></td><td style="width:123.9pt; border-top:0.75pt solid #000000; border-bottom:0.75pt solid #000000; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:6pt; margin-bottom:30pt; page-break-inside:avoid; page-break-after:avoid; font-size:11pt"><span>Department and address</span></p></td></tr><tr><td colspan="4" style="width:200.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:6pt; font-size:11pt"><span></span></p></td><td colspan="3" style="width:145.15pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:6pt; font-size:11pt"><span>Signature</span><span style="width:122.19pt; font-family:'Lucida Console', monospace; display:inline-block">..................</span></p></td></tr><tr><td colspan="5" style="width:200.5pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span></span></p></td><td colspan="2" style="width:144.8pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:3pt; font-size:11pt"><span>Date</span><span style="width:143.59pt; font-family:'Lucida Console', monospace; display:inline-block">.....................</span></p></td></tr><tr><td colspan="7" style="width:356.1pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; font-size:11pt"><span>I have received the above specimen(s) / item(s) from</span><span style="width:65.58pt; font-family:'Lucida Console', monospace; display:inline-block">.........</span><span>on</span><span style="width:66.95pt; font-family:'Lucida Console', monospace; display:inline-block">..........</span></p></td></tr><tr><td colspan="3" style="width:180.05pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; margin-bottom:3pt; font-size:11pt"><span style="width:155.95pt; font-family:'Lucida Console', monospace; display:inline-block">.......................</span></p><p style="margin-top:3pt; text-align:center; font-size:11pt"><span>Signature</span></p></td><td colspan="4" style="width:165.25pt; padding-right:5.4pt; padding-left:5.4pt; vertical-align:top"><p style="margin-top:12pt; margin-bottom:3pt; font-size:11pt"><span style="width:184.8pt; font-family:'Lucida Console', monospace; display:inline-block">...........................</span></p><p style="margin-top:3pt; text-align:center; font-size:11pt"><span>(Print name)</span></p></td></tr><tr style="height:0pt"><td style="width:40.85pt"></td><td style="width:77.95pt"></td><td style="width:72.05pt"></td><td style="width:20.1pt"></td><td style="width:0.35pt"></td><td style="width:20.9pt"></td><td style="width:134.7pt"></td></tr></tbody></table>