11. Place/Location of shooting :

12. Time and date of shooting :

13. Particulars of payment of fees made :

to AWBI along with this application

Declaration under Clause b of Rule 2 –

Certificates

a) Certified that this application is only a pre shoot permission and registration of performing animals. Until the permission is issued, shooting with performing animals will not be undertaken. No post shoot approval will be entertained unless pre-shoot application is approved.

b) Certified that the place, date and time of shooting will be duly intimated to Animal Welfare Board of India before 2 working days for inspection during shooting, if required.

c) Certified that no other animal not contained in the application will be employed (Animals found in the back ground in natural sequences such as birds or live stock or pets are exempt from this).

d) Certified that the animals included in this application will be properly housed, protected, fed and safeguarded from any violence or infight among themselves or from others.

e) Certified that adequate Veterinary and nursing care will be provided during and after the film shooting

f) Certified that any animal / bird species protected by Wild Life Protection Act, 1972 and amended in August 2006 included in this study are annexed with the ownership certificate and the transportation certificate from Competent Authority.

g) Certified that the animals/birds included in this film shooting were not subjected to cruelties which has been listed by the AWBI and also displayed in its Website (www.awbi.org).

h) Certified that the “instructions and conditions for issue of Certificate of Registration by AWBI under the Performing Animals (Registration) Rules, 2001 under the Prevention of Cruelty to Animals Act 1960” were taken into consideration in filling the relevant columns of the application.

i) Certified that no column in this application is left blank. (In case the column does not have a reply the words “Nil” or “Not Applicable” must be used to answer the column)

Declaration

I ------------------------------------------ S/o -------------------------- representing

---------------------------------------- do hereby declare that particulars given in the above application are true to best of my knowledge and belief. It is further declared that no cruelty was/will be caused to animals during shooting of films and the requirements stipulated in the Performing animals (Registration) Rules 2001 will be/have been complied with. I also under take to face penalty/legal action in case of any cruelty during shooting of the film.

Station : Signature of the Applicant

Date : Name, Address, contact

numbers and e-mail ID :