Department for Environment, Food & Rural Affairs
Scottish Executive
Welsh Ministers
The Welfare of Animals (Slaughter or Killing) Regulations 1995 (as amended)
Application for a:
Provisional Licence to slaughter or kill animals; or
Tick ONE box only
Certificate of Competence
Registered Licence to slaughter or kill animals
BEFORE COMPLETING THIS APPLICATION PLEASE READ THE GUIDANCE NOTES ON PAGE 5
1. This application should be completed in BLOCK CAPITALS using black ink or in black font if
completing the form on your computer.
2. You should use this form if you work in a slaughterhouse. If you work elsewhere contact your local
Animal Health Office, however this does not apply if you are applying for a registered licence which
must be sent to the FSA in York, see page 4.
3. If there is not enough space for you to answer any question, or if you wish to add extra information,
please use extra sheets of paper and attach them to this application. Alternatively you can complete
the additional information box at the end of the form.
PLEASE READ THE DECLARATIONS CAREFULLY, TOGETHER WITH THE DATA PROTECTION ACT
AND DATA SHARING STATEMENT BEFORE SIGNING THIS APPLICATION.
4. Completed applications for a provisional licence or certificate of competence should be submitted to
your Official Veterinarian. Applications for a registered licence should be submitted to the FSA in York.
Section 1 Personal Information
Surname First name(s)
Day
Month
Year
Date of Birth
Applicants must not be below the age of 18
Address
Post code
Telephone number (including national dialling code)
Email address
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This form is no longer in use and has been withdrawn
Print Form
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Section 2 - Offences and Convictions
Do you have a record of any conviction(s) or Home Office Simple Caution(s) for any animal welfare offence?
Convictions which are spent under the Rehabilitation of Offenders Act 1974 are not required to be disclosed.
Yes
No
If “YES” give details of the Infringement(s)
Have you had a previous application for a slaughterer’s licence refused or had a licence suspended
or revoked?
Yes
No
If “YES” give details
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Section 3 – Information about the activities to which this application relates
Enter in the columns below each combination of operations, species and equipment for which you require a
Provisional Licence / Certificate of Competence. If your certificate of competence was issued under the
Slaughter of Poultry (Licences and Specified Qualifications) Regulations 1991 or is a licence issued by the
Rabbinical Commission or the Chief Rabbi, please state in the box below each combination of operations,
species and equipment for which you are applying for a registered licence.
Please refer to section 3 of the guidance notes
Operations Species Equipment
This form is no longer in use and has been withdrawn
Section 4 – Declaration and signature
Data protection – Fair Processing Notice
Other enforcement authorities in the United
Kingdom or Competent Authority in other Members
States of the European Union to aid investigations
concerning breaches or potential breaches of law,
compliance checks and for enforcement purposes.
Defra, The Scottish Executive and the Welsh
Ministers are data controllers in respect of any
personal information supplied in connection with
your application. Animal Health (AH) an Executive
Agency of Defra, will be responsible for processing
data relating to persons in England. AH will also
process the data relating to
The information may also be supplied to:
the Scottish Executive; Welsh Ministers; The
Department of Agriculture and Rural Development,
Northern Ireland (DARDNI); Rural Economy,
Jersey; The Department of Agriculture, Fisheries
and Forestry, Isle of Man; and The State
Agriculture and Countryside Board, Guernsey as
appropriate for enforcement and statistical
purposes. Information (including personal data)
may also be released under the Environmental
Information Regulations or the Freedom of
Information Act 2000.
businesses and persons in Scotland and Wales on
behalf of the Scottish Executive and the Welsh
Ministers respectively. The information will be used
to process your application and issue your
Provisional Licence, Certificate of Competence or
Registered Licence. The information may be made
available to:
HM Revenue & Customs
Local Authorities
I declare that I have not provided any information which I know to be false or misleading for the purpose of
obtaining a Provisional Licence, Certificate of Competence or Registered Licence to slaughter or kill animals.
Signature
Date
For a Provisional Licence and Certificate of Competence please present this form to your Official Veterinarian.
For a registered licence please send it to:
FSA, Kings Pool, Peasholme Green, York, YO1 7PR
IMPORTANT: FOR APPLICATIONS FOR A REGISTERED LICENCE ONLY
Before sending this application please check that you have included:
1. Your certificate of competence (tick box)
form WAS 3; or
a certificate issued under the Slaughter of Poultry
(Licences and Specified Qualifications) Regulations
1991; or
a licence issued by the Rabbinical Commission or the
Chief Rabbi
2. The administrative fee (cheque payable to Food Standards Agency) if you have not paid over the
telephone (+44 1904 455395) using a debit card.
