Form PPQ 526 PPQ 526 Application for Permit to Move Live Plant Pests, Noxious

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UNITED STATES DEPARTMENT OF AGRICULTURE
SECTION A – TO BE COMPLETED BY THE APPLICANT
ANIMAL AND PLANT HEALTH INSPECTION SERVICE
PLANT PROTECTION AND QUARANTINE

1. NAME, TITLE, AND ADDRESS (Include ZIP Code)

APPLICATION FOR PERMIT TO MOVE
LIVE PLANT PESTS, NOXIOUS WEEDS,
SOIL, AND PROHIBITED PLANTS
3. TYPE OF PEST TO BE MOVED
*

Pathogens

Arthropods

Noxious Weeds

Other (Specify) ______________________________
This permit does not authorize the introduction, importation, interstate
movement, or release into the environment of any genetically
engineered organisms or products.

A.
SCIENTIFIC NAMES OF
PEST TO BE MOVED

B. CLASSIFICATION
(Orders, Families,
Races, or Strains)

2. TELEPHONE NO. (
C.

LIFE
STATES, IF
APPLICABLE

)

D.
NO. OF
E.
F. ARE PESTS G.
SPECIMENS OR SHIPPED FROM ESTABLISHED
(Country or State)
UNITS
IN U.S.?

MAJOR HOST(S)
OF THE PEST

4.
5.
6.
7. WHAT HOST MATERIAL OR SUBSTITUTES WILL ACCOMPANY WHICH PESTS (Indicate by line number)

8. DESTINATION

9. PORT OF ARRIVAL

11. NO. OF SHIPMENTS

10. APPROXIMATE DATE OF ARRIVAL OR
INTERSTATE MOVEMENT

12. SUPPLIER

13. METHOD OF SHIPMENT
Air Mail

Air Freight

Baggage

Auto

14. INTENDED USE (Be specific, attach outline of intended research.)

15. METHODS TO BE USED TO PREVENT PLANT PEST ESCAPE

17. Applicant must be a resident of the U.S.A.

16. METHOD OF FINAL DISPOSITION

SIGNATURE OF APPLICANT (Must be person named in Item 1.)

18. DATE

I/We agree to comply with the safeguards printed on the reverse of
this form, and understand that a permit may be subject to other
conditions specified in Sections B and C.

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)
SECTION B – TO BE COMPLETED BY STATE OFFICIAL
19. RECOMMENDATION
Concur
(Approve)

20. CONDITIONS RECOMMENDED
Comments
(Disapprove)

(Accept USDA Decision)

21. SIGNATURE

22. TITLE

23. STATE

24. DATE

SECTION C – TO BE COMPLETED BY FEDERAL OFFICIAL
25. PERMIT NO.

PERMIT
(Permit not valid unless signed by an authorized official of the U.S. Department of Agriculture, Animal and Plant Health Inspection Service.)
Under authority of the Plant Protection Act of 2000, permission is hereby granted to the applicant named above to move pests described, except as deleted, subject to conditions
stated on or attached to this application. (See standard conditions on reverse side.)

* For exotic plant pathogens, attach a completed PPQ Form 526-1 (Live Plant Pathogens).

26. SIGNATURE OF PLANT PROTECTION AND QUARANTINE OFFICIAL

PPQ FORM 526
DEC 2012

27. DATE

28. LABELS ISSUED

(Previous editions are obsolete.)

29 VALID UNTIL

30. PEST CATEGORY

STANDARD SAFEGUARDS OF PERMIT
1. All pests must be shipped in sturdy, escape-proof containers.
2. Upon receipt of pests, all packing material media, substrate, soil, and shipping
containers shall be sterilized or destroyed immediately after removing pests.
3. Pests shall be kept only within the laboratory or designated area at the
permittee’s address.
4. No living pests kept under this permit shall be removed from the confined area
except by prior approval from State and Federal regulatory officials.
5. Without prior notice and during reasonable hours, authorized PPQ and State
regulatory officials shall be allowed to inspect the conditions under which the
pests are kept.
6. All pests kept under this permit shall be destroyed at the completion of the
intended use, and not later than the expiration date, unless an extension is
granted by the issuing office.
7. All necessary precautions must be taken to prevent escape of pests. In the
event of an escape, please notify: USDA/APHIS, Plant Protection and
Quarantine, Permits and Risk Assessment, Unit 133, Riverdale, Maryland 20737
(Phone: 866-524-5421)

PPQ FORM 526 (Reverse)