進口管有許可證申請表-漁農自然護理署.docVIP

進口許可證申請表 此欄由辦理機關填寫 For official use only IL 香港法例586章保護瀕危動植物物種條例 活生動物Live animals □ Application for a LICENCE TO IMPORT 動物標本Animal specimens □ Protection of Endangered Species of Animals and Plants Ordinance, Cap. 586 植物標本Plant specimens □ 填寫此申請表前請先詳閱附加的注意事項內容Please read the attached notes before filling in this application form 1. 申請人姓名／公司名稱及地址 Name of Applicant/Company Address 2. 供應商姓名及地址 Supplier’s Name Address 聯絡人姓名 Contact Person’s Name …………………………………………….…………… 電話 傳真 Telephone: Fax: …………… 3. (a) 公司的香港商業登記證號碼 H.K. Business Registration No. of Company … 或or 申請者身分證/護照號碼 Identity Card/Passport No. of Applicant …..…… (b) 如果持有有效的管有許可證，請提供管有證號碼： If you hold a valid possession licence, please provide licence number APO/PL 4. (a) 用途：(請參考附加的注意事項) Purpose: (Please refer to attached notes) (b) 預期抵港的日期 Expected date of arrival …… (c) 運輸方法：空運/船運/火車/貨車/其他（請說明） Transportation : By air/ship/train/truck/others (Please specify) 動/植物標本詳細內容 (如多於壹個物種，請填附頁。) Details of Animals and Plants specimens ( If more than one species, please fill in annex) No.1 5. 動/植物的物種Species of animal/plant (a) 學名（拉丁文名稱）Scientific Name (b) 俗名Common Name ` 6. 公約 # 附錄編號 (Ⅰ、Ⅱ或Ⅲ）及來源 (請參考附加的注意事項） CITES # Appendix No. (I, II or III) and source (please refer to attached notes) 7. 標本的描述 (如活生、毛皮 或根等） Description of specimens (e.g. live, skin, root) 8. 數量： 數目(頭/件)、 重量(公斤)等 Quantity : number (head/pc), weight (kg), etc. 9. 來源地、公約# 准許證編號及日期 Country (Region) of Origin, CITES # Permit No. and Date 10. 先前出口地、公約# 准許證編號及日期 Country (Region) of Previous Export, CITES # Permit No. and Date 本人已閱畢附加的應注意事項及警告，並聲明上面各項填報詳情均為正確無訛。本人明白必須完全遵守證上所列各項條件，獲發的許可證方為有效。而證上 所列的有關物品，進口時須經由漁農自然護理署獲授權人員查驗。I have read the attached notes and warning and I declare that all the particulars given above are true and correct. I understand that any licence, if issued, is valid only when all the licence conditions stipulated on the licence are fully complied with and that the specimens must