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

According to the Paperwork Reduction Act of 1995, an agency may 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 numbers for this information collection
are 0579-0054, 0579-0088, and 0579-0207. The time required to complete this information collection is estimated to average .5 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

OMB APPROVED
0579-0054, 0579-0088,
and 0579-0207

SECTION A – TO BE COMPLETED BY THE APPLICANT

I

I

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

I □

12. SUPPLIER

13. METHOD OF SHIPMENT

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.

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.

Air Mail

□

Air Freight

□

Baggage

□

Auto

16. METHOD OF FINAL DISPOSITION

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

18. DATE

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

J

19. RECOMMENDATION

□

Concur
(Approve)

□

(Accept USDA Decision)

20. CONDITIONS RECOMMENDED

□

Comments
(Disapprove)

21. SIGNATURE

22. TITLE

I

23. STATE

I

24. DATE

I

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

I

27. DATE

28. LABELS ISSUED

(Previous editions are obsolete.)

29 VALID UNTIL

30. PEST CATEGORY

I

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)

PRIVACY ACT STATEMENT
Authority: The Honeybee Act, 7 U.S.C. 281-286; the Plant Protection Act, 7 U.S.C. 7701-7772 and 7781-7786; and the
Animal Health Protection Act, 7 U.S.C. 8301-8321.
Purpose: This data will be used to enable persons wishing to move a regulated commodity into, from, or within the
United States to apply for a permit, pay permit application fees, check the status of a permit application, and view issued
permits and other information online in a secure manner.
Routine Uses:
In addition to those disclosures generally permitted under 5 U.S.C. 552a (b) of the Privacy Act, records maintained in the
system may be disclosed outside USDA as follows:
1. To the Department of Homeland Security's Customs and Border Protection agency, which inspects shipments that
arrive at United States ports for compliance with permit conditions;
2. To cooperative Federal, State, and local government officials, employees, or contractors, and other parties engaged to
assist in administering the program. Such contractors and other parties will be bound by the nondisclosure provisions of
the Privacy Act. This routine use assists the agency in carrying out the program, and thus is compatible with the purpose
for which the records are created and maintained;
3. To State government regulatory officials in the State of destination for review and comment;
4. To the appropriate agency, whether Federal, State, local, or foreign, charged with responsibility of investigating or
prosecuting a violation of law or of enforcing, implementing, or complying with a statute, rule, regulation, or order issued
pursuant thereto, of any record within this system when information available indicates a violation or potential violation of
law, whether civil, criminal, or regulatory in nature, and either arising by general statute or particular program statute, or by
rule, regulation, or court order issued pursuant thereto;
5. To the Department of Justice when the agency, or any component thereof, or any employee of the agency in his or her
official capacity, or any employee of the agency in his or her individual capacity where the Department of Justice has
agreed to represent the employee, or the United States, in litigation, where the agency determines that litigation is likely to
affect the agency or any of its components, is a party to litigation or has an interest in such litigation, and the use of such
records by the Department of Justice is deemed by the agency to be relevant and necessary to the litigation; provided,
however, that in each case, the agency determines that disclosure of the records to the Department of Justice is a use of
the information contained in the records that is compatible with the purpose for which the records were collected;
6. For use in a proceeding before a court or adjudicative body before which the agency is authorized to appear, when the
agency, or any component thereof, or any employee of the agency in his or her official capacity, or any employee of the
agency in his or her individual capacity where the agency has agreed to represent the employee, or the United States,
where the agency determines that litigation is likely to affect the agency or any of its components, is a party to litigation or
has an interest in such litigation, and the agency determines that use of such records is relevant and necessary to the
litigation; provided, however, that in each case, the agency determines that disclosure of the records to the court is a use
of the information contained in the records that is compatible with the purpose for which the records were collected;
7. To appropriate agencies, entities, and persons when the agency suspects or has confirmed that the security or
confidentiality of information in the system of records has been compromised; the agency has determined that as a result
of the suspected or confirmed compromise there is a risk of harm to economic or property interests, a risk of identity theft
or fraud, or a risk of harm to the security or integrity of this system or other systems or programs (whether maintained by
the agency or another agency or entity) that rely upon the compromised information; and the disclosure made to such
agencies, entities, and persons is reasonably necessary to assist in connection with the agency's efforts to respond to the
suspected or confirmed compromise and prevent, minimize, or remedy such harm;
8. To USDA contractors, partner agency employees or contractors, or private industry employed to identify patterns,
trends or anomalies indicative of fraud, waste, or abuse; and
9. To the National Archives and Records Administration or to the General Services Administration for records
management inspections conducted under 44 U.S.C. 2904 and 2906.
Disclosure: Furnishing this information is voluntary; however, failure to furnish this information may impede the ability to
apply for a permit.