Illinois Department of Natural Resources | |||||||
One Natural Resources Way Springfiled, IL 62702-1271 www.dnr.illinois.gov | |||||||
APPLICATION FOR PERMIT FOR DISPOSAL OR TRANSFER
| |||||||
Name of Permittee: | < | ||||||
Institution: | < | ||||||
Address: | < | ||||||
Phone: | < | ||||||
Email: | < | ||||||
Address of endangered or threatened species holding facilities: | |||||||
Same as above | |||||||
Your permit: | < | ||||||
Type of E&T permit held: |
[X] Scientific [X] Educational [ ] Zoological/Botanical [ ] Limited permit (hobbyist) | ||||||
| |||||||
| |||||||
Animal information | |||||||
Id: < Species: < Admission date: < | |||||||
| |||||||
"I hereby certify that the information contained herein is true and accurate to the best of my knowledge." Signature: __________________________ Date: <
|