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 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.
OMB APPROVED
0579-0054 and
0579-0207
UNITED STATES DEPARTMENT OF AGRICULTURE ANIMAL AND PLANT HEALTH INSPECTION SERVICE PLANT PROTECTION AND QUARANTINE
APPLICATION FOR PERMIT TO MOVE LIVE PLANT PESTS, NOXIOUS WEEDS, SOIL, AND PROHIBITED PLANTS
SECTION A – TO BE COMPLETED BY THE APPLICANT
1. NAME, TITLE, AND ADDRESS (Include ZIP Code)
3. TYPE OF PEST TO BE MOVED |
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Pathogens |
Arthropods |
Noxious Weeds |
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Other (Specify) ______________________________ |
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This permit does not authorize the introduction, importation, interstate |
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2. TELEPHONE NO. ( |
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movement, or release into the environment of any genetically |
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engineered organisms or products. |
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B. CLASSIFICATION |
C. LIFE |
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NO. OF |
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F. ARE PESTS |
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SCIENTIFIC NAMES OF |
(Orders, Families, |
STATES, IF |
SPECIMENS OR |
SHIPPED FROM |
ESTABLISHED |
MAJOR HOST(S) |
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PEST TO BE MOVED |
Races, or Strains) |
APPLICABLE |
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UNITS |
(Country or State) |
IN U.S.? |
OF THE PEST |
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7. WHAT HOST MATERIAL OR SUBSTITUTES WILL ACCOMPANY WHICH PESTS (Indicate by line number)
8. DESTINATION |
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9. PORT OF ARRIVAL |
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10. APPROXIMATE DATE OF ARRIVAL OR |
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INTERSTATE MOVEMENT |
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11. NO. OF SHIPMENTS |
12. SUPPLIER |
13. METHOD OF SHIPMENT |
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Air Mail |
Air Freight |
Baggage |
Auto |
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14.INTENDED USE (Be specific, attach outline of intended research.)
15. METHODS TO BE USED TO PREVENT PLANT PEST ESCAPE
16. METHOD OF FINAL DISPOSITION
17. Applicant must be a resident of the U.S.A. |
SIGNATURE OF APPLICANT (Must be person named in Item 1.) |
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. |
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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)Comments
(Disapprove)
(Accept USDA Decision)
20. CONDITIONS RECOMMENDED
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 |
(Previous editions are obsolete.) |
DEC 2012 |
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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)
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.
