Change of Licence Class or Contact Details

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Please complete this form if you are updating your contact details or seeking to add or amend your class of Native Animal Keeper Licence.

Privacy notice

This application requests information that identifies you and is defined as ‘personal information’ under the Privacy and Personal Information Act 1998 (NSW) (PPIP Act). Supply of this information is voluntary, but your licence request may not be able to be processed if the information is not provided.

It is an offence to provide false or misleading information in applications and documents in connection with matters under the Biodiversity Conservation Act 2016.

The Department of Planning and Environment (the department) collects and manages the personal information you provide in accordance with the PPIP Act. Information supplied on this form will be used by officers of the department to assess and process your licence request. Your personal information, including any matters relating to your compliance with this licence may be disclosed to third parties for the purposes of confirming information provided by you, and for law enforcement purposes. The department will not otherwise use your personal information except for purposes listed as exemptions in the PPIP Act.

As required by the Biodiversity Conservation Act 2016 (NSW), a public register of wildlife licences will be published on the department’s website, which may include certain personal information.

When you purchase, trade or export with another licence holder they are required to record and store details of those transactions, including some of your personal information. This information is provided to the department for information and compliance purposes, including randomly checking compliance. When you buy or sell to someone you must tell them that you are recording their information and that it may be provided to the department.

Personal information collected by the department will be stored securely and disposed of according to the Records Management Policy. You have a right to access to modify and/or update your personal information the department holds about you. For inquiries about privacy or access to your information, contact the Information Access & Privacy team on 9860 1440 or privacy@dpie.nsw.gov.au.

Licence number

I wish to:

Change my personal contact detailsAdd a new licence class to my licence

Change my personal contact details

First name

Last name

Attached proof of name change e.g. marriage certificate or new identification

Date of birth

Home/daytime phone number

Mobile number

Your email address

Residential address where animals will be kept

Address

Suburb

State

State is incorrect

The state must be NSW to be valid.

Postcode

Is the premises where the animal is kept the same as the postal address?

YesNo

Postal address

If the search is unable to find your address, you can free type this information

Suburb

State

Postcode

Reminder to keep your animal keeper records up to date

Click this link to update your Animal Keeper records: Log into your E-book here.

Animal keeper record declaration

Click this link to update your Animal Keeper records: Log into your E-book here.

I declare that my Animal Keeper Record Book, is up-to-date and shows the disposal of my entire animal collection, or I have updated my online native animal keeper record book (currently e-book) to show that I no longer possess animals requiring a licence *

Declaration

I declare that I am the person named in this form and that all information provided by me in this form is true and correct.

I declare that the premises nominated above, as the place where all my animal(s) will be held, will not be used for the conduct of any commercial activity.

I declare that I do not currently have in my possession any animal(s) from the group of species applied for in this application and will not acquire any such animal(s) prior to the granting of the licence class to me.

I declare I have not been convicted of an offence or issued with a penalty infringement notice under the Biodiversity Conservation Act 2016 or the Biodiversity Conservation Regulation 2017

I declare I have not been issued with a written or verbal warning, or entered into an enforceable undertaking in relation to a contravention of the Biodiversity Conservation Act 2016 or the Biodiversity Conservation Regulation 2017

I declare I have not had a biodiversity conservation licence suspended or cancelled.

If you require assistance

Contact:
Wildlife Licensing, National Parks and Wildlife Service
Locked Bag 5022, Parramatta NSW 2124
Phone: 02 9585 6406
Email: wildlife.licensing@environment.nsw.gov.au

Important

All mandatory fields must be completed before submitting.

After you click 'Submit' below, a new page will display. Please review all your responses and provide your signature on this page and click the 'Submit Signed Response' button.

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