THIRD SCHEDULE Regulation 12 (2) SECOND SCHEDULE ACCESSORY AGREEMENT Regulation 12(3) THE NATIONAL ENVIRONMENT (ACCESS TO GENETIC RESOURCES AND BENEFIT SHARING) REGULATIONS, 2005 THE NATIONAL ENVIRONMENT (ACCESS TO GENETIC RESOURCES AND BENEFIT SHARING) REGULATIONS, 2005 PRIOR INFORMED CONSENT FORM: ACCESSORY AGREEMENT AGR3 FORM: I/we ................................................................................................... . being the owner/custodian of the following genetic resources ............................................................................................................ ............................................................................................................ (State the genetic resources) located at ........................................................................................... , (State location by local council, village, sub county and district) hereby consent that .......................................................................... . (Name and address of applicant for prior infonned consent) may apply to the competent authority for consideration to access the above stated genetic resources found under my ownership/custody. 1......................................................................................................... 2 ...................................................................................................... . 3....................................................................................................... . For the purposes of ........................................................................... . (State the purpose e.g. commercial, research, educational etc) On condition that- 1.............................. :...............................................- ........................ ; 2........................................................................................................ ; 3........................................................................................................ ; 2 3 5........................................................................................................ ; The applicant(s) has*lhave* obtained the following accessory agreements 1. 2. ................................................................................................... 1. (Attach additional infonnation where necessary) Date of consent: ............................. 20 ....... . Signed ,I' .. ............................................................................................... .. Signed ..................................... . Lead agency, local community or owner* *Delete whichever is not applicable 402 L~'_, I/We............................... being the owners/local communityllead agency/custodians of the genetic resources located at ....................... . in .................... district of the Republic of Uganda hereby consent that MIS ..................... may access the following genetic resources- This consent is valid from ............... 20. ... to .............. 20 ... . This consent is granted subject to the following conditions: 4............................................................................................; ........... ; Date .................. . AGR2 LEAD AGENCY/ LOCAL COMMUNITY/OWNER c.c. The Competent Authority 403