Form PPQ 519 PPQ 519 Compliance Agreement

Citrus Greening and Asian Citrus Psyllid; Quarantine and Interstate Movement Regulations

PPQ 519 2010

Businesses

OMB: 0579-0363

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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, 0088, 0129, 0198, 0238, 0257, 0306, 0310, 0322, 0346, and 0363. The time required to complete this information collection is estimated to average 1.25 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.

FORM APPROVED

OMB NUMBER 0579-

0054/0088/0129/0198/

0238/0257/0306/0310/

0322/0346/0363

UNITED STATES DEPARTMENT OF AGRICULTURE

ANIMAL AND PLANT HEALTH INSPECTION SERVICE

PLANT PROTECTION AND QUARANTINE

COMPLIANCE AGREEMENT

1. NAME AND MAILING ADDRESS OF PERSON OR FIRM

     

2. LOCATION

     

3. REGULATED ARTICLE(S)

     

4. APPLICABLE FEDERAL QUARANTINE(S) OR REGULATIONS

     

5. I / WE AGREE TO THE FOLLOWING:

     

6. SIGNATURE


7. TITLE

     

8. DATE SIGNED

     

The affixing of the signatures below will validate this agreement which shall remain in

effect until canceled, but may be revised as necessary or revoked for noncompliance.

9. AGREEMENT NO.

     

10. DATE OF AGREEMENT

     

11. PPQ/CBP OFFICIAL (NAME AND TITLE)

     

12. ADDRESS

     

13. SIGNATURE


14. U.S. GOVERNMENT/STATE AGENCY OFFICIAL (NAME AND TITLE)

     

15. ADDRESS

     

16. SIGNATURE


PPQ FORM 519 (MAY 2007) Previous editions are obsolete


File Typeapplication/msword
File TitleUNITED STATES DEPARTMENT OF HOMELAND SECURITY
Authorkastratchko
Last Modified Bykastratchko
File Modified2010-09-28
File Created2010-09-28

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