VS 17-129 Application for Import or In Transit Permit

No animals, animal semen, animal
embryos, birds, poultry, or hatching
eggs will be imported unless a
completed application has been
received (9 CFR Part 92 and 9 CFR
Part 93).

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 0579-0040, 0579-0055, 0579-0218, 0579-0228, 0579-0245, and
0579-0473. The time required to complete this information collection is estimated to average between .16 and 2 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.

OMB Approved
0579-0040, 0579-0055,
0579-0218, 0579-0228,
0579-0245, 0579-0473

1. NAME AND ADDRESS OF SHIPPER IN COUNTRY OF ORIGIN

UNITED STATES DEPARTMENT OF AGRICULTURE
ANIMAL AND PLANT HEALTH INSPECTION SERVICE
VETERINARY SERVICES

APPLICATION FOR IMPORT OR IN TRANSIT PERMIT
(Animals, Animal Semen, Animal Embryos, Birds, Poultry, or Hatching Eggs)

INSTRUCTIONS TO IMPORTER: Complete and submit one copy to USDA,
APHIS, VS, 4700 River Road, Unit 38, Riverdale, MD 20737. Prepare a separate
application for each shipment.

2. NAME AND ADDRESS OF IMPORTER (include ZIP code)

3. PORT OF EMBARKATION (from Canada, show only for ocean vessel or airplane

TELEPHONE NUMBER (include area code)

4. MODE OF TRANSPORTATION (name of airline or vessel and flight number)

shipments)

5. ANIMAL, ANIMAL SEMEN, ANIMAL EMBRYOS, BIRDS, POULTRY, OR HATCHING EGGS
A.
B.
C.
D.
DESCRIPTION
(sex, age, registered name and number, tattoo, tag number, other markings)
NUMBER
BREED
SPECIES

E. PURPOSE OF IMPORTATION

6. ROUTE OF TRAVEL FROM ORIGIN TO FINAL DESTINATION INCLUDING ALL CARRIER STOPS ENROUTE
(In city, country format; from Canada, show route of travel only for ocean vessel or airplane shipment)

7. PROPOSED SHIPPING DATE (from Canada, show only for ocean vessel or airplane
shipment)

8. PROPOSED ARRIVAL DATE

9. IMPORT QUARANTINE FACILITY (if applicable, also list a contagious equine metritis (CEM) quarantine facility)

10. NAME AND MAILING ADDRESS OF PERSON TO WHOM DELIVERY
WILL BE MADE (after quarantine, when required)

11. WHERE DELIVERY WILL BE MADE IN THE UNITED STATES
(after quarantine, when required) (physical location; no P.O. Boxes)

TELEPHONE NUMBER (include Area code)

12. REMARKS

13. SIGNATURE OF IMPORTER

VS FORM 17-129
DEC 2020

14. DATE SIGNED

Previous edition may be used.