Western Australian Consolidated RegulationsForm 1
Artificial Breeding of Stock Act 1965
Artificial Breeding (Pig) Regulations 1984
APPLICATION FOR A LICENCE OR RENEWAL OF LICENCE
MINISTER FOR AGRICULTURE 2 ,
DEPARTMENT OF AGRICULTURE 3 ,
SOUTH PERTH.
I/We
................................................................................................................................
of
....................................................................................................................................
hereby apply for * a
licence to use the premises described hereunder for
* the renewal of
my/our licence to use the premises described hereunder for the
* collection and processing of semen from boars
for general sale or use with respect to the collection, dilution, examination,
chilling, freezing, storing, distribution, sale and use of semen;
* storage and sale of semen from boars;
* transplantation of ova from pigs and any
processes connected with the production, handling, fertilization and storage
of ova for sale or use.
Address of premises
.......................................................................................................
Description of premises
.................................................................................................
Dated this ....................................... day of
............................................... 19 ...............
....................................................
Signature of Applicant(s).
* Strike out whichever is not applicable.
Fee.................................................attached.
Form 2
Artificial Breeding of Stock Act 1965
Artificial Breeding (Pig) Regulations 1984
LICENCE
MINISTER FOR AGRICULTURE 2 ,
DEPARTMENT OF AGRICULTURE 3 ,
SOUTH PERTH.
................................................................ of
.....................................................................
(Name of Licensee(s))
(Address)
* is/are hereby licensed to use the premises
described hereunder for the: —
* collection and processing of semen from boars
for general sale or use with respect to the processes of collecting, diluting,
examining, chilling, freezing, storing, distribution, sale and use of semen.
* storage and sale of semen from boars.
* transplantation of ova from pigs and any
processes connected with the production, handling, fertilization and storage
of ova for sale or use.
Address of premises
..........................................................................................................
Description of premises
....................................................................................................
This licence remains in force for 3 years from the date of issue i.e.
until ........................
...................19 ...... and is issued subject to the conditions
prescribed by the Artificial Breeding of Stock Act 1965 and regulations
made thereunder, and to the
following conditions —
(Insert here any special conditions)
These conditions may be varied by the Minister.
Issued this ........................................ day of
.................................................. 19 ...............
........................................................
Minister for Agriculture 2 .
* Strike out whichever is not applicable.
Form 3
Artificial Breeding of Stock Act 1965
Artificial Breeding (Pig) Regulations 1984
APPLICATION FOR TRANSFER OF LICENCE
MINISTER FOR AGRICULTURE 2 ,
DEPARTMENT OF AGRICULTURE 3 ,
SOUTH PERTH.
I/We
....................................................................................................................................
of
.........................................................................................................................................
being the holder(s) of a licence to use the premises described hereunder,
hereby apply for the transfer of that licence to
.........................................................................................
of
.........................................................................................................................................
Address of premises
............................................................................................................
licensed for the —
* collection and processing of semen from boars
for general sale or use with respect to the collection, detection,
examination, chilling, freezing, storing, distribution, sale and use of semen.
* storage and sale of semen from boars.
* transplantation of ova from pigs and any
processes connected with the production, handling, fertilization and storage
of ova for sale or use.
Dated this ........................................ day of
...................................................... 19 ............
Fee ............................................... attached.
..............................................
Signature of Applicant(s).
..............................................
Signature of Transferee(s).
* Strike out whichever is not applicable.
Form 4
Artificial Breeding of Stock Act 1965
Artificial Breeding (Pig) Regulations 1984
APPLICATION FOR VARIATION OF A LICENCE
MINISTER FOR AGRICULTURE 2 ,
DEPARTMENT OF AGRICULTURE 3 ,
SOUTH PERTH.
I/We
................................................................................................................................
of
....................................................................................................................................
being the holder(s) of a licence in respect of the premises at
........................................
.........................................................................................................................................
for the purpose of
...........................................................................................................
hereby apply for a variation of the licence so as to authorize the use of the
premises for
.........................................................................................................................................
Fee ............................................... attached.
Dated this ........................................ day of
........................................................ 19 ..........
..............................................
Signature of Licensee(s).