ST-473 Recordation Form

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Form ST-473

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OMB NO. 0581-0055
Expiration Date: 01/31/2022

U.S. DEPARTMENT OF AGRICULTURE
AGRICULTURAL MARKETING SERVICE
SCIENCE AND TECHNOLOGY - PLANT VARIETY PROTECTION OFFICE

RECORDATION FORM
The following statements are made in accordance with the Privacy Act of 1974 (5 U.S.C. 552a) and the Paperwork Reduction Act (PRA) of 1995.
OMB Collection #0581-0055

Use this form to request a revision on a PVP original application(s)
A fee of $41 per application is required
If an assignment is being requested, attach assignment document to this form.
CURRENT OWNER(S) OF RECORD
1. CURRENT NAME OF OWNER:

2. CURRENT OWNER ADDRESS:

3. CURRENT OWNER TELEPHONE: (+00 (000) 000-0000)

4. CURRENT OWNER FAX NUMBER:

5. CURRENT OWNER EMAIL:

6. TYPE OF RECORDATION: (Check all that apply) (See attached appendix for definitions and instructions)

Change Name of Owner(s)
Change Address of Owner(s)
Change Name of Representative
Change Address of Representative
Variety Name Change (No Fee Charged)
Assignment (transfer of authority or ownership)
Security Interest, License, Grant, Conveyance
Merger
Revocation of Assignment, Security, Interest, License, Grant
Other (specify)

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Form ST-473

OMB NO. 0581-0055
Expiration Date: 01/31/2022

U.S. DEPARTMENT OF AGRICULTURE
AGRICULTURAL MARKETING SERVICE
SCIENCE AND TECHNOLOGY - PLANT VARIETY PROTECTION OFFICE

RECORDATION FORM
The following statements are made in accordance with the Privacy Act of 1974 (5 U.S.C. 552a) and the Paperwork Reduction Act (PRA) of 1995.
OMB Collection #0581-0055

NEW OWNER(S)

7. NEW NAME OF OWNER:
8. NEW OWNER ADDRESS:

9. NEW OWNER TELEPHONE: (+00 (000) 000-0000)

10. NEW OWNER FAX NUMBER:

11. NEW OWNER EMAIL:

NEW REPRESENTATIVE / AGENT
12. NEW NAME OF REPRESENTATIVE:
13. NEW REPRESENTATIVE ADDRESS:

14. NEW REPRESENTATIVE TELEPHONE:
(+00 (000) 000-0000)

15. NEW REPRESENTATIVE FAX NUMBER:

16. NEW REPRESENTATIVE EMAIL:

STATEMENT AND SIGNATURE
17. Statement and Signature: To the best of my knowledge and belief, the foregoing information is true and correct and any
attached copy is a true copy of the original document.
PRINT NAME

SIGNATURE

18. TOTAL NUMBER OF APPLICATIONS INVOLVED:

DATE

TOTALS
19. TOTAL AMOUNT: (multiply total applications by $41)

Fees must be paid by U.S. funds either by credit card or checks made payable to the: “Treasurer of the United States”
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Form ST-473

OMB NO. 0581-0055
Expiration Date: 01/31/2022

U.S. DEPARTMENT OF AGRICULTURE
AGRICULTURAL MARKETING SERVICE
SCIENCE AND TECHNOLOGY - PLANT VARIETY PROTECTION OFFICE

RECORDATION FORM
The following statements are made in accordance with the Privacy Act of 1974 (5 U.S.C. 552a) and the Paperwork Reduction Act (PRA) of 1995.
OMB Collection #0581-0055

The PVP Number(s), Crop kind(s), Variety name(s) for the affected application.
Attach list if more space is needed.
PVP NUMBER

CROP KIND

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VARIETY NAME

Form ST-473

OMB NO. 0581-0055
Expiration Date: 01/31/2022

U.S. DEPARTMENT OF AGRICULTURE
AGRICULTURAL MARKETING SERVICE
SCIENCE AND TECHNOLOGY - PLANT VARIETY PROTECTION OFFICE

RECORDATION FORM
The following statements are made in accordance with the Privacy Act of 1974 (5 U.S.C. 552a) and the Paperwork Reduction Act (PRA) of 1995.
OMB Collection #0581-0055

TERMS and DEFINITION
Recordation:
Grant:
To record changes requested by the representative or agent of the
A gift of legal rights or privileges from one owner to another.
applicant.
Conveyance:
Assignment:
The transfer of personal property from one owner to another.
When an owner transfers his authority rights from one person to
Revocation:
another to handle his business, crop kind, variety, seeds, and sale
Cancellation or annulment of a privilege, title or authorization.
of seeds, or the transfer of ownership from one company to another. Revocation of assignment (transfer of authority) agreement,
Security Interest:
including security interest.
Property interest used as collateral.
Revocation of license (authority to use or sell seeds).
License:
Revocation of grant privileges.
To give permission to exercise legal rights or privileges from one
Merger:
A legal combination of two or more companies to form a new
owner to another.
company.
RECORDATION EXPLANATION and FEE REQUIREMENTS
Recordation is a revision of the original application filed with the Plant Variety Protection Office and requires an additional fee
payment of $41 per application. All recordation transactions such as the transfer of authority, transfer of ownership, or change of
owner’s name require an assignment document with an authorized signature(s) and should be attached to this form.
Recordation fee(s) can be calculated by multiplying the total number of application(s) by $41.
FEE PAYMENT OPTIONS

Check
All fees must be paid by US funds. Make check payable to the “Treasurer of the United States.” Include the PV number(s) on the
check.
Credit card
Attach the “Request for Service (ST-471) form” for all credit card transactions. Enter all credit card information, including the credit
card type (Visa/MasterCard/American Express), the credit card number, the security code number, name and address of agency,
cardholder’s name, telephone number and email address. Include the PV number(s) for each application, crop kind and variety
name(s).
Money Transfer
Any domestic or foreign company requesting a money transfer must be affiliated with a USA bank and must provide the following
information: A nine digit routing number, bank account number, check number, account type (saving or checking) and payment
amount. Include the PV number(s) for each application.
Plant Variety Protection Office cannot process credit card payments or money transfer without an authorized signature.
BURDEN and NONDISCRIMINATION STATEMENTS
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 0581-0055. 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.
The U.S. Department of Agriculture (USDA) prohibits discrimination in all its programs and activities on the basis of race, color,
national origin, age, disability, and where applicable, sex, marital status, familial status, parental status, religion, sexual orientation,
genetic information, political beliefs, reprisal, or because all or part of an individual’s income is derived from any public assistance
program (not all prohibited bases apply to all programs.) Persons with disabilities who require alternative means for communication
of program information (Braille, large print, audiotape, etc.) should contact USDA’s TARGET Center at (202) 720-2600 (voice and
TDD).
To file a complaint of discrimination, write to USDA, Director, Office of Civil Rights, 1400 Independence Avenue, S.W., Washington,
D.C. 20250, or call (800)795-3272 (voice) or (202) 720-6382 (TDD). USDA is an equal opportunity provider and employer.

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