PPQ 526 Application and Permit to Move Live Plant Pests or Noxio

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PPQ 526 Dec 2011

Select Agent Registration

OMB: 0579-0213

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OMB APPROVED
0579-0054 and 0579-0213
EXP DATE XX//XXXX

No permit can be issued to move live plant pests or noxious weeds until an application is received (7 CFR 330 (live plant pests) or 7 CFR 360 (noxious weeds)).
U.S. DEPARTMENT OF AGRICULTURE
ANIMAL AND PLANT HEALTH INSPECTION SERVICE
PLANT PROTECTION AND QUARANTINE
PERMITS AND RISK ASSESSMENT, UNIT 133
RIVERDALE, MARYLAND 20737
APPLICATION FOR PERMIT TO MOVE
LIVE PLANT PESTS OR NOXIOUS WEEDS
3. TYPE OF PEST TO BE MOVED
*
Pathogens
Arthropods
Noxious Weeds

SECTION A - TO BE COMPLETED BY THE APPLICANT
1. NAME, TITLE, AND ADDRESS (Include ZIP Code)

Other (Specify) _______________________________________
This permit does not authorize the introduction, importation, interstate
movement, or release into the environment of any genetically
engineered organisms or products.
A.

2. TELEPHONE NO. (

B. CLASSIFICATION
(Orders, Families, Races,
or Strains)

SCIENTIFIC NAMES OF
PESTS TO BE MOVED

C.

LIFE
STATES, IF
APPLICABLE

)

D. NO. OF
SPECIMENS
OR UNITS

E.

SHIPPED FROM
(Country or State)

F. ARE PESTS
ESTABLISHED IN
U.S.?

G.

MAJOR HOST(S)
OF THE PEST

4.
5.
6.
7. WHAT HOST MATERIAL OR SUBSTITUTES WILL ACCOMPANY WHICH PESTS (Indicate by line number)

8. DESTINATION
11. NO. OF SHIPMENTS

9. PORT OF ARRIVAL

10. APPROXIMATE DATE OF ARRIVAL OR INTERSTATE
MOVEMENT

12. SUPPLIER

13. METHOD OF SHIPMENT
Air Mail

Air Freight

Baggage

Auto

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)
18. DATE
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 Section B and C.
WARNING:
Any alteration, forgery, or unauthorized use of this document is subject to civil penalties of up to $250,000 (7 U.S.C. s7734(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. s1001).
SECTION B - TO BE COMPLETED BY STATE OFFICIAL
19. RECOMMENDATION
Concur
(Approve)

20. CONDITIONS RECOMMENDED
Comments
(Disapprove)

(Accept USDA Decision)
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 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 the pests described, except as deleted, subject to the 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.
26. SIGNATURE OF PLANT PROTECTION AND QUARANTINE OFFICIAL

PPQ FORM 526
DEC 2011

27. DATE

Previous editions are obsolete.

28. LABELS ISSUED

29. VALID UNTIL

30. PEST CATEGORY

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
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 this issuing office.
7. All necessary precautions must be taken to prevent escape of
pests. In the event of an escape, notify this office.

PPQ FORM 526 (Reverse)


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Authorsmharris
File Modified2011-12-06
File Created2011-12-06

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