Form AD-942 Biological Shipment Record - Quarantine Facility

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BIOLOGICAL SHIPMENT RECORD -QUARANTINE FACiliTY
Form AD-942
This form is for use in recording details concerning living material for biological control and pollination studies, and other beneficial
uses (biological control ag~nts, parasitized or diseased hosts, pollinators, competitors, antagonists, and other material required for
biological control studies) that are 1. Consigned from quarantine to researchers in non-quarantine areas of the U.S. quarantine facility location, or
2. Shipped from U.S. quarantine to researchers at U.S. non-quarantine locations in the 48 contiguous states.
Note: Use Form AD-94 I for shipments from quarantine to quarantine, to U.S.looations outside 48 contiguous states (Hawaii, Alaska, U.
S. territories), or to all foreign locations. Use Form AD-943 for non-quarantine shipments to domestic locations.
Information from this form will be computerized and puj>lished by the U.S. Department of Agriculture, Agricultural Research Service,
Insect Identification and Beneficial Insect Introduction Institute, Beneficial Insect Introduction Laboratory (Biological Control Documentation Center), Beltsville, Maryland 20705. Full credit will be given to the individuals and organizations responsible for collection,
shipment, culture and release of the organisms included in these records. Completion of the form is voluntary.
INSTRUCTIONS
.Use a separate AD-942 set for each beneficial species or each parasitized/diseased host/pest species shipped/consigned.
.Type or print firmly with a ball point pen to record on all copies.
.Quarantine Facility is to complete Section I (instructions below). Receiver is to complete Sections II and III (instructions below and on
reverse of cover sheet).
~ Record additional information in "Remarks" blocks in applicable sections of the form, and additional release information on Form AD942A, "Supplemental Data," on reverse of this cover sheet.
.Fill out all blocks as completely as possible. Use "N/A" for those not applicable, "UNK" for unknown, "942A" when supplemental
data form is used. Shaded blocks are for Documentation Center use only.
.Codes for invertebrate stages, plant parts, and microbial organisms listed on reverse of form may be used.
.See reverse of form for Routing and Copy Distribution Information.
SECTION I -MATERIAL SHIPPED/CONSIGNED
Block Number
2. Organism shipped A. Genus, species, subspecies, author -.Give full scientific name of beneficial species being shipped -also when shipping parasitized /
diseased host
material. If species name is unknown, use genus name and "sp." (or further designations such as n.sp., sp.A, sp. ill. [ J, etc.) pending
fmal determi- nation or description. .If only non-beneficial material is shipped, enter scientific name.
B. Order: Family -Give order:family of beneficial species or of non-beneficial species if no beneficial species are included. Add higher
taxon name for nonarthropods.
C. Determined by -Names of persons providing identification of material listed in blocks 2A and 5. Two determiners of material may
be involved; if identification is based on comparison with specimens identified by a taxonomist,list taxonomist's name in parentheses
following determiner of the material actually being shipped. Add affiliation of identifiers; use acronyms. (E.g., L.R. Ertle, BIRL (p.M.
Marsh, SEL».
4. Type of organism -Parasites, predators and weed feeders include nematodes. Other includes competitors (e.g., dung beetles), host
material (check also in block 8) and other non-beneficial material for experimental use; may also be used for plants for biological
control. Microbials include diseased animals and plants -see codes on reverse of form -and cultures/isoiat.es of microbial (fungal,
bacterial, viral, rickettsial, protozoan) pathogens, antagonists, competitors, etc. Explain "Microbial" and "Other" in remarks, block 20.
5. Numbers and stages shipped -If appropriate term is not listed in Codes on reverse side of form, spell out stage. Give total individuals
of each stage and
total individuals of all stages. If estimated, check Est block. If parasitized hosts are shipped/consigned, give estimated percent
parasitized, if possible.
6. Dates transformed to stages shipped -.Inclusive dates of egg deposition, larval or adult eclosion, or pupation to stages shipped, or of
parasitization or infection. If unknown, so state. ."Shipped directly" means shipped directly as received from foreign/overseas source;
"emerged in quarantine" is self explanatory, but see also block 16.
9-15. Collection data -Information in these blocks from pertinent AD-941 forms. In block 12,list file nos. of all pertinent AD-941 forms

