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APPLICATION to KEEP RESTRICTED BIRDS Permit Covers the Keeping of Restricted Avian Fauna at the Address Stated on the Authority

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APPLICATION to KEEP RESTRICTED BIRDS Permit Covers the Keeping of Restricted Avian Fauna at the Address Stated on the Authority Department of RESTRICTED BIRDS APPLICATION Agriculture and Food APPLICATION TO KEEP RESTRICTED BIRDS Permit covers the keeping of restricted avian fauna at the address stated on the authority. Completed forms should be returned to: Further information Department of Environment and Conservation The permitting requirements is available from DEC Locked Bag 30 Bentley Delivery Centre WA 6983 Wildlife Licensing Section Or faxed to (08) 9219 8242 Phone: (08) 9219 9835 Email: [email protected] RESTRICTED BIRD PERMITS ARE ISSUED FOR A 1-YEAR PERIOD, WITH FEES PAYABLE AS BELOW. PLEASE ALLOW FIVE (5) WORKING DAYS TO PROCESS COMPLETE AND CORRECT APPLICATIONS. Applicant Title: Given name(s): Surname: Street address (residential): Suburb: State/Territory: Postcode: Street address (postal): Suburb: State/Territory: Postcode: Street address (aviary): Suburb: State/Territory: Postcode: Phone Fax: Email: Mobile: Date of birth: Date of application: Signature: RESTRICTED BIRDS APPLICATION current as at 1st May 2013 Page 1 RESTRICTED BIRDS APPLICATION Applicant is required to provide: 1. Proof of identity and age (driver’s licence, passport, or other appropriate document). 2. Details of any relevant convictions in Australia in the past five years. Relevant conviction means a wildlife related offence. Fees and Payment Money order/cheques made payable to Department of Environment and Conservation to be attached to completed application form OR complete credit card details below. Please do not send cash via post. Licence Type (tick one only) Category of Permit being sought (tick only one): Restricted Keeping Permit (1 year) No Fee Restricted Keeping Permit (1 year) Fee $30.00 (use form on page 3) CREDIT CARD PAYMENT (VISA & MASTERCARD ONLY) Name of Cardholder: Expriry Date: / Signature of Cardholder: RESTRICTED BIRDS APPLICATION current as at 1st May 2013 Page 2 RESTRICTED BIRD KEEPING CATEGORIES EXEMPT BIRDS - If these species are the only birds kept, no licence is required Canary, Common, Serinus canaria Duck, Muscovy, Cairina moschata Finch, Volatinia jacarina Cardinal, Red-crested, Paroaria coronata Grassquit, Blue-black, Jacarini Pigeon, Luzon Bleeding Heart, Gallicolumba luzonica Chicken; Domestic Fowl; all bantams; Red Parrotfinch, Red-throated; Red-faced Pytilia, Crimson-winged; Aurora Finch, Pytilia Jungle Fowl, Gallus gallus Parrotfinch, Erythrura psittacea phoenicoptera Duck, domestic breeds only, Anas spp. Peafowl, Common; Indian Peafowl, Pavo Pytilia, Green-winged; Melba Finch, Pytilia cristatus melba Duck, Mallard; Mallard, Anas platyrhynchos Peafowl, Green, Pavo muticus Swan, Mute; White Swan, Cygnus olor Goose, All Domestic Strains, Anser anser Pheasant, Golden, Chrysolophus pictus Turkey, Common, Meleagris gallopavo Firefinch, Red-billed, Lagonosticta senegala Pheasant, Himalayan Monal; Impeyan Turtle-Dove, Laughing, Streptopelia Pheasant, Lophophorus impejanus senegalensis Guineafowl, Helmeted, Numida meleagris Pheasant, Kalij, Lophura leucomelanos Turtle-Dove, Spotted, Streptopelia chinensis Pigeon, Domestic; Rock Dove, Columba livia Pheasant, Lady Amherst's, Chrysolophus Waxbill, Lavender; Lavender Finch, Estrilda amherstiae caerulescens Goose, Swan; Chinese Goose, Anser Pheasant, Reeves's, Syrmaticus reevesii Pheasant, Siamese Fireback, Lophura diardi cygnoides Grassquit, Cuban; Cuban Finch, Tiaris canora Pheasant, Swinhoe's, Lophura swinhoii Ground-dove, White-bibbed; Pigeon, Goldfinch; European Goldfinch AA Waxbill, Zebra; Golden-breasted Waxbill; White-breasted Ground; Jobi Island Dove, Carduelis carduelis Orange-breasted Waxbill, Amandava subflava Gallicolumba jobiensis FREE-OF-CHARGE RESTRICTED KEEPING BIRDS - A free licence is required for the birds listed here. Canary, Yellow-fronted; Green M30 Lovebird, Masked, Agapornis Partridge, Chukar; Chukor or Chukka Singing Finch, Serinus mozambicus personatus Partridge, Alectoris chukar Cockatoo, Sulphur-crested, M30 Lovebird, Nyasa; Lilian’s M30 Pheasant, Ring-necked; M20 Cacatua galerita Lovebird, Agapornis lilianae Common Pheasant, Phasianus colchicus