Annexure I

S.No. Form for Declaration of stock of Exotic LiveSpecies

Nameofthe Owner stock holder
Addressofthe Owner stockholder
PhoneNumber
4 email-id
Name ofthe Species
a) Common Name

b) Scientificname
6 Photoof the species
7 Numbers
8 Juvenile/ /Adult
9 Male/Female
10 Country/ State of Origin
Address of the facility where Exotic Live
11 Species to bekept/transferred
12 Date ofImport transfer,if applicable
DGFT license Number for import
Reference no. of original stock under
13 transfer. if appicable
Letter number of NOC issued by the
14 CWLW, IF APPLICABLE
15 Remarks

Date: Name&Signature
Place

(as per Guideline provided on the Parivesh portal)