Report created by RaptorMed (www.raptormed.com)

Illinois Department of Natural Resources

One Natural Resources Way • Springfiled, IL 62702-1271 • www.dnr.illinois.gov

 

APPLICATION FOR PERMIT FOR DISPOSAL OR TRANSFER
OF ENDANGERED OR THREATENED SPECIES

 

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)
 
[<>]Application for transfer of specimen
<>
[<>]Application for disposal of specimen
 Explanation of need for disposal and methods to be used:

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:   <>

Send completed application to DNR.ETPermit@illinois.gov