National Environmental Management: Biodiversity Act, 2004 (Act No. 10 of 2004)

Regulations

Purchase

An applicant completing this part must also complete and sign part 1

RECIPIENT OF INDIGENOUS BIOLOGICAL RESOURCES BEING EXPORTED (IMPORTER)

1. Name of recipient/importer:

2.	Contact details of recipient/importer (include postal/physical address, phone, fax and e-mail address):

REQUIREMENTS OF OTHER LEGISLATION

3.	Have you complied, or have you taken steps to comply, with other legislative requirements for the collection and export of the indigenous biological resources? Provide details, including reference numbers and waybill numbers where appropriate:

PURPOSE OF EXPORT

4. State the purpose for which the indigenous biological resources are to be exported:

5. Will the intended bioprospecting that is the subject of the permit application, have some benefit for—

5.1	the conservation of biodiversity in South Africa Y/N

5.2	the economic development of South Africa Y/N

5.3	any other matter that is in the public interest? Y/N

6. If yes, provide details:

FEES

7. Has the fee of R5200 been paid? Please attach a copy of the invoice Y/N

Signature of applicant for permit:

Date:

Capacity of signatory:

Endorsement of juristic body, if applicable

Name of juristic body:

Signature of duly authorised officer from the juristic body:

Date: