vs 17-65B Agreement for the Importation, Quarantine and Exhibition

Importation of Animal and Poultry, Animal/Poultry, Products Certain Animal Embryos, Semen, and Zoological Animals

VS 17-65B2011

Private Sector

OMB: 0579-0040

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U.S. Department of Agriculture
Animal and Plant Health Inspection Service
Veterinary Service

AGREEMENT FOR THE IMPORTATION, QUARANTINE AND
EXHIBITION OF CERTAIN WILD RUMINANTS AND WILD SWINE

________________________________________________, operator(s) of the zoological park known as ___________________________________
located at _________________________________________, and __________________________________________________ hereby request a
permit for the importation of ________________________________________________________________________________________
___________________________________________________, for exhibition purposes at the said zoological park, said animals originating in a
country where foot-and-mouth disease or rinderpest exists and being subject to restrictions under regulations contained in Part 93, Title 9, Code of
Federal Regulations.
In making this request it is understood and agreed that:
1. The animals for which an import permit is requested will be held in isolation at a port of embarkation in the country of origin, approved by the
Deputy Administrator, Veterinary Services as a port having facilities which are adequate for maintaining wild animals in isolation from all other animals
and having veterinary supervision by officials of the country of origin of the animals. Such animals will be held in such isolation for not less than 60
days under the supervision of the veterinary service of that country to determine whether the animals show any clinical evidence of foot-and-mouth
disease, rinderpest , or other communicable disease and to assure that the animals will not have been exposed to such a disease within the 60 days
next before their exportation from at country.
2. Shipment will be made direct from such port of embarkation of the port of New York as the port of entry in this country. If shipment is made by
ocean vessel the animals will not be unloaded in any foreign port en route. If shipment is made by air, the animals will not be unloaded at any port or
other place of landing expect at the port approved by the Deputy Administrator, Veterinary Serv ice as a port not located in a country where rinderpest
or foot-and-mouth disease exist or as a port in such a country having facilities and inspection adequate for maintaining wild animals in isolation form all
other animals.
3. No ruminants or swine will be aboard the transporting vehicle, vessel or aircraft except those which an import permit has been issued.
4. The animals will be quarantined for not less than 30 days in the Department's Animal Quarantine Station in New York Animal Import Center in
Newburgh, NY.
5. Upon release from quarantine the animals will be delivered to the zoological park named in this agreement to become the property of the park
and they will not be sold, exchanged or removed from the premises without prior consent of the Veterinary Services.

Signature of Importer
Subscribed and sworn to before me this _____________day of _______________________________, 20____

(Title or Designation)

(Name of Zoological Park)
(Signature of Officer of Zoological Park)
(Title of Officer)
Subscribed and sworn to before me this _____________day of _______________________________, 20____

(Title or Designation)
VS FORM 17-65B (SEP 2005)

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 number for this information collection is 0579-0040. The time required
to complete this information collection is estimated to average .5 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.


File Typeapplication/pdf
File TitleInForms - vs17-65b.wpf
Authorkhbrown
File Modified2011-01-31
File Created2007-08-07

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