Annexure 4

ORDINARY PERMIT

Issued in terms of the provisions of the National Environmental Management: Biodiversity Act, 2004 (Act No. 10 of 2004)

NAME OF ISSUING AUTHORITY

NAME

ADDRESS

PROVINCE

DETAIL OF PERMIT-HOLDER

NAME

ID NO.

SURNAME

PASSPORT NO.

POSTAL ADDRESS

RESIDENTIAL ADDRESS

ADDRESS

ADDRESS

ADDRESS

TOWN

POSTAL CODE

PROVINCE

DETAIL OF SPECIES INVOLVED

SPECIES

SEX

(if known)

QUANTITY

MARKING

(if applicable)

COMMON NAME

SCIENTIFIC NAME

DETAIL OF RESTRICTED ACTIVITIES INVOLVED

NAME AND SURNAME OF PURCHASER/SELLER

RESIDENTIAL ADDRESS OF PURCHASER/SELLER

IN THE CASE OF INTERNATIONAL IMPORT/EXPORT:

NAME AND SURNAME OF CONSIGNEE/CONSIGNOR

RESIDENTIAL ADDRESS OF CONSIGNEE/CONSIGNOR

IN THE CASE OF A HUNT:

NAME AND SURNAME OF HUNTING CLIENT (if applicable)

NAME AND SURNAME OF PROFESSIONAL HUNTER (if applicable)

NAME AND SURNAME OF HUNTING OUTFITTER (if applicable)

WEAPON AND METHOD OF HUNTING

IN THE CASE OF POSSESSION OF ELEPHANT IVORY OR RHINOCEROS HORN:

WEIGHT OF EACH PIECE APPLIED FOR

LENGTH OF THE ELEPHANT IVORY

BASE CIRCUMFERENCE OF ELEPHANT IVORY OR RHINOCEROS HORN

REGISTRATION NUMBER

MICROCHIP NUMBER

PERMIT VALIDATION

PERIOD OF

VALIDITY

FROM:

TO:

RECEIPT NUMBER

SIGNATURE ISSUING OFFICER

SIGNATURE PERMIT-HOLDER

DATE STAMP: