APHIS 7042 Rabies Vaccination Certificate

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 these information collections are 0579-XXXX. The time required to complete these information collections is estimated to average .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.		OMB Approved 0579-XXXX
UNITED STATES DEPARTMENT OF AGRICULTURE ANIMAL AND PLANT HEALTH INSPECTION SERVICE Animal care	Rabies Vaccination Certificate
The name and address of the person intending to import the dog(s) into the continental United States or Hawaii
Identity of the dog(s) based on the breed, sex, age, color, markings, and other identifying information
Specify a date of rabies vaccination at least 30 days before the date of arrival of the dog at a U.S. port
Specify a date of expiration of the vaccination which is after the date of arrival of the dog at a U.S. port. If no date of expiration is specified, then the date of vaccination shall be no more than 12 months before the date of arrival at a U.S. port
Signature and the license number of the veterinarian issuing the certificate
Date

APHIS Form 7042

SEP 2011