Conure, Jandaya; Jandaya Parakeet, Lovebird, Peach-faced, M30 Pheasant, Silver, Lophura M20 Aratinga jandaya Agapornis roseicollis nycthemera Conure, Sun; Sun Parakeet, Aratinga Lovebird, Fischer’s, Agapornis M30 Parakeet, Alexandrine, Psittacula solstitialis fischeri eupatria Cordon-bleu, Blue-capped; Blue- Lovebird species hybrids, M30 Parakeet, Plum-headed, M10 headed Cordon-bleu, Uraeginthus Agapornis spp. (if neither parent Psittacula cyanocephala cyanocephalus species is $30) Cordon-bleu, Red-cheeked, Munia, Black-headed; Black-headed Red Bishop, Northern; Orange M10 Uraeginthus bengalus Nun, Lonchura Malacca Bishop, Euplectes francisanus Fody, Madagascan Red; M20 Munia, White-rumped; Bengalese M20 Scaup, New Zealand, Aythya Madagascar Weaver, Foudia Mannikin, Lonchura striata Novaeseelandiae madagascariensis Dove, Namaqua; Cape or M30 Munia, White-headed, M20 Shelduck, Paradise; New Zealand Masked Dove, Oena capensis Lonchura maja Shelduck, Tadorna variegate Dove, Ruddy Ground; Talpacoti, M20 Goose, Egyptian, Alopochen Silverbill, Indian; White-throated Columbina talpacoti aegyptiacus Munia; Common Silverbill, Lonchura malabarica Dove, Collared; Collared Turtle-dove; Munia, Red; Red Strawberry Finch; Red Siskin, Hooded; Yellow Siskin; Indian Ring Dove; Barbary Dove or Indian Avadavat; Tiger Finch; Red Black-hooded Yellow Siskin, Carduelis (fawn or white variations), Streptopelia Waxbill, Amandava amandava magellanica decaocto Cordon-bleu, Blue-breasted; Blue- Mannikin, Nutmeg; Spicefinch; Spotted Sparrow, Java; Paddy Finch, AA breasted Waxbill, Uraeginthus Munia; Scaly-breasted Munia, Lonchura Padda oryzivora (Can only be angolensis punctulata kept in areas south of Coral Bay) Quail, Japanese, Coturnix japonica Parakeet, Red-fronted; Red- M10 Sparrow, Paradise; Aberdeen M20 fronted Kakariki, Cyanoramphus Finch; Redheaded Amadina, novaezelandiae Amadina erythrocephala Greenfinch, Oriental, Carduelis sinica Greenfinch; European Greenfinch, Waxbill, Common; St Helena M20 Carduelis chloris Waxbill, Estrilda astrild Parrot, Meyer’s; Brown Parrot, M10 Parakeet, Rose-ringed; Indian or M10 Weaver, Cut-throat; Cut-throat M30 Poicephalus meyeri African Ringneck Parrot or Finch; Ribbon Finch, Amadina Parakeet, Psittacula krameri fasciata Parakeet, Yellow-fronted; M10 Grenadier Weaver; Red Bishop; M10 Yellow-fronted Kakariki, Red Bishop, Southern; Red Cyanoramphus auriceps Bishop; Grenadier Weaver, Euplectes orix RESTRICTED BIRD KEEPING LICENCE - Fee $30 per year (Single licence to also cover birds from above categories held at the same address) Caique, Black-headed; Macaw, Hyacinth, Anodorhynchus Parakeet, Moustached, Psittacula Black-headed Parrot, Pionites hyacinthinus alexandri melanocephala Chaffinch, Fringilla coelebs Macaw, Red-fronted, Ara rubrogenys Redpoll, Carduelis flammea M10 Duck, Mandarin, Aix galericulata Macaw, Scarlet, Ara macao Rhea, Greater, Rhea americana Conure, Golden-capped; Parrotfinch, Red-headed, Erythrura Siskin, European; Spruce Siskin; M30 Golden-capped Parakeet, Aratinga cyaneovirens Eurasian Siskin, Carduelis spinus auricapillus Macaw, Blue and Yellow; Blue Parakeet, Derbyan, Psittacula M12 Twinspot, Peters’s, Hypargos and Gold Macaw, Ara ararauna derbiana niveoguttatus Caique, White-bellied; Parakeet, Malabar, M10 Twinspot, Dybowski’s, M20 White-bellied Parrot, Pionites Psittacula columboides Euschistospiza dybowskii leucogaster Lory, Dusky, Pseudeos fuscata M10 Parrotfinch, Bamboo; Tawny-breasted Waxbill, Black-rumped; M20 Parrotfinch, Erythrura hyperythra Red-eared Waxbill, Estrilda troglodytes Conure, Peach-fronted, Munia, Green; Green M20 Parrotfinch, Tri-coloured; Three- Golden-crowned Conure; Strawberry Finch, Green coloured Parrotfinch; Tanimbar Peach-fronted Parakeet, Aratinga aurea Avadavat, Amandava Formosa Parrotfinch, Erythrura tricolor Lovebird species hybrids, M30 Pytilia, Yellow-winged, Pytilia Waxbill, Orange-cheeked, Estrilda Agapornis spp. (if one of the hypogrammica melpoda parent species is $30) Lovebird, Black-cheeked, M30 Siskin, Red; Venezuelan M30 Yellowhammer, Emberiza citrinella Agapornis nigrigenis Siskin; Black-hooded Red Siskin, Carduelis cucullate Macaw, Green-winged; Red and Green Macaw, Ara chloropterus Legend AA – ADVANCED AVICULTURAL LICENCE REQUIRED M# = MAXIMUM NUMBER OF THIS SPECIES ALLOWED TO BE KEPT RESTRICTED BIRDS APPLICATION current as at 1st May 2013 Page 3.
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