Amend my private wildlife licence

Amend my Private Wildlife Licence

To complete this form:

1. You must be the Holder of a current Victorian private wildlife licence.

2. You will need to refer to your current wildlife licence number and record book number.

Once processed, an amended licence will be posted to you (please allow 7-10 days for delivery).

Licence details

Select Licence Type (required) *

This Licence authorises the holder to possess, keep, breed, buy, sell and dispose of any dingo for non-commercial purposes and to possess any dingo at other sites for the non commercial purposes of exercising, obedience training, education, or display at shows conducted by a canine association. A list of species allowed for this licence type is available at https://www.vic.gov.au/private-wildlife-licences.

This Licence authorises the holder to possess, keep, buy, sell and dispose of prepared or mounted specimens of any dead wildlife specified in the licence for non-commercial purposes. A list of species allowed for this licence type is available at https://www.vic.gov.au/private-wildlife-licences .

This Licence authorises the holder to possess, keep, breed, buy, sell and dispose of any wildlife listed in Schedules 2 and 7 and specified in the licence for non-commercial purposes. A list of species allowed for this licence type is available at https://www.vic.gov.au/private-wildlife-licences .

This Licence authorises the holder to possess, keep, breed, buy, sell and dispose of any wildlife listed in Schedules 2, 3 and 7 and specified in the licence for non-commercial purposes. A list of species allowed for this licence type is available at https://www.vic.gov.au/private-wildlife-licences .

Licensee full name (required) *

Date of birth (required) *

Licence number (required) *(8-digit number only)

Record Book number (required) *(The book number is on the front cover, in top-right corner).

Personal details

No changes required

First name (required) *

Middle names (if any)

Family name (required) *

Date of birth (required) *

Address details

No changes required

RESIDENTIAL

Street address

City

State

Postcode

Please note: Only one person may hold wildlife licences at any given premises. Multiple licence holders are not permitted and therefore an amendment to the licence may not be processed if a wildlife licence already exists at this residential or operational address.

POSTAL is same as above

Do you have a PO Box ? *

Yes; send mail to my PO Box (below)No; send mail to a different street address (below)

PO Box No, Town, State, Post Code

Postal street address

Street address

City

State

Postcode

Contact details

No changes required

Email

Phone

Concession details

No changes required

Do you hold a valid Commonwealth Health Care Card? *

YesNo

You must hold a current Concession card (shown below) and be an eligible person under the State Concessions Act 2004.

Please note: Seniors and Student Cards do not meet eligibility requirements for the concession rate. If you are claiming a concession rate, you may be asked to provide proof of eligibility. False or misleading information may result in the cancellation of your licence.

Upgrade to Advanced licence

Do you wish to upgrade to an Advanced licence?

NoYes; please calculate the upgrade fee and send me a payment notice for action.

Collection, use and disclosure of personal information

Privacy and Data Protection Act 2014

The Department of Energy, Environment and Climate Action (DEECA) is committed to protecting personal information provided by you in accordance with the principles of the Victorian privacy laws. The information you provide may be made available as required to any authorised law enforcement agency, used to monitor compliance with licence conditions and used to provide information from DEECA relevant to your licence. Your contact details may also be used by DEECA or its contracted service providers under confidentiality agreements to survey you about your experience with DEECA and seek feedback related to the keeping of wildlife. A wildlife licence amendment may not be processed if the information required is not provided. You may access the information you have provided to DEECA by contacting the Customer Contact Centre on 136-186.

Lodgement

1. Please check your amendment carefully to ensure all information is correct and complete.

2. If you have previously (or in this form) provided an email address, a copy of this amendment will be sent to you for your records in (about) 5 minutes.

3. If you have a question or need to correct a mistake contact us at customer.service@delwp.vic.gov.au or call 136-186 (8am-6pm, Mon-Fri).

When lodged (click blue button) your amendment will be processed within five business days.

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