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(including any
needed subletter designations from Section Ill) for all material included in this shipment.
16-17. Culture data -Indicate whether and where cultured. If cultured in quarantine, give number of generations at time of shipment/
consignment, and complete block 17 if different from block 13.
19. Shipped/consigned to -Give full name and address of person to whom shipment/consignment is made; include agency designation (e.
g., USDA-ARS, or -FS; DOA-CE, etc.). If this is a consignment to a researcher of the same affiliation or location as the quarantine
facility, only name andlfflliation acronym is needed.
SECTION II -MATERIAL RECEIVED
30. InventoryA. Number received -Record number of the Organism shipped (block 2A) received dead or alive; check E for estimate. Totals should
relate to those in
block 5. Use block 31 to record additional species in shipment.
B. Number emerged -Record numbers of larvae or adults emerging from eggs or immature stages, respectively, or from parasitized
host material or from plant materia! shipped, check E for estimate. Use block 31 to record additional species in shipment.
31. Other species included -Note; Only the species listed in block 2A of this form should be included in this shipment/consignment from
quarantine. If other species are discovered in the shipment by the receiver, the shipping quarantine facility should be informed
immediately. Specimens may need to be killed and returned to quarantine facility. Indicate in block 31 A if specimens were returned to
quarantine. Refer to instructions for "2C" for completion of "31 B."
34. Intended use -Complete Section III ifblock A is checked. If part of the material is released immediately and part retained for culture
or study, check blocks A and B or C. If only B or C is checked, this completes this form; report releases from these cultures on Form
AD-943.
SECTION III -RELEASE
.f material from this shipment is released at more than 3 sites, use F'ormAD-941A below, to record additional releases. .
.0. Target hosts/prey -Be as specific as possible; i.e., give genus-species of host/prey against

~ hiCh this material is actually released. If more than two hosts/prey
are present at the release site, or actual host/prey species present is unknown, give gener'c names (e.g., Heliothis spp., Lygus spp.) or,
if more appropriate,
use other general term (e.g., aphids, dung flies, etc.; Note: Recording of family names e most important in this case). Give further
details in block 43 or on Form AD-942A below. I
1. Host/prey food -Use common name of plants or animals, or generic names of hosts/prey that lack common names. Also note if food
is other than
plant or animal (e.g., dung, decayed material, etc.). If more than one food sOUrce of the target host/prey is present at release site, note
here and give details in block 43 or on Form AD-942A below.
-2. Released by -Give name of actual releaser and affiliation acronym (including supervisor, if appropriate, in parentheses).
3. Remarks -Also use Form AD-942A below for additional comments concerning release. -,- ,,-, OMBNO.O5IS-0013'c.:., ('llnnl r"ftAr"ftl"T" A , IShipper'sFileNumber
SUPPLEMENT AL NOTE: .Do not fold this sheet over form when writing,- carbons will distort entries. (From AD-942)
DA T A -If additional copies are needed, photocopy for Fach site & staple to form.

RELEASE SITE DETAILS, SITE NO.

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.Township, route no.,Farmer's name, etc. .Map of release site.

w-

E
~ONDITIOI\I OF CROP FIELD
,CONDITIONOF RELEASE MATERIAL
~E~~!N~NT TARGET HOST {PREY
STAGE PRESENT
TEMP.
TARGET HOST/PREY ABUNDANCE

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ADDITIONAL HOST/PREY PRESENT
OTHER COMMENTS
Reported by & Date

Number and stages releascd (see codes)
Dates of release (m,d,:\,)
Target hosts/prey at release A. Primary -Genus. species
B. Other -Genus, species C. Families
F Dod (plant/animal/other) of target host/prey at release
Rel~!se~pyI lEst I
SITE 6
0 Field OGreenhOuse Dcage Dother:
[gs!J
~
REPORTED BY
A. Name B.Date (m,d,y)

