RACING GREYHOUND CONTROLLER LICENCE APPLICATION THIS IS A

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Racing Greyhound Controller Licence Application


Racing Greyhound Controller Licence Application

This is a special licence under Section 39H of the Domestic Animals Act 2000 and it is valid for one year.

If you had day-to-day control of a greyhound that was registered with an ACT greyhound racing controlling body prior to 30 April 2018, you are considered to hold a racing greyhound controller licence until 30 October 2018, unless you surrender or cancel the licence.

However, if you worked in, or were involved in, greyhound racing in the ACT and received assistance from the Territory in relation to the ending of greyhound racing in the ACT, then you are ineligible to apply for registration of a greyhound as a racing greyhound or seek a racing greyhound controller licence for the period agreed in writing between the Territory and yourself as a condition of the assistance.

Your Details

Name:


Address:


Address of Premises where greyhounds will be kept:


Phone number:


Mobile (if different):


Email:



Are you the registered keeper of the racing greyhounds for which you will have day-to-day control?

Yes No


If no, please enter the details of up to three registered keepers on the next page. If there are more than four registered keepers for the greyhounds you will have day-to-day control of, please attach additional information.


Have you had any conviction or finding of guilt within the last 10 years against a law of a Territory or State for an offence relating to greyhound racing or the welfare, keeping or control of an animal?

Yes No

If yes, please provide details:


Have you had any disciplinary action taken against you under a gaming law or a rule of racing or betting, in the ACT or elsewhere?

Yes No

If yes, please provide details:


Have you received assistance from the Territory in relation to the end of greyhound racing in the ACT?

Yes No


If yes, what is the end date of your period of ineligibility to apply for a racing greyhound controller licence?

_______/_______/_______



Registered Keeper #1

Name:


Address:


Phone number:


Mobile (if different):


Email:


Keeper of:

(Greyhound names)




Registered Keeper #2

Name:


Address:


Phone number:


Mobile (if different):


Email:


Keeper of:

(Greyhound names)




Registered Keeper #3

Name:


Address:


Phone number:


Mobile (if different):


Email:


Keeper of:

(Greyhound names)




Please provide details of the racing greyhounds for which you have day-to-day control:

Name

Age

Registration number

Micro-chip number

Address to be kept at

Greyhound racing controlling body the greyhound is registered with (if applicable)























































































Please note: When your application has been submitted, an assessment will be made by Domestic Animal Services Staff and you will be contacted to finalise your application and make payment of the appropriate fees

If you have any questions regarding this application process please contact Access Canberra on 13 22 81    

By signing this form I acknowledge that the above information is true and correct to the best of my knowledge. I understand that it is an offence under the Criminal Code 2002 to make false and misleading statements.

I declare that I intend to be the controller of racing greyhounds listed on this form:

Signature:_______________________________________ Date:



This application may be submitted via:

Email: [email protected]


Postal: Domestic Animal Services

GPO BOX 158

Canberra City ACT 2601


Or delivered in person between 10am and 3pm on Monday, Tuesday, Thursday, Friday and Saturday to:

Domestic Animal Services, Mugga Lane, Symonston ACT



Privacy Statement: Transport Canberra and City Services adheres to the ACT Information Privacy Act 2014. As a general rule the personal information that is provided to us is not passed on to other organisations or third parties without your written consent. However, your information may be provided to the ACT Civil and Administrative Tribunal or another court or tribunal if required by law. You can view our privacy policy on the About US page of the Directorate’s website (https://www.tccs.act.gov.au/about-us/privacy-policy-statement).



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