VS 17-129 Application for Import or In Transit Permit

User Fee Regulations, 7 CFR 354 and 9 CFR 130

VS17-129

User Fee Regulations, 7 CFR 354 and 9 CFR 130-Private Sector

OMB: 0579-0094

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No animals, animal semen, animal embryos, birds, poultry,
or hatching eggs may be imported unless a completed
application has been received (9 CFR 92 and CFR 93).

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 number for this information collection is 05790040 and0090. The time required to complete this information collection is estimated to average .17 hours per
response, including the time for reviewing instructions, searching data sources, gathering and maintaining the data
needed, and completing and reviewing the collection of information.

FORM APPROVED OMB NO. 0579-0040 and 0579 -0094
U.S. DEPARTMENT OF AGRICULTURE
ANIMAL AND PLANT HEALTH INSPECTION SERVICE
VETERINARY SERVICES

1. NAME AND ADDRESS OF SHIPPER IN COUNTRY OF ORIGIN

APPLICATION FOR IMPORT OR IN TRANSIT PERMIT
(Animals, Animal Semen, Animal Embryos, Birds, Poultry, or Hatching Eggs)
INSTRUCTION TO IMPORTER: Complete and submit one copy to the Veterinary Services, APHIS, U.S.
Department of Agriculture, 4700 River Road, Riverdale, MD 20737. Prepare a separate application for
each shipment.
3. PORT OF EMBARKATION (From Canada show only for ocean vessel or airplane
shipments)

2. NAME AND ADDRESS OF IMPORTER (Include Zip Code)

4. COUNTRY FROM WHICH SHIPPED

5. MODE OF TRANSPORTATION (Name of Airline or Vessel, flight no.)

TELEPHONE NUMBER (Include Area Code)

6. ANIMALS, ANIMAL SEMEN, ANIMAL EMBRYOS, BIRDS, POULTRY, OR HATCHING EGGS
NO.

BREED

SPECIES

DESCRIPTION
(Sex, Age, Registered Name and No., Tattoo, Tag No., Other Markings)

6E. PURPOSE OF IMPORTATION

7. ROUTE OF TRAVEL INCLUDING ALL CARRIER STOPS ENROUTE (From Canada show route of travel only for ocean vessel or airplane shipment)

8. PROPOSED SHIPPING DATE (From Canada show only for ocean vessel
or airplane shipment)

11. NAME AND MAILING ADDRESS OF PERSON TO WHOM DELIVERY WILL BE MADE
(After quarantine, when required) (Include Zip Code)

9. PROPOSED ARRIVAL DATE

10. UNITED STATES PORT OF ENTRY

12. WHERE DELIVERY WILL BE MADE IN U.S. (After quarantine, when required)
(Location of place)

TELEPHONE NUMBER (Include Area Code)

13. REMARKS

14. SIGNATURE OF IMPORTER

VS FORM 17-129 (MAY 96)

16. DATE SIGNED


File Typeapplication/pdf
File TitleVS17-129
File Modified2008-11-20
File Created2008-11-20

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