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:arm AD-942A i~j~
,-j. ,

U.S. Department of Agriculture
BIOLOGICAL SHIPMENT RECORD -QUARANTINE FACI llTY
(Shipment/Consignment from Quarantine)
SECTION I -REPORT OF MATERIAL SHIPPED, CONSIGNED or RELEASED
ROM (Quarantine facility .name ana aaa",ss) 12.0RGANISM SHIPPED- .Gen., sp..subSP., auth. [MJ 3. QUARANTINE FILE
NO.
os. & STAGES SHIPPED (see codes)
TOTAL: DShlPped directly DEmerged in Quarantine
ATES ORIGINALLY 10. LOCATION- Country & Provlnce{Stateoforlgln II. ORIGINALCOLLECTORS IELD
COLLECTED (m,d,y) (names & affiliations)

AB CULTURED IF 1+)
)verseas DNa

n Quarantine
--~~~~~J (numberof
-generations)

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4. TYPE OF ORGANISM-explain MI & OT
in blk.20
0 PArasite DwEed feeder
-, --".. 'c DpRedator OpOlllnator OMlcroblal OOTher
6. OATES TRANSFORMED TO STAGES SHIPPED 7. MATING OBSERVED
(month.day,yearJ
00 Yes % No
8. HOST I PREY I PEST MATERIAL
PRESENT
OBeneficial with host/prey
I ii: ~~~~~~~~~lAS ~~~~~_D Host/Prey/pest only 0 None
12. FOREIGN/OVERSEAS SOURCE
FILE NOs.
S:Orde"r;Faml/Y --C:DeteTmi;:;"edbY(;;a;;;-e8&affi/i;H~ns)~
113.0RIGINAL HOST/PREY -Gen., sp.(orother food source) I
)ATE S ppe 2.2. REPRESENTATIVE ry :1 2.3.PACKING/HANDLING 2.A.SHI~PED VIA 2.5. SCREENED OR PACKAGED
BY
:onsigned (m,d,y,) SPECIMENS L!e~
RETAINED
00 number: Usual Other (explain in blk. 20)

17. LAB HOST/PREv-Gen., sp. (if different from blk.13)

M NC

00 00
146. V.S.
f.ee filea)

aD
, 140 STAGE/PART OF HOST/PREY I
---ATTACKED -~. I

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IS. INTENDED HOST/PREy-Gen., sp. (if different from blk.13J
120. REMARKS

, IS. ORIGINAL FOOD SOURCE OF
HOST/PREY

27. DATE OPENED 128.

I A.container l B. contents
(m,d,y) CONDITION RECEIVED
30. INVENTORY OF MATERIAL RECEIVED (use codes) 31.0THER SPECIES INCLUDED OR EMERGED
Number and stages B. Number Emerged (stages) A.Order:Famlly and Genus, B. Determined by I C. No. and receIved (blk.2)
Beneflclals Host/Prey species. author, If known (name & affiliation) Stages
Alive Dead Alive Dead Alive, Dead Huse codes))ATE OF RECEIPT
m,d",,)

ALS :~ ~.~ ~~~~~~~ I
;
~=RE'c8~:-"'_JCIMENS FROM SHIPMENT !ETAINED BY RECEIVER
'es 0 No
number

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Types of~
ffis!J
I [gst)

-------

--Locations (State, County, nearest Town or physical feature, map coordinates)
(Ule AD-942A for more details)
--Number and stages released.
(lee codes)

--@
Lab CUlture/studY
~. 0 B.ORelease intended
c.O No release Intended
SECTION III -REPORT OF RELEASE
SITE 1 SITE 2 -~SITE 3 -OFleld OGreenhouse OCage

I OFieid OGreenhouse OCage I OFleid OGreenhouse OCage
IOOther: OOther: OOther:

Target hosts/prey at release A.. Primary -Genus, species
B. Other -Genus. species :. Families

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32. REMARKS
Food (plant/animal/other) of target host/prey at release.

