Application for a Licence to Operate a Supply Facility

New or Renewal Licence Application

Please complete this application for a licence to operate a supply facility under the Animals for Research Act in full. The Director appointed under the Animals for Research Act will determine all applications in accordance with the requirements of the Act. A licence expires with the 31st day of December of the year of issue. Licenses must be renewed annually. A separate application and payment of fees is required for each Supply Facility you operate.

Required Fees

The fee is $100 for a supply facility.

Fields marked with an asterisk () are mandatory.

Type of Registration(required)

New

Renewal

Certificate Number(required)

(Format must be 4 digits)

Facility Information

Organization Name(required)

Operator Information

Operator Name (person)(required)

Position Title(required)

Telephone Number(required)

(Format must be 10 digits)

Email Address(required)

(Example: name@example.com)

Confirm Email Address(required)

(Example: name@example.com)

Mailing Address

Postal Code(required)

(Format must be A#A #A#)

(if necessary, continue to select the Postal Code Lookup button until your correct street name is shown or complete the address fields with the correct information)

Unit Number

Street Number(required)

Street Name(required)

PO Box

County

City/Town(required)

Province(required)

Contact Information

Same as Operator Information

Last Name(required)

First Name(required)

Position Title(required)

Telephone Number(required)

(Format must be 10 digits)

Email Address(required)

(Example: name@example.com)

Supply Facility Information

Supply Facility 1

Supply Facility Name(required)

Address

Building Name

Postal Code(required)

(Format must be A#A #A#)

(if necessary, continue to select the Postal Code Lookup button until your correct street name is shown or complete the address fields with the correct information)

Unit Number

Street Number(required)

Street Name(required)

PO Box

County

City/Town(required)

Province(required)

On-site Contact

Last Name(required)

First Name(required)

Position Title(required)

Telephone Number(required)

(Format must be 10 digits)

Email Address(required)

(Example: name@example.com)

Confirm Email Address(required)

(Example: name@example.com)

Registration Fee Total $

Owner of premise (if not the operator)(required)

Types or species of animals that are bred and reared on the premises(required)

Certification

Certification(required)

I certify that the foregoing information is, to the best of my knowledge, information and belief, true. I undertake to furnish to the Director appointed under the Animals for Research Act details of any material changes from the information provided on this form and any attachments no later than ten (10) business days after the date any such changes are made.

Operator Name (First and Last Name)(required)

Position Title(required)

Date (yyyy/mm/dd)(required)

If you have any questions, please contact AHWApplications@ontario.ca or 226-979-2385.

Summary

Note: To make changes to the information below, please click the “Back” button (at the top of this page) to access previous pages or “Edit Section” to make corrections.

Application for a Licence to Operate a Supply Facility
under s. 4 of the Animals for Research Act

New or Renewal Licence Application

Required Fees

Facility Information

Operator Information

Mailing Address

Contact Information

Supply Facility Information

Supply Facility 1

Address

On-site Contact

Certification

Summary

Error!

Thank you for your Submission.

Form Submission:

Application for a Licence to Operate a Supply Facility under s. 4 of the Animals for Research Act

New or Renewal Licence Application

Required Fees

Facility Information

Operator Information

Mailing Address

Contact Information

Supply Facility Information

Supply Facility 1

Address

On-site Contact

Certification

Summary

Error!

Thank you for your Submission.

Form Submission:

Application for a Licence to Operate a Supply Facility
under s. 4 of the Animals for Research Act