3. Two passport sized photographs (please write your name in block letters on the back of each
photograph)
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GUIDANCE NOTES ON COMPLETING THE APPLICATION FORM
Part 1 – Personal Information
This section asks you to provide your full name, address
and date of birth
Section 2 – Offences and Convictions
The further information or details of the infringement
section must be completed if applicable. If you have a
Conviction or Home Office Simple Caution record of any
animal welfare offence you must declare:
The legislation breached
The penalty imposed, including any
Restriction/ Disqualification Order with
details of its start/end date
When the offence was committed
Name of the court if there was a
conviction
Date of Conviction/date of issue of
Home Office Simple Caution
Who took the enforcement action (e.g.
police, local authority, RSPCA)
In considering applications for a Provisional Licence /
Certificate of Competence any record of a Home Office
Simple Caution or Conviction under the following
legislation will generally be taken as grounds for refusing
an application.
the Animal Welfare Act 2006;
the Animal Health & Welfare (Scotland)
Act 2006;
the Welfare of Animals (Transport)
England Order 2006;
The Welfare of Animals (Transport)
(Scotland) Regulations 2006;
The Welfare of Animals (Transport)
(Wales) Order 2007;
The Welfare of Animals (Transport)
Regulations (Northern Ireland) 2006;
the Welfare of Animals (Slaughter or
Killing) Regulations 1995 (as amended);
the Slaughter of Poultry Act 1967
the Slaughterhouses Act 1974
the Slaughter of Animals (Scotland) Act
1980,
the Protection of Animals Act 1911 to
1964;
the Protection of Animals (Scotland) Act
1912 to 1964;
article 4 or 6 of the Welfare of Animals
(Transport) Order 1997;
Articles 5, 6, 7 and 8 of the Welfare of
animals at Markets Order 1990; or
any other provision concerning the
welfare of animals.
However, evidence of action taken to avoid a repetition
of the offence(s) may be taken into account, as will the
seriousness of the offence(s).
If you are applying for a provisional licence you must
give full details if you have been refused any
slaughterer’s licence or if you have had a slaughterer’s
licence suspended or revoked. You must declare:
The reason for suspension or revocation
When the suspension or revocation took effect
The authority responsible for the suspension
or revocation
A recent conviction for animal welfare offences under
the legislation listed in the Animal Welfare (Slaughter or
Killing) Regulations 1995 schedule 1.8 (b) would disbar
an individual from being granted a provisional licence.
However under normal circumstances an individual
would not be barred for life unless the decision by the
court prevented the individual from working with animals.
The normal ruling is applied and a conviction would be
considered spent after a period of seven years. If the
offence has occurred seven years previous to the
application it is likely that the vet would issue a
provisional licence allowing the individual to work under
supervision until such time as they were able to
demonstrate competence to undertake the duties.
Section 3 - Information about the activities to which
this application relates
Operations:
Enter the appropriate WORD(S) indicated in bold
below in the ‘Operations’ column:
the RESTRAINT of any animal for the
purposes of stunning, slaughtering or killing
that animal;
the STUNNING of any animal;
the SLAUGHTER of any animal (religious
slaughter only);
the KILLING of any animal;
the PITHING of any animal;
the ASSESSMENT of effective stunning,
pithing, or killing of any animal by any
person whose duty it is to make such an
assessment;
the SHACKLING or HOISTING of any
stunned animal; and
the BLEEDING of any animal which is not
dead
The Official Veterinarian can tell you about operations
which do not require a licence.
Species:
Enter in this column each species for which the
application is made e.g. Pigs, Sheep, Goats,
Horses, Deer, Rabbits, Domestic fowls, Turkeys,
Ducks, Geese, Other. For Bovine, specify Cattle,
Calves, Bison or Buffalo.
Equipment:
Enter in this column the equipment, instruments or
method for which the application is made e.g.
captive bolt, concussion stunner, electric stunner,
gas mixture etc. If you are applying to slaughter
by a religious method, state this here.
Section 4 – Declaration and signature
You must sign and date the form. Unsigned forms will
not be processed. It is an offence to provide information
which you know to be false or misleading.
This form is no longer in use and has been withdrawn
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Additional Information
This form is no longer in use and has been withdrawn
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