-Released by (Name&affiliationJ

'iEMARKS (use AD. 942A for more detaii8}
m AD-942

135.INTENDED LAB HOST/PREY -Gen., sp.
r29:RE"P()RTED OR EXAMINED BY
( 5/)('

~
~
[gs!J
PART 1 -DOCUMENTATION CENTER COpy
44. REPORTEO BY I.A. Name
lB. Date (m,d,'
U.S. Department of Agriculture
BIOLOGICAL SHIPMENT RECORD -QUARANTINE FACI LlTY
(Shipment/Consignment from Quarantine)

SECTION I -REPORT OF MATERIAL SHIPPED, CONSIGNED or RELEASED

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)S. 8c STAGES SHIPPED (see codes)
TOTAL: DShiPped directly DEmerged in Quarantine
~TES ORIGINALLY 11°. LOCATION- Country & Province/State of Origin
III. ORIGINAL COU..ECTORS ELD COLLECTED (m.d,y) I
(names&affiliationsJ

A.B CULTURED (F 1+)
Iverseas 0 No
1Quarantine
(number of
generations)

aOrde(;Famity -c: Determ;;;"edby (names '& affili-;;"tions)ATE s 22. REPRESENTATIVE ~ :1 23.PACKING/HANDLING I2A.SHI~PED VIA 25. SCREENED OR PACKAGED BY
)nsigned (m,d,y,) SPEClM~ L!e!]
RETAINED
00 number: Usual Other (explain in blk. 20)
6, DATES TRANSFORMED TO STAGES SHIPPED
(month,day,year)
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~46. V.S.
M NC I,seefjles)
0 oi aD

00 bo
4. TYPE OF ORGANISM-explain MI & or
inblk.20
OPArasite OWEed feeder 0 PRedator OPOllinator OMlcrobial DoT her
7. MATING O~ERVED
DYes % DNa
8. HOST / PREY / PEST MATERIAL.
PRESENT
DBeneficial with host/prey
10 Hostfprey/pest only 0 None
12. FOREIGN/OVERSEAS SOURCE
FlLEN05.
18. INTENDED HOST/PREY-Gen.. sp. (if different from blk. 13)
120. REMARKS
15. ORIGINAL FOOD SOURCE OF HOST/PREY
SECTION II --REPORT OF RECEIPT AND INTENDED USE

ATE OF RECEIPT n,d,y)
30. INVENTORY OF MATERIAL RECEIVED (use codes) Number and stages B. Number Emerged (stages) received (blk.2)
Beneficials Host/Prey ~Iive Dead Alive Dead Alive Dead

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ILS-

---

~
'ECIMENS FROM SHIPMENT Lab culture/study 35.INTENDED LAB HOST/PREY -Gen sp ETAINED BY RECEIVER ., .
es DNo 0 B.DRelease intended
number c.D No release intended
SECT1ON III -REPORT OF RELEASE
SITE 1 SITE 2. SITE 3 -[OFleld OGreenhouse Ocage OField OGreenhouse OCage

I OFieid OGreenhouse Ocage
:O~o~ IOOther: OOther:
@s!J
IIEstl
rypes of rel~a~- -- _ocations (State, County, learest Town or physical eature, map coordinates)
Use AD-942A for more details)
~umber and stages released.
'Bee codes}
~ --~)ates of release (m,d,y)
-arget hosts/prey at release \. Primary -Genus, species
28.

I A.container
CONDITION
RECEIVED

I. Other -Genus, species
:. Families
31.0THER SPECIES INCLUOED OR EMERGED
A.Order: Family and Genus, B. Determined by species, author. If known (name & affiliation)
=ood (plant/animal/other) of target host/prey at release.
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lB. Contents
Released by (Name & affiliation}

EMARKS (useAD.942Aformoredetails)
29. REPORTED OR EXAMINED BY

.No.and
Stages
-fuse codes)@!J
~
44. REPORTED BY
A. Name B-:--Q~!!-~)'Jn AD-942
(5,/9(
PART 2 -QUARANTINE FACILITY COpy

u.s. Department of Agriculture
BIOLOGICAL SHIPMENT RECORD -QUARANTINE FACI LITY
(Shipment/Consignment from Quarantine)
145. FINAL DETERMINATION -~en.. sp., subsp.. autn.

