0920-22BY Other Animal Import Form

Form

OMB Control No. 0920-XXXX

Expiration Date: XX/XX/XXXX

Request to Import CDC-Regulated Animals (Excluding Dogs and Nonhuman Primates)

Request to import CDC-Regulated Animals (Excluding Dogs and Nonhuman Primates)

Section 1: Importer’s (consignor) Contact Information
Date of Application: __ __ / __ __ / __ __ __ __ M M D D Y Y Y Y
Name: Institution
Address: State abbr. County Zip Code
Email: Phone Number ( ) -
Will the animal be housed at the same location as the importer? (i.e., Is there a different recipient?) Yes No (if no, skip to section 3)
Section 2. Recipient’s (Consignee) Contact Information (If different from Importer)
Name: Institution:
Address: State abbr. County Zip Code
Email: Phone Number ( ) -
Section 3: Animal Information Animals you are requesting to import: Civets African Rodents (Gambian pouch rat, African porcupines, multimammate rat, etc.) Other Viverridae (binturongs, genets, linsangs, etc.) Bats Small (carapace <4 inches) turtles, tortoises, or terrapins Turtle, tortoise, or terrapin viable eggs Fresh water snails (Oncomelania hupensis, Biomphalaria pfeifferi, etc.) Species: Source of Animals: Wild caught Captive bred Number of animals/eggs being imported: Animal Identification (tattoo, microchip #, etc): Also permitted: attach document with unique animal identifying information Please indicate if not applicable (i.e. eggs): IDs N/A Location of animal pre-importation: Country:____________________________________________ Type of facily (breeding facility, zoo, research institution, refuge, etc.):___________________________________________ Contact at current location: Name: ______________________________ Address:______________________________ Email: _ Phone Number
Section 4: Proposed Purpose of Importation
Your request must be limited to scientific, exhibition, or educational purposes.
Purpose Scientific Exhibit Educational
Please provide a short description of the intended use of the imported animals:
If you are proposing to import for scientific or educational purposes, please provide an approved IACUC protocol. If you are proposing to import for exhibition, please attach evidence that your establishment is open to the general public at routinely scheduled hours on five (5) or more days each week. Also provide a copy of your USDA exhibitor’s license.

Section 5: Transportation Information
Name of courier responsible for ground transportation:
		Courier Contact information: Address: Phone:
Flight Information
		Port of Entry:
		Date of Arrival:
		Time of Arrival:
		Carrier(s):
		Flight Number(s):
		Air Waybill Number(s):
Description of transport containers or cages
Description of precautions for handlers and other procedures to minimize exposure of animals during transport
Description of method of providing food and water without requiring people to be directly exposed to the animals during transit
	Section 6. Routine Veterinary Care
	Please describe any routine veterinary care the animals receive before and after importation.

Section 7. Holding Facility and Quarantine Procedure
Please describe the holding facility and any quarantine procedures after importation.

Section 8: Additional Information
Please provide any additional biosafety or biosecurity measures that you will implement to prevent the introduction and spread of zoonotic diseases

CDC must receive your request with the information listed above at least 2 weeks (10 business days) before the date of your proposed shipment of CDC regulated animals into the United States. We process requests in the order they are received, so submit your request as early as possible.

Submitting a request does not guarantee a permit will be issued. CDC reserves the right to deny requests to import any CDC regulated animals. Submitting false information or making other false statements is punishable with fines and imprisonment. No permits are given upon arrival.

To import CDC regulated animals into the United States, you must also comply with importation regulations enforced by:

1. US Customs and Border Protection

2. US Fish and Wildlife Service

3. US Department of Transportation (The International Air Transport Association [IATA] has guidelines on shipping live animals. www.iata.org/en/programs/cargo/live-animals/)

CDC Resources:

• www.cdc.gov/poxvirus/monkeypox/african-ban.html

• www.cdc.gov/importation/bringing-an-animal-into-the-united-states/african-rodents.html

• Turtles | Bringing an Animal into U.S. | Importation | CDC

• Civets | Bringing an Animal into U.S. | Importation | CDC

• Bats | Bringing an Animal into U.S. | Importation | CDC

Public reporting burden of this collection of information is estimated to average 30 minutes 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. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB Control Number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Reports Clearance Officer, 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30329; ATTN: PRA 0920-XXXX.