Form PPQ 564 PPQ 564 Request for Additional Mailing Labels

According to the Paperwork Reduction Act of 1995, an agency many not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0579-0049. The time required to complete this information collection is estimated to average .080 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.		OMB APPROVED 0579-0049 Exp. Date
U.S. DEPARTMENT OF AGRICULTURE ANIMAL AND PLANT HEALTH INSPECTION SERVICE PLANT PROTECTION AND QUARANTINE REQUEST FOR ADDITIONAL MAILING LABELS	INSTRUCTIONS: The enclosed green-and-yellow labels are to be used only for those shipments which will be made by mail, (air mail, air parcel post, surface mail, or parcel post). Please see paragraphs 12, 13, and 14 of circular Q.37-2 for details on importations made by means other than by mail. Please use this form for requesting additional mailing labels. NOTE: Shipments imported by mail must be accompanied by USDA-PPQ approved label bearing permit no. (7 CFR 319.37).

FROM	TO
NAME	USDA, APHIS, PPQ 4700 RIVER ROAD, UNIT 136 RIVERDALE, MD 20737-1236
STREET ADDRESS
CITY AND STATE (include ZIP Code)
TELEPHONE NO. (include Area Code)

Please furnish ___________ labels bearing permit number ________________ for the importation of the following:

BOTANICAL NAME OF PROPAGATING MATERIAL	FROM COUNTRIES OF ORIGIN	NUMBER OF SHIPMENTS EXPECTED DURING NEXT 12 MONTH PERIOD
SIGNATURE AND TITLE		DATE

PPQ FORM 564

MAY 2009 Previous editions obsolete.

WARNING: Any alteration, forgery, or unauthorized use of this document is subject to civil penalties of up to $250,000 (7 U.S.C. 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. 1001).