Form ASF VSDIR 1 ASF VSDIR 1 Veterinary Services Dog Import Record: Dog(s) from an AS

OMB Approved 0579-XXXX, Exp. XX/XXXX

** ACTION REQUIRED - PLEASE READ CAREFULLY **

Documentation for dogs imported for resale into the United States from countries with
African swine fever must be completed and submitted to APHIS Veterinary Services via email
to [email protected] within 2 business days following the dogs’ arrival.
Dear Importer:
Thank you for your recent import permit application requesting permission from the U.S.
Department of Agriculture’s Animal and Plant Health Inspection Service (APHIS) to import
dog(s) for resale into the United States. Dogs for resale include any transfer of ownership or
control of an imported dog at least 6 months of age to another person. Your application,
submitted to APHIS’ Animal Care program, indicates the dog(s) are coming from a country
affected by African swine fever (ASF). As a result, you must meet Animal Care’s requirements
along with the requirements established by APHIS’ Veterinary Services program to prevent the
introduction of disease.
To comply with Veterinary Services’ requirements, the shipment of dog(s) must meet the
following conditions:
 The dog(s) and their shipping crate/container must be free of dirt, wood shavings, hay,
straw, or any other organic/natural bedding material.
 All bedding that accompanies the dog(s) during transit must be properly disposed of at
the U.S. post-entry point(s) of concentration.
 Each dog must have an ISO compliant microchip implanted, and the individual microchip
number must be verified immediately before each animal is bathed.
 Each dog must be bathed at the U.S. post-entry point(s) of concentration within 2
calendar days of arrival in the United States. Bathing must be documented in Part 2 of
the attached Veterinary Services Dog Import Record.
The attached “Veterinary Services Dog Import Record” must be completed and submitted
with a copy of the associated Animal Care import permit via email to
[email protected] within 2 business days of the dog(s)’ entry into the
United States.
If you have any questions about Veterinary Services’ requirements, please contact the VS Live
Animal Import Team before the dog(s) leave the country of origin.
_____________________________________________________________________________
PAPERWORK REDUCTION ACTION DISCLOSURE: 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-XXXX. The time
required to complete this information collection is estimated to average 1 hour 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.

ASF VSDIR 1 (MAY 2021)

Veterinary Services Dog Import Record: Dog(s) from an ASF
Affected Country
**All parts of this document must be completed and submitted via email to
[email protected] within 2 business days of the dog(s)’ entry into the United States**
PART 1: IMPORT VERIFICATION
I. Importer Contact Information:
Name of Importer: _____________________________________________________________________
Phone Number: _______________________________________________________________________
Email: _______________________________________________________________________________
Address: _____________________________________________________________________________

II. Shipment Information:
Country of Origin (Exporting Country): _____________________________________________________
APHIS Animal Care Import Permit #: ____________________________________________ (attach copy)
Number of dog(s) shipped: ______________________________________________________________
Date of arrival into the U.S.: _____________________________________________________________
U.S. Port of Entry: _____________________________________________________________________
Address(es) of first post-entry point(s) of concentration: ______________________________________
____________________________________________________________________________________
____________________________________________________________________________________

III. Importer Certification:
I, _____________________________ (importer of record), verify by checking the boxes below that the following
Veterinary Services import conditions as described in APHIS Federal Order DA-2021-01 (June 21, 2021) were met for
all dog(s) in this shipment and that required supporting documents, including a copy of the associated Animal Care
Import Permit(s), are attached to this form.
 The dog(s) and their shipping crate/container was free of dirt, wood shavings, hay, straw, or any other
organic/natural bedding material.
 All bedding that accompanied the dog(s) during transit was properly disposed of at the post-entry point(s) of
concentration.
Disposal methods may include incineration; or disinfecting the bedding with an APHIS Approved Disinfectant, placing
the bedding in a leakproof bag, sealing the bag, disinfecting the bag exterior with an APHIS Approved Disinfectant,
inserting the disinfected bag into another leakproof bag, sealing that bag, disinfecting the bag exterior with the same
disinfectant product, and disposing of the bag in a landfill in accordance with all state and local regulations.

 Each dog has an ISO compliant microchip implanted, and the microchip number was verified immediately
before the animal was bathed.
 Each dog was bathed at the U.S. post-entry point(s) of concentration destination within 2 calendar days of
arrival in the United States.
Bathing of all dogs in the shipment must be complete before this form is submitted. Bathing documentation is
attached, and includes each dog’s microchip number, a brief description of the animal (age, breed, gender, color/
markings), the date the bath was completed, and the name and contact information of the person that bathed the
dog(s).

_________________________________________
Importer Signature

___________________
Date

Page 1 of ___

APHIS Veterinary Services may require, at its discretion, animal inspection at the post-entry point(s) of concentration in the United States to
verify import requirements were met. Documented non-compliance with any of APHIS’ import requirements by an importer could result in
the suspension or revocation of import permit issuance or other appropriate enforcement action based on the situation.

