Regulatiun 12(1)
FIRST SCHEDULE
THE NATIONAL ENVIRONMENT (ACCESS TO GENETIC
RESOURCES AND BENEFIT SHARING) REGULATIONS,
2005
APPLICATION FOR PRIOR INFORMED CONSENT
Form: AGR 1
IIwe* hereby further declare that to the best of my/our information,
the information given in this application is correct and true and that
the prior informed consent will only be used for applying to the
competent authority to access genetic resources from Uganda.
Date .................... .
Signature of applicant .................... .
FOR OFFICIAL USE ONLY
Application received on ................................................ 20..... .
*DeJete whicbever is not applicable
•
To': ................ :..................... (Lead agency)
...................................... (Local Community)
...................................... (Owner)
IIwe* ................................................................................................. .
of .......................................... (;dd;;;~;j
........................................... ..
hereby apply for prior informed consent to enable me/us to apply to
the competent authority to access genetic resources under your
ownership/jurisdiction.
The prior informed consent is being applied for, for the genetic
resources located at
........................................... ....................................................
~
(State location by local council,. village, sub county and district)
The prior informed consent is being applied for in respect of the
following genetic resources............................................................................................................
...........................................................................................................
IIwe* declare' that I am/we* are' willing to enter into an accessory
agreement with you on terms and conditions acceptable to you.
400
".......
401