Form PPQ 587 PPQ 587 Application for Permit to Import Pants or Plant Products

Importation of Emerald Ash Borer Host Material from Canada

587

Private Sector-Business or other for Profit

OMB: 0579-0319

Document [pdf]
Download: pdf | pdf
According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it
displays a valid OMB control number. The valid OMB control numbers for this information collection are 0579-0049, 0172, and 0173.
The time required to complete this information collection is estimated to average .5 hours per response, including the time for reviewing
instructions, search existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection
of information.
U.S. DEPARTMENT OF AGRICULTURE
ANIMAL AND PLANT HEALTH INSPECTION SERVICE
PLANT PROTECTION AND QUARANTINE

APPLICATION FOR PERMIT TO IMPORT PLANTS OR
PLANT PRODUCTS

INSTRUCTIONS: PLEASE TYPE OR PRINT
CLEARLY. PERMITS ARE NOT ISSUED TO
P.O. BOXES. READ THE ENTIRE
APPLICATION BEFORE COMPLETING.
ATTACH ADDITIONAL SHEETS OF PAPER
IF MORE SPACE IS NEEDED.

1. NAME AND UNITED STATES ADDRESS OF APPLICANT:

FORM APPROVED
OMB NO. 0579-0049,
0172, and 0173

FORWARD COMPLETED APPLICATION TO
USDA-APHIS-PPQ
Permit Unit
4700 River Road, Unit 136
Riverdale, MD 20737-1236
1-877-770-5990; FAX: (301) 734-5786

2. CHECK ONE:

9
RENEWAL:
9
AMENDMENT: 9
NEW PERMIT:

TELEPHONE: (

)

FAX: (

PERMIT # ________________
PERMIT # ________________

)

3. Plants or Plant Products to be Imported

Country of Origin

Scientific Names of Plants or Plant Products

4. INTENDED USE: PROPAGATION
5. CHECK MEANS OF IMPORTATION:

9

CONSUMPTION

9

AIR MAIL OR AIR PARCEL POST
SURFACE MAIL OR PARCEL POST

6. SIGNATURE OF APPLICANT:

Plant Parts
(seeds, cuttings, rhizomes,
plants, bulbs, fruits, etc.)

RESEARCH: LAB ANALYSIS

9
9

AIR FREIGHT

9

9

U.S. Port or Ports
of Arrival

GROWING

9

BAGGAGE OR CAR

TRUCK, RAIL OR WATER FREIGHT

9

9

7. DATE:

PPQ FORM 587 (MD) (APR 2007)
WARNING: Any alteration, forgery, or unauthorized use of this document is subject to civil penalties of up to $250,000 (7 U.S.C.s 7734(b)) or punishable
by a fine of not more than $10,000, or imprisonment of not more than 5 years, or both (18 U.S.C.s 1001)

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it
displays a valid OMB control number. The valid OMB control numbers for this information collection are 0579-0049, 0172, and 0173.
The time required to complete this information collection is estimated to average .5 hours per response, including the time for reviewing
instructions, search existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection
of information.
U.S. DEPARTMENT OF AGRICULTURE
ANIMAL AND PLANT HEALTH INSPECTION SERVICE
PLANT PROTECTION AND QUARANTINE

APPLICATION FOR PERMIT TO IMPORT PLANTS OR
PLANT PRODUCTS

INSTRUCTIONS: PLEASE TYPE OR PRINT
CLEARLY. PERMITS ARE NOT ISSUED TO
P.O. BOXES. READ THE ENTIRE
APPLICATION BEFORE COMPLETING.
ATTACH ADDITIONAL SHEETS OF PAPER
IF MORE SPACE IS NEEDED.

