FORM NO. 11

[See rule 34 of the Wild Lift Protection

(Manipur) Rules, 1974]

Form of declaration of trophy etc.


To


    The Chief Wild Life Warden/Authorised officer

   __________________________

   __________________________

 


Sir,


                 I, ............................................................. resident of ................................................................ in  the District of ........................................ declare that I have in my control, custody or possession the following :
 

Animal article/ Trophy derived from animals specified in Schedule II to the Wild Life (Protection) Act,   1972.

 Number Description including name of animal from which derived Dimen­sions

How

obtained

 Premises where kept
1 2 3 4 5 6
 

 

 

 

          
 
 
1. Animal article

2. Trophy

Place:
Date:

Yours faithfully,

 


 Signature of the applicant