Form VS 17-8 VS 17-8 Agreement of Pet Bird Owner

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 and 0579-0245. 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.

UNITED STATES DEPARTMENT OF AGRICULTURE
ANIMAL AND PLANT HEALTH INSPECTION SERVICE
VETERINARY SERVICES
1. NAME AND ADDRESS OF OWNER (Include ZIP CODE)

This report is authorized by law or
regulation (9 CFR 93). Failure to
complete and sign the form will
result in abandonment of birds.

OMB Approved
0579-0040 and
0579-0245

AGREEMENT OF PET BIRD OWNER
INSTRUCTIONS: Complete items 1 through 6 and the applicable Agreement A, B, and C. Distribute copies as identified

2. DATE OFFERED FOR ENTRY
3. NUMBER OF BIRDS

4. COMMON NAME OF BIRDS

5. TRAVEL ROUTE OF IMPORTATION
6. OWNER’S AGREEMENT – SIGN A, B, C, OR D BELOW. (Refusal to sign this form automatically places option D into effect).
A Section A:
I do hereby declare that the pet birds identified above will be maintained in my personal possession, separate and apart from all other birds and poultry at the location
indicated in item (1) below for a minimum of 30 days until released by an inspector of the Animal and Plant Health Inspection Service (APHIS) of the United States
Department of Agriculture (USDA). If the birds must be moved. I agree to contact the official listed in item (2) below prior to such movement.
I do hereby agree that the bird(s) will be available for inspection during the aforementioned period of confinement at the address in item (1) below and at such times as
deemed necessary by an inspector of APHIS, USDA. I further agree to immediately notify the Federal Official in item (2) below if any signs of disease are noted or if
the bird(s) die during the confinement period.
I understand if a laboratory specimen is taken and if found to be infected with or exposed to a communicable disease of poultry, that the bird(s) will be disposed of by
APHIS, USDA.
(1) LOCATION WHERE BIRDS WILL BE HELD

(2) NAME AND ADDRESS OF FEDERAL OFFICIAL TO CONTACT

STATE

PHONE NUMBER
(Include Area Code)
DATE SIGNED

SIGNATURE OF OWNER
LABORATORY SPECIMEN(S) TAKEN
SPECIMEN(S) SUBMITTED BY (Name)

B

REFERRAL NUMBER

Section B:
I certify that the birds have been in my possession for at least 90 days; that they are apparently healthy; and that they have not been exposed to any other birds
during those 90 days.
SIGNATURE OF OWNER
OWNER’S TELEPHONE NUMBER
DATE SIGNED
AREA CODE
PHONE NUMBER

WITNESSED BY (Signature)

C

TITLE

Section C: As the birds have not met the entry requirements for the U.S., I agree to export my birds to (Country).
SIGNATURE OF OWNER

D

DATE SIGNED

DATE SIGNED

Section D: As the bird(s)/hatching eggs have not met the entry requirements for the U.S., I hereby abandon my bird(s)/hatching eggs to APHIS of USDA for disposal.
SIGNATURE OF OWNER

7. PORT OF ENTRY

DATE SIGNED

8. CARRIER AND FLIGHT NO. FROM BIRD’S ITINERARY

9. VS FORM 17-30 DOCUMENT NUMBER

10. COMMENTS

I certify that I have, this day, inspected the bird(s) identified above offered for importation, and have found them to be free of evidence of communicable disease or exposure
thereto, and release them for the purpose as stated above.
11. PORT RELEASING OFFICIAL (Signature)
12. TITLE
13. DATE SIGNED

I have inspected the bird(s) above, and find that all applicable provisions of 9 CFR Part 93, as amended, have been met.
14. FINAL RELEASING OFFICIAL (Signature)

VS FORM 17-8
JUL 2014

15. TITLE

(Previous editions are obsolete)

16. DATE RELEASED