Licence Not Required (Surrender)

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Please only complete this form if you longer possess any native animals of any class that were authorised to be kept under the following licence. Please only complete this form if you do not wish to renew the licence and provide the reason in the form below.

This form can only be used to surrender a Native Animal Keeper Licence and a Companion Animal Keeper Licence. To surrender other licence types, please contact the Wildlife Team.

Phone: 02 9585 6406
Email: wildlife.licensing@environment.nsw.gov.au

Privacy notice

This application requests information that identifies you and is defined as ‘personal information’ under the NSW Privacy and Personal Information Act 1998 (PPIP Act). Supply of this information is voluntary, but we may not be able to progress your request without this information.

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 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 personal information except for purposes listed as exemptions in the PPIP Act.

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.

Licensee details

Licence number

Select the class of licence you currently have.

Licence type

CompanionAnimal Keeper

Contact details

First name

Middle name

Last name

Date of birth

Home/daytime phone number

Mobile phone number

Your email address

Residential address where the animals were kept

Address

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

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

Postal address

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

Suburb

State

Postcode

Reason for not renewing:

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 and my lodgements are up-to-date and show 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.

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.

*IMPORTANT - Ensure the State field in the 'Address where animal will be kept' section above is NSW and you have completed the reCAPTCHA verification*

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