PPQ Form 203 Foreign Site Certificate of Inspection and/or Treatment

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 0579-0049. 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

FOREIGN SITE CERTIFICATE OF INSPECTION
 AND/OR TREATMENT

OMB APPROVED
0579-0049
EXP: XX/XXXX

1. CERTIFICATE NO.

2. COUNTRY OF ORIGIN

3. DATE LOADED

4. FOREIGN PORT OF EXPORT

5. CARRIER IDENTIFICATION

6. U.S. PORT OF ENTRY

7. SHIPPER (Name and Address - Include ZIP Code)

9. COMMODITY

12. LOCATION OF INSPECTION AND/OR TREATMENT

8. CONSIGNEE (Name and Address - Include ZIP Code)

10. NO. CONTAINERS
(Identify as box, sack,
1/2 Bruce box, flat,
cardboard box, etc.)

11. CONTAINER
IDENTIFICATION MARKS

13. DATE

This certifies that the shipment described above has been inspected and/or treated in accordance with agricultural requirements for
entry into the United States.
14. SIGNATURE OF PLANT PROTECTION AND QUARANTINE OFFICER

PPQ FORM 203
(JUL 2007)

15. DATE ISSUED