M NC

DO DO
SECTION I -REPORT OF MATERIAL SHIPPED, CONSIGNED or RELEASED

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NOS. & STAGES SHIPPED (see codes)
s!J
s!J
sO
DATES ORIGINALLY
FIELD COLLECTED (m,d,y)

~ULTUREDTF 1+)
] Overseas 0 No

J In Quarantine
(number of
generations)

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---"
SHIPPED/CONSIGNED TO
TOTAL:
10. U:>CATION- Country &Provlnce)StateofOrlgiri

IS: Order; Family
C:oetermln-edbyi';iames&affilia"tiOns)13:-0RIGINAL HOST/PREY -Gen., sp. (or other food-source)
DATE shipped/ Izz. REPRESENTATIVE consigned (m,d,Y,i SPECIMENS
RETAINED nllmber,

6. DATES TRANSFORMED TO STAGES SHIPPED I (month, day, year)
'17. LAB HOST/PREY-Gen., sp. (if differen t from blk.13)
DShiPped directly DEmerged in Quarantine
-

/4. TYPE OF ORGANISM-explain MI & or In blk.20
0 PArasite OWEed feeder 10 PRedator OPOlllnator
I:JMlcrobial DOTher
ORIGINAL COU-ECTORS
(names& affiliations)
[Ye~ 123, PACKING/HANDLING
IDusua' DOther (explain in blk. 20)
14. STAGE/PART OF HOST/PREY
ATTACKEO
MATING OBSERVED
~Yes % DNa
8. HOST / PREY / PEST MATERIAL
PRESENT
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DBeneficial with host/prey
0 Hostfprey/pest onlY 0 None
18. INTENDED HOST/PREY-Gen., sP. (if different from blk.13)
120. REMARKS
FILE NOs.
15. ORIGINAL FOOD SOURCE OF HOST/PREY
24.SHI~PED VIA ;~.SCREENED OR PACKAGED BY

m AD-942
'-IIJ(,

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EMARKS (use AD-942A-for more details)
n AD-942

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(5/%
,44.REPORTED BY
!A. Name
~_Qat_e (m.d.y)

-CODES NOTE: Use combination of Invertebrates and Plants codes for weed feeders and other phytophages shipped in or with
plant host material (e.g., L in SH, A with FO).
INVERTEBRATES PLANTS
A -adults PL -whole plant ST -stems
M -male SO -seeds RT -roots
F -female SH -seed heads TU -tubers
E -eggs SP -seed pods FO -foliage
L -larvae (for holometabola) RS -rosette LV -leaf,leaves N -nymphs ( for heterometabol~) FL -flowers
J -juveniles (for nematodes)
P -pupae, puparia
C -cocoons (can also be A in C, or P in C)
MU -mummies, cadavers
PH ( ) -parasitized host -give stage and
estimated % parasitized
(e.g., PHA, PH L. PHE, etc., 70%J
H -host
MICROBIAL ORGANISMS -not including nematodes MI -cultures or isolates of microbial pathogens,
antagonists, and competitors; fungi, bacteria, viruses, rickettsia, protozoa
D[ ] -disease suspects for pathogen diagnosis
(e.g., DPL, DFO, etc. -plant and plant parts; DHA. DHE. etc. -invertebrate stages)
-ROUTING AND COpy DISTRIBUTIONQUARANTINE FACILITY
1. Retain Shipper (Pending Copy J (Part 4J
2. Send remaining 3 copies and original cover sheet with materia! shipped.
3. When copies of completed form are returned by receiver .Send Documentation Center Copy (Part tJ and original cover sheet to Beneficial Insect Introduction Laboratory, BARCEast, ARS, USDA, Beltsville, Maryland 20705.
.Retain Quarantine Facility Copy (Part 2J for your records; discard Shipper (Pending) Copy.
.If Form AD.942A is used -photocopy for your records and for receiver, if requested.
RECEIVER
1. When form is completed (Section III is completed,or blocks 32B or C are checked) -return copies 1 and 2, and original cover
sheet, to originating Quarantine Facility.
2. Retain Receiver Copy (Part 3J for your records.
3. If Form AD -942A is used -photocopy for your records or request photocopy from Quarantine Facility.

Public reporting burden for this collection of information is estimated to average 5 minutes 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. Send comments regarding
this burden estimate or any
other aspect of this collection of information, including suggestions for reducing this burden, to USDA,
Clearance Officer, OIRM, Room 404-W. Washington, D.C. 20250;

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and the Office of Information and Regulatory Affairs, Office of Management and Budget, Washington, D.
C. 20503.

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