PPQ Form 519 Compliance Agreement

Foreign Quarantine Notices

PPQ FORM 519 (SEP 2012)

Individual

OMB: 0579-0049

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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 this information collection are 0579-0049, 0088, 0155, 0310,
0317, 0322, 0331, 0337, 0346, 0363, 0383, and 0450. The time required to complete this information collection is estimated to average .50 to 1.25 hours per
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UNITED STATES DEPARTMENT OF AGRICULTURE
ANIMAL AND PLANT HEALTH INSPECTION SERVICE
PLANT PROTECTION AND QUARANTINE
1. NAME AND MAILING ADDRESS OF PERSON OR FIRM

OMB APPROVED
0579-0049, 0088, 0155,
0310, 0317, 0322, 0331,
0337, 0346, 0363, 0383,
and 0450

COMPLIANCE AGREEMENT
2. LOCATION

3. REGULATED ARTICLE(S)

4. APPLICABLE FEDERAL QUARANTINE(S) OR REGULATIONS

5. I / WE AGREE TO THE FOLLOWING:

6. SIGNATURE

7. TITLE

8. DATE SIGNED

9. AGREEMENT NO.

The affixing of the signatures below will validate this agreement, which shall remain in
effect until canceled, but may be revised as necessary or revoked for noncompliance.

11. PPQ/CBP OFFICIAL (NAME AND TITLE)

12. ADDRESS

13. SIGNATURE

14. U.S. GOVERNMENT/STATE AGENCY OFFICIAL (NAME AND TITLE)

15. ADDRESS

16. SIGNATURE

PPQ FORM 519 (SEP 2012)

Previous editions before 2010 are obsolete.

10. DATE OF AGREEMENT


File Typeapplication/pdf
File TitleUNITED STATES DEPARTMENT OF HOMELAND SECURITY
Authorkastratchko
File Modified2018-07-02
File Created2018-07-02

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