Western Australian Consolidated Regulations Western Australian Consolidated Regulations[Section 10]
Form 1
Artificial Breeding of Stock Act 1965
Artificial Breeding (Horses) Regulations 1982
APPLICATION FOR CERTIFICATE OF COMPETENCY
CHIEF VETERINARY SURGEON
DEPARTMENT OF AGRICULTURE 2
SOUTH PERTH
I…………………………………………………………………………………
of
………………………………………………………………………………
hereby apply for the issue to me of a certificate as an authorized inseminator
of horses.
My qualifications are……………………………………………………………
(Describe and attach evidence of qualifications,
if any)
I am nominated as an authorized inseminator by
....……………………………
……………………………………………………………………………………
(Attach nomination of licence holder)
I intend to carry out artificial insemination at
……………………………………
……………………………………………………………………………………
(State name and address of licensed premises)
I CERTIFY that the information given above is true and correct.
Dated this …………………… day of
……………………19
…………………
……………………………………………………
Signature of Applicant.
Fee
……………………………………………attached.
Form 2
[Section 10]
Western Australia
Artificial Breeding of Stock Act 1965
Artificial Breeding (Horses) Regulations 1982
Certificate No.
………………………………………
CERTIFICATE OF COMPETENCY
I HEREBY CERTIFY THAT
……………………………………………………
of
………………………………………………………………………………....
nominated by
……………………………………
of ………………………….
possesses the requisite knowledge and experience as an authorized inseminator
of horses and is hereby authorized to carry out artificial insemination of
horses at
.…………………………………………………………………………............
………………………………………………….…………………………………
Issued this ………………………day
of
……………………19………………
Chief Veterinary Surgeon.
…………………………………………………….
Form 3
[Section 7]
Artificial Breeding of Stock Act 1965
Artificial Breeding (Horses) Regulations 1982
APPLICATION FOR LICENCE OR RENEWAL OF LICENCE
MINISTER FOR AGRICULTURE 3
DEPARTMENT OF AGRICULTURE 2
SOUTH PERTH
I/We………………………………………………………………………………
of
…………………………………………………………………………………
hereby apply for * a
licence
* the renewal of
my/our licence
to use the premises described hereunder for the artificial breeding of horses.
Address of
premises………………………………………………………………
Description of premises
………………………………………………………….
The Veterinary Surgeon nominated to supervise is
……………………………
……………………………………………..
of
………………………………..
Dated this ……………………..day of
……………………..19………………
………………………………………………..
Signature of Applicant(s).
Fee
…………………………………………….attached.
* Strike out whichever is not applicable.
Form 4
[Section 7]
WESTERN AUSTRALIA
Artificial Breeding of Stock Act 1965
Artificial Breeding (Horses) Regulations 1982
LICENCE
……………………………………………………………………………………
(Name of licensee(s))
of
…………………………………………………………………………………
is/are hereby licensed to use the premises described hereunder for the
artificial breeding of horses.
Address of
premises………………………………………………………………
Description of premises
……………………………………………………….....
This licence remains in force until
……………………19
…………………and is issued subject to the
Artificial Breeding of Stock Act 1965 and regulations made thereunder,
and to the following conditions —
The Veterinary Surgeon nominated to supervise
is………………………………
………………………………………
of
………………………………………
Issued this ……………………day of
……………………19…………………
…………………………………………………
MINISTER FOR AGRICULTURE 3 .
Form 5
[Section 7]
Artificial Breeding of Stock Act 1965
Artificial Breeding (Horses) Regulations 1982
APPLICATION FOR TRANSFER OF LICENCE
MINISTER FOR AGRICULTURE 3
DEPARTMENT OF AGRICULTURE 2
SOUTH PERTH
I/We………………………………………………………………………………
of
…………………………………………………………………………………
being the holder(s) of a licence to use the premises described hereunder,
apply for the transfer of that licence
to…………………………………………………
………………………………………of…………………………………………
Address of premises licensed for the artificial breeding of horses
………………
Dated this ………………………day
of.………………………19………………
Fee
……………………………………attached.
………………………………………….
Signature of Applicant(s).
………………………………………….
Signature of Transferee(s).