Compliance Agreement