1. NAME AND UNITED STATES ADDRESS OF APPLICANT:

FORM APPROVED
OMB NO. 0579-0049,
0172, and 0173

FORWARD COMPLETED APPLICATION TO
USDA-APHIS-PPQ
Permit Unit
4700 River Road, Unit 136
Riverdale, MD 20737-1236
1-877-770-5990; FAX: (301) 734-5786

2. CHECK ONE:

9
RENEWAL:
9
AMENDMENT: 9
NEW PERMIT:

TELEPHONE: (

)

FAX: (

PERMIT # ________________
PERMIT # ________________

)

3. Plants or Plant Products to be Imported

Country of Origin

Scientific Names of Plants or Plant Products

4. INTENDED USE: PROPAGATION
5. CHECK MEANS OF IMPORTATION:

9

CONSUMPTION

9

AIR MAIL OR AIR PARCEL POST
SURFACE MAIL OR PARCEL POST

6. SIGNATURE OF APPLICANT:

Plant Parts
(seeds, cuttings, rhizomes,
plants, bulbs, fruits, etc.)

RESEARCH: LAB ANALYSIS

9
9

AIR FREIGHT

9

9

U.S. Port or Ports
of Arrival

GROWING

9

BAGGAGE OR CAR

TRUCK, RAIL OR WATER FREIGHT

9

9

7. DATE:

PPQ FORM 587 (MD) (APR 2007)
WARNING: Any alteration, forgery, or unauthorized use of this document is subject to civil penalties of up to $250,000 (7 U.S.C.s 7734(b)) or punishable
by a fine of not more than $10,000, or imprisonment of not more than 5 years, or both (18 U.S.C.s 1001)

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it
displays a valid OMB control number. The valid OMB control numbers for this information collection are 0579-0049, 0172, and 0173.
The time required to complete this information collection is estimated to average .5 hours per response, including the time for reviewing
instructions, search existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection
of information.
U.S. DEPARTMENT OF AGRICULTURE
ANIMAL AND PLANT HEALTH INSPECTION SERVICE
PLANT PROTECTION AND QUARANTINE

APPLICATION FOR PERMIT TO IMPORT PLANTS OR
PLANT PRODUCTS

INSTRUCTIONS: PLEASE TYPE OR PRINT
CLEARLY. PERMITS ARE NOT ISSUED TO
P.O. BOXES. READ THE ENTIRE
APPLICATION BEFORE COMPLETING.
ATTACH ADDITIONAL SHEETS OF PAPER
IF MORE SPACE IS NEEDED.

1. NAME AND UNITED STATES ADDRESS OF APPLICANT:

FORM APPROVED
OMB NO. 0579-0049,
0172, and 0173

FORWARD COMPLETED APPLICATION TO
USDA-APHIS-PPQ
Permit Unit
4700 River Road, Unit 136
Riverdale, MD 20737-1236
1-877-770-5990; FAX: (301) 734-5786

2. CHECK ONE:

9
RENEWAL:
9
AMENDMENT: 9
NEW PERMIT:

TELEPHONE: (

)

FAX: (

PERMIT # ________________
PERMIT # ________________

)

3. Plants or Plant Products to be Imported

Country of Origin

Scientific Names of Plants or Plant Products

4. INTENDED USE: PROPAGATION
5. CHECK MEANS OF IMPORTATION:

9

CONSUMPTION

9

AIR MAIL OR AIR PARCEL POST
SURFACE MAIL OR PARCEL POST

6. SIGNATURE OF APPLICANT:

Plant Parts
(seeds, cuttings, rhizomes,
plants, bulbs, fruits, etc.)

RESEARCH: LAB ANALYSIS

9
9

AIR FREIGHT

9

9

U.S. Port or Ports
of Arrival

GROWING

9

BAGGAGE OR CAR

TRUCK, RAIL OR WATER FREIGHT

9

9

7. DATE:

PPQ FORM 587 (MD) (APR 2007)
WARNING: Any alteration, forgery, or unauthorized use of this document is subject to civil penalties of up to $250,000 (7 U.S.C.s 7734(b)) or punishable
by a fine of not more than $10,000, or imprisonment of not more than 5 years, or both (18 U.S.C.s 1001)


File Typeapplication/pdf
File TitleI:\MRPBS - Marketing & Regulatory Programs Business Services\ITD - Information Technology Division\AIM - Applications and Infor
Authorkastratchko
File Modified2007-04-27
File Created2007-04-18

© 2024 OMB.report | Privacy Policy