VS 17-32 Application for Inspection and Dipping

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 0579-0040, 0579-0324, and 0579-XXXX. The time required
to complete this information collection is estimated to average .12 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
0579-0040, 0579-0324,
and 0579-XXXX

PORT OF ENTRY
UNITED STATES DEPARTMENT OF AGRICULTURE
ANIMAL AND PLANT HEALTH INSPECTION SERVICE
VETERINARY SERVICES

PROPOSED DATE OF ENTRY

APPLICATION FOR INSPECTION AND DIPPING
NUMBER

BREED

SPECIES

PURPOSE

Inspection and, when necessary, supervised dipping, are hereby requested under 92, 9 CFR, for livestock described, when offered for Importation. The
undersigned agrees to waive all claims against the United States for any loss or damage to livestock occasioned by or resulting from dipping, or resulting
from the fact that they are later found to be still tick infested, and also for all subsequent loss or damage to any other animals In the possession or control of
such importer which may come in contact with the animals so dipped.
PREMISES OF ORIGIN

MUNICIPALITY OF ORIGIN

STATE OF ORIGIN

RECORD OF LAST DIPPING

NAME AND BUSINESS ADDRESS OF IMPORTER

FOR DELIVERY TO

LOCATED AT

This is to certify that the Information given above is correct and that any ruminants or swine covered by this application have originated In Mexico and that
none of the animal have been in any other country during the time foot-and-mouth disease existed there, or have been corralled, pastured, or held with
such ruminants during the preceding 60 days, unless accompanied by a valid import permit issued by Veterinary Services.
Acknowledgement is hereby made that only certain dips (Listed in 9 CFR Parts 72, 73, and 74) are permitted for treatment against cattle fever ticks and
scabies.
If I am advised that precautionary dipping Is to be against scabies, then _____________________________ dip is hereby requested.
This application may become null and void If the livestock are not submitted for Inspection on the “Accepted date” approved by the Port Veterinarian of
Veterinary Services.
Signature and Title (Imported or Authorized Agent)

Date

TO BE FILLED OUT WHEN ANIMALS ARE AT PORT OF ENTRY
This is to further certify that the above-described livestock while en route to the port of entry have not been trailed or driven through fever-tick-infested areas prior to being offered
for Importation, except that for cattle exposed to such infestation In Mexico offered for importation into the State of Texas, this part of the certification need not be completed.
Signature and Title (Imported or Authorized Agent)

VS FORM 17-32 (APR 2014)

Date