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Wildlife Special Use Permit (WSUP)
DENR permit application form for orher use of wildlife
Your Browser Doesn't Support Canvas. Showing the Text Content of the PDF Instead: Republic of the Philippines
Department of Environment and Natural Resources
National Capital Region
National Ecology Center, East Avenue, Diliman, Quezon City
E-mail: denrncr@hotmail.com
APPLICATION FOR:
PERMIT FOR OTHER USES OF WILDLIFE
(Subject in Duplicate)
A. COMMERCIAL
B. RESEARCH
_____ Animal
EXHIBITION/SHOWS
_____ Animal
_____ Plant
_____ Plant
EDUCATIONAL/DOCUMENTATION C.
_____ Animal
Attach
2x2 photo
_____ Plant
CLEARANCE TO OPERATE
_____ Animal
_____ Plant
_____________________
(Date)
The Regional Director
DENR – National Capital Region
National Ecology Center, East Avenue
Quezon City
Thru: The ARD, Technical Services
Sir/Madam:
In accordance with R.A. 9147 otherwise known as the Wildlife Resource
Conservation and Protection Act and other pertinent wildlife rules and regulations with
which I shall familiarize myself and to which strict compliance of same is herby promised,
1. I, ___________________________________ have the honor to apply for the above
permit.
2. I am ______ years of age, citizen of ______________________________________,
by birth
(if by naturalization, submit papers for verification)
Date of birth: _____________________ Place: ______________________________
Residence: _________________________________ Tel No.: __________________
Business Address: __________________________ Tel No.: ___________________
3. My occupation/profession is an/a _________________________________________
4. I am single/married and the name of my spouse/wife is ________________________
5. I am member/not a member of a sportsmen and/or game club and/or scientific or
conservation society. State name/s of organization/s, if a member _______________.
6. I intend to use the following wildlife for exhitbition/education/research:
Kind/Species
_______________________
_______________________
_______________________
_______________________
No.
________
________
________
________
Kind/Species
_______________________
_______________________
_______________________
_______________________
No.
________
________
________
________
7. Wildlife species to be used/collected under this permit shall be taken by
_____________________________________________________________________
(Indicate collection techniques to be used)
8. I understand that the information stated in this application are true and correct and
any omission of facts herein shall cause the disapproval of this application and/or
cancellation of the permit that may be issued to me.
9. I understand that the filing of this application conveys no right to take, collect or
possess any wildlife until a permit is issued to me by the Regional Director of DENRNCR.
10. The Application fee of Php ___________ in ___________ made payable to the
Regional Director, DENR-NCR with Official Receipt No. __________________ is
herewith enclosed. Non-approval or non-issuance of the permit does not entitle me to
refund the fee.
___________________________
(Signature of Applicant)
TIN: ______________________
____________________________________
(Address)
REPUBLIC OF THE PHILIPPINES)
QUEZON CITY:
SUBSCRIBE AND SWORN to before me this _________________________
Day of ____________________, 20____. Applicant exhibited to me his/her Community Tax
No. _____________________________, issued at ________________________________
on ___________________________ 20______.
_________________________________
(Officer authorized to Administer Oath)
Print Name Clearly and Sign
_________________________________
(Official Designation)
