Form PPQ 519 PPQ 519 Compliance Agreement

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 0579-0054, 0088, 0129, 0198, 0238, 0257, 0306, 0310. The time required to complete
this information collection is estimated to average 1.25 hours per response, including the time for reviewing instructions, searching existing data sources,
gathering and maintaining the data needed, and completing and reviewing the collection of information.

UNITED STATES DEPARTMENT OF AGRICULTURE
ANIMAL AND PLANT HEALTH INSPECTION SERVICE
PLANT PROTECTION AND QUARANTINE

FORM APPROVED
OMB NUMBER 05790054/0088/0129/0198/
0238/0257/0306/0310

COMPLIANCE AGREEMENT
2. LOCATION

1. NAME AND MAILING ADDRESS OF PERSON OR FIRM

3. REGULATED ARTICLE(S)

4. APPLICABLE FEDERAL QUARANTINE(S) OR REGULATIONS

5. I/WE AGREE TO THE FOLLOWING:

6. SIGNATURE

7. TITLE

8. DATE SIGNED

9. AGREEMENT NO.

The affixing of the signatures below will validate this agreement which shall remain in
effect until cancelled, but may be revised as necessary or revoked for noncompliance.

12. ADDRESS

11. PPQ/CBP OFFICIAL (NAME AND TITLE)

13. SIGNATURE

14. U.S. GOVERNMENT/STATE AGENCY OFFICIAL (NAME AND TITLE)

15. ADDRESS

16. SIGNATURE

PPQ FORM 519 (MAY 2007)

Previous editions are obsolete.

10. DATE OF AGREEMENT