Dog & Cat Import Form printable pdf download

ANIMAL QUARANTINE STATION 99-951 Halawa Valley Street, Aiea, Hawaii 96701 (808) 483-7151 RabiesFree@hawaii.gov

AQS 278 (11/11)

PAGE 1 of 2

DOG & CAT IMPORT FORM

I. FORM & DOCUMENTS

(

Number of dogs and cats entering Hawaii:______

Separate form must be filled out for each pet)

Except for the original health certificate, all documents must be received by the Animal Quarantine Station along with this

completed form no less than 10 days before arrival to qualify for the 5-day-or-less and direct airport release program.

ESTIMATED DATE OF ARRIVAL

PET NAME

MICROCHIP NUMBER

SPECIES:

DOG

CAT

√ CHECK ALL DOCUMENTS ENCLOSED, INDICATE PROGRAM APPLYING FOR AND AMOUNT OF ENCLOSED PAYMENT

DOCUMENTS SUBMITTING

TYPE OF PROGRAM APPLYING FOR

PREPAYMENT

RECENT

DIRECT

NEIGHBOR ISLAND

SUBSEQUENT

5 DAYS

RABIES

* HEALTH

** HAWAII

AIRPORT

120 DAY

INSPECTION PERMIT

ENTRY $78 SEE

OR LESS

AMOUNT ENCLOSED

VACCINE

CERT.

HEALTH CERT.

RELEASE

$1,080

$145

REQUIREMENT!

$224

CERT.

$165

Make money order or cashier's check out to: Department of Agriculture

NO PERSONAL CHECKS ACCEPTED

SEND ALL DOCUMENTS IN TOGETHER AS A SET WITH THIS DOG AND CAT IMPORT FORM COMPLETED AND NOTARIZED

* An original health certificate may be submitted upon arrival in Honolulu to State inspectors if not submitted w/ this form.

* *Owners of dogs and cats located in Hawaii that will be departing and returning for the 5-day-or-less program must also submit the

original health certificate issued in Hawaii used for departure that contains the pet's Hawaii address and date of departure from Hawaii

to qualify under the resident Hawaii pet requirements.

● PET LOCATED IN HAWAII: Check box

If pet will be leaving Hawaii and returning

(Refer to Pets located in Hawaii requirements)

● SUBSEQUENT ENTRY: Check box

If pet is entering Hawaii again and give date of previous entry:

(Refer to Re-Entry pet

requirements to see if pet qualifies. Pet must meet qualifications for this lower fee )

II. PRIMARY OWNER INFORMATION - LEGAL OWNER OF PET REQUIRED (Authorized Handler Information Use Section IV!)

NAME: LAST

FIRST

M.I.

IDENTIFICATION NO. ( DRIVER'S LICENSE, STATE ID, MILITARY ID, S.S.)

I.D. EXPIRATION DATE

BIRTH DATE

CURRENT ADDRESS: STREET

CITY

STATE

ZIP

TELEPHONE: HOME

WORK

CELL

E-MAIL ADDRESS:

HAWAII STREET ADDRESS: (if known)

CITY

ISLAND

ZIP

TELEPHONE: HOME

WORK

OTHER

□

III. OWNER GROUP

Civilian

Army

Navy

Marines

Coast Guard

Air Force

⇨ ⇨ ⇨ ⇨

□

IV. CO-OWNER or AUTHORIZED HANDLER / AGENT INFORMATION

PERSON IS:

CO-OWNER

HANDLER

(Co-owners are also recognized as legal owners)

NAME: LAST

FIRST

M.I.

IDENTIFICATION NO. (DRIVER'S LICENSE, STATE ID, MILITARY ID, S.S. ,etc)

I.D. EXPIRATION DATE

BIRTH DATE

TELEPHONE: HOME

WORK

OTHER

Dog & Cat Import Form

Related Articles

Related forms

Related Categories