Veterinary Services Dog Import Record: Dog(s) from an ASF
Affected Country
PART 2: INDIVIDUAL DOG IDENTIFICATION AND BATHING VERIFICATION
**Bathing must be completed within 2 calendar days of the dog(s)’ entry into the United States.**
APHIS Animal Care Import Permit #: ______________________________

I. Bathing Confirmation:
Dog(s) listed on the following page(s) were bathed at the U.S. post-entry point(s) of concentration within
2 calendar days of arrival in the United States.
Microchip #: ___________________________________________________________
Dog name (if applicable): _________________________________________________
Age and gender: ________________________________________________________
Breed, color, and markings: _______________________________________________
Date of bath: ___________________________________________________________
Microchip #: ___________________________________________________________
Dog name (if applicable): _________________________________________________
Age and gender: ________________________________________________________
Breed, color, and markings: _______________________________________________
Date of bath: ___________________________________________________________
Microchip #: ___________________________________________________________
Dog name (if applicable): _________________________________________________
Age and gender: ________________________________________________________
Breed, color, and markings: _______________________________________________
Date of bath: ___________________________________________________________
Microchip #: ___________________________________________________________
Dog name (if applicable): _________________________________________________
Age and gender: ________________________________________________________
Breed, color, and markings: _______________________________________________
Date of bath: ___________________________________________________________
Microchip #: ___________________________________________________________
Dog name (if applicable): _________________________________________________
Age and gender: ________________________________________________________
Breed, color, and markings: _______________________________________________
Date of bath: ___________________________________________________________

Page 2 of ___
APHIS Veterinary Services may require, at its discretion, animal inspection at the post-entry point(s) of concentration in the United States to
verify import requirements were met. Documented non-compliance with any of APHIS’ import requirements by an importer could result in
the suspension or revocation of import permit issuance or other appropriate enforcement action based on the situation.

Veterinary Services Dog Import Record: Dog(s) from an ASF
Affected Country
Bathing Confirmation, continued (use if shipment contains more than 5 dogs)
Microchip #: ___________________________________________________________
Dog name (if applicable): _________________________________________________
Age and gender: ________________________________________________________
Breed, color, and markings: _______________________________________________
Date of bath: ___________________________________________________________
Microchip #: ___________________________________________________________
Dog name (if applicable): _________________________________________________
Age and gender: ________________________________________________________
Breed, color, and markings: _______________________________________________
Date of bath: ___________________________________________________________
Microchip #: ___________________________________________________________
Dog name (if applicable): _________________________________________________
Age and gender: ________________________________________________________
Breed, color, and markings: _______________________________________________
Date of bath: ___________________________________________________________
Microchip #: ___________________________________________________________
Dog name (if applicable): _________________________________________________
Age and gender: ________________________________________________________
Breed, color, and markings: _______________________________________________
Date of bath: ___________________________________________________________
Microchip #: ___________________________________________________________
Dog name (if applicable): _________________________________________________
Age and gender: ________________________________________________________
Breed, color, and markings: _______________________________________________
Date of bath: ___________________________________________________________
Microchip #: ___________________________________________________________
Dog name (if applicable): _________________________________________________
Age and gender: ________________________________________________________
Breed, color, and markings: _______________________________________________
Date of bath: ___________________________________________________________
Microchip #: ___________________________________________________________
Dog name (if applicable): _________________________________________________
Age and gender: ________________________________________________________
Breed, color, and markings: _______________________________________________
Date of bath: ___________________________________________________________
[Duplicate this page as needed to capture all dog information]

Page ____ of ____
APHIS Veterinary Services may require, at its discretion, animal inspection at the post-entry point(s) of concentration in the United States to
verify import requirements were met. Documented non-compliance with any of APHIS’ import requirements by an importer could result in
the suspension or revocation of import permit issuance or other appropriate enforcement action based on the situation.

Veterinary Services Dog Import Record: Dog(s) from an ASF
Affected Country
II. Attestation and Signatures
By signing the below, I attest that each of the dogs in this shipment were identified and bathed as described
within this document.
____________________________________________________
Importer Name, phone, and email

________________________________
Importer Signature and Date

____________________________________________________
Bather name, phone number, and email

________________________________
Bather’s Signature and Date

____________________________________________________
Bather name, phone number, and email (if applicable)

________________________________
Bather’s Signature and Date

____________________________________________________
Bather name, phone number, and email (if applicable)

________________________________
Bather’s Signature and Date

____________________________________________________
Bather name, phone number, and email (if applicable)

________________________________
Bather’s Signature and Date

____________________________________________________
Bather name, phone number, and email (if applicable)

________________________________
Bather’s Signature and Date

____________________________________________________
Bather name, phone number, and email (if applicable)

________________________________
Bather’s Signature and Date

____________________________________________________
Bather name, phone number, and email (if applicable)

________________________________
Bather’s Signature and Date

____________________________________________________
Bather name, phone number, and email (if applicable)

________________________________
Bather’s Signature and Date

____________________________________________________
Bather name, phone number, and email (if applicable)

________________________________
Bather’s Signature and Date

Page ____ of ____
APHIS Veterinary Services may require, at its discretion, animal inspection at the post-entry point(s) of concentration in the United States to
verify import requirements were met. Documented non-compliance with any of APHIS’ import requirements by an importer could result in
the suspension or revocation of import permit issuance or other appropriate enforcement action based on the situation.