Form PPQ Form 587 PPQ Form 587 Application for Permit to Import Plants or Plant Product

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 valid OMB
control numbers. The valid OMB control numbers for this information collection are 0579-0129, 0173, 0190, 0242, 0285, 0289, 0421, and 0446. 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
PLANT PROTECTION AND QUARANTINE
APPLICATION FOR PERMIT TO IMPORT PLANTS
OR PLANT PRODUCTS

INSTRUCTIONS: PLEASE TYPE OR PRINT
CLEARLY. PERMITS ARE NOT ISSUED TO
P.O. BOXES. READ THE ENTIRE
APPLICATION BEFORE COMPLETING.
ATTACH ADDITIONAL SHEETS OF PAPER
IF MORE SPACE IS NEEDED.

1. NAME AND UNITED STATES ADDRESS OF U.S. RESIDENT/LEGAL ALIEN:

OMB APPROVED
0579- 0129, 0173, 0190,
0242, 0285, 0289, 0421,
and 0446

FORWARD COMPLETED APPLICATION TO
USDA-APHIS-PPQ
Permit Unit
4700 River Road, Unit 133
Riverdale, MD 20737-1236
1-877-770-5990; FAX: (301) 734-5786

MAILING ADDRESS (If different than physical address):

APPLICANT’S NAME:
ORGANIZATION NAME:
U.S. ADDRESS (Include City, State, and Zip Code):

PHONE: (

)

FAX: (

)

E-MAIL:

2. Plants or Plant Products to be Imported:

Country of Origin
Scientific Names of Plants or Plant Products

(Province or Territory,
if applicable)

3. Intended use:

Plant Parts
(seeds, cuttings, rhizomes,
plants, bulbs, fruits, etc.)

U.S. Port or Ports
of Arrival

Plants for planting (Nursery stock) Small lots of seed Fruit and vegetables  Other_________________________

4. Means of importation:

Mail or Express carrier Cargo shipment Personal baggage or car

5. SIGNATURE OF APPLICANT:

6. PRINTED NAME OF APPLICANT:

7. DATE:

WARNING: Any alteration, forgery, or unauthorized use of this document is subject to civil penalties of up to $250,000 (7 U.S.C.s 7734(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.s 1001).
PPQ FORM 587 (MD)
MAY 2014