Fillable Def Watc 20121206 (Department for Environment, Food & Rural Affairs)

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Def Watc 20121206 (Department for Environment, Food & Rural Affairs)

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DEF-WATC (Rev. 11/12)
Application for a licence to operate a travelling
circus in England using wild animals
Welfare of Wild Animals in Travelling Circuses (England) Regulations 2012
Section 1 – Operator to be licensed
Operator Details
*First Name
*Family Name
*Email
Mobile telephone number
Other telephone number
*Business Address
Postcode
*Name of Circus
Name of Business if
different from above
*Mandatory Fields
Section 2 – Disqualifications
I confirm that I am not disqualified under any of the following legislation:
(1) Section 5(3) of the Pet Animals Act 1951 (a) from keeping a pet shop;
(2) Section 1 of the Protection of Animals (Amendment) Act 1954 (b) from having custody of an animal;
(3) Section 3(3) of the Animal Boarding Establishments Act 1963(c) from keeping a boarding establishment for animals;
(4) Section 4(3) of the Riding Establishments Act 1964(d) from keeping a riding establishment;
(5) Section 3(3) of the Breeding of Dogs Act 1973(e) from keeping a breeding establishment;
(6) Section 6(2) of the Dangerous Wild Animals Act 1976(f) from keeping a dangerous wild animal; or
(7) Section 34 of the Animal Welfare Act 2006
Section 3 – Payment Details
The fee for this application is £389.36. Please submit a cheque or postal order made payable to “Animal Health and
Veterinary Laboratories Agency” or “AHVLA” with this form.
Please note: you will also be charged for the costs of the inspection, once it has taken place. The fee for inspections will be
£72.53 per hour plus the actual costs of any travelling, accommodation and other expenses reasonably incurred by or on
behalf of the inspector. The hourly rate will be charged for the time spent carrying out an inspection, travelling to or from the
site of inspection and on associated administration.
DEF-WATC (Rev. 11/12)
Section 4 – Attachments
Attached To follow by
Yes No post/email
(1) Tour Itinerary
(2) List of animals to be licensed*
(3) List of current location of animals to be licensed*
(4) Individual Record
(5) Care Plans
(6) List of authorised persons
*We cannot begin to process the application without these items
Please tick as appropriate.
If this application is being submitted while the circus is at winter quarters or not in England please indicate what date touring
starts in England
/
/
Section 5 – Details of Lead Vet
Name
Practice address
Postcode
Telephone number
Section 6 – Circuses travelling from outside England
Are you a travelling circus from another country outside England? ...................................................................Yes No
If no, please move to Section 7.
If yes, when do you intend to arrive in England?
/
/
Do you hold a licence or other authorisation as an operator of a travelling circus in your home country?......... Yes No
If yes, please attach a copy to this application form.
Section 7 – Declaration
I am aware of the provisions of the Welfare of Wild Animals in Travelling Circuses (England) Regulations 2012. The details
contained in the application form and any attached documentation are correct to the best of my knowledge and belief.
Signing below indicates that you have read and understood the above declaration, and that in Section 2, and agree to us
contacting the lead veterinarian listed in Section 5 in relation to your licence application.
*Operator Signature
*Full name
*Capacity
Date
DEF-WATC (Rev. 11/12)
Data Protection – Fair Processing Notice
The purpose of this Fair Processing Notice is to inform you of the use that will be made of your personal data, as required by
the Data Protection Act 1998.
The data controller in respect of any personal data supplied by yourself in connection with your application is Defra.
Defra will use your personal data primarily for the purposes of processing your application for a licence to operate a travelling
circus using wild animals.
Defra may be required to release information, including personal data and commercial information, on request under the
Environmental Information Regulations 2001 or the Freedom of Information Act 2000. However, Defra will not permit any
unwarranted breach of confidentiality nor will we act in contravention of our obligations under the Data Protection Act 1998.
Defra’s Information Charter – Public Service Guarantee on Data Handling, which gives details of your rights in respect of the
handling of your personal data is on the Defra website. A document explaining the Guarantee is also on this website. If you
don’t have access to the internet, please telephone the Defra Helpline 08459 335577 and ask to speak to the Data Protection
Officer for a copy of the Information Charter and “explanation” document.
If you believe that any of the information we hold concerning you is incorrect or out of date, please provide us with the
accurate information in writing together with supporting evidence (if appropriate). You should address your correspondence
to Circus Licensing Team, 2 The Square, Temple Quay, Bristol BS1 6PN.
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Completed 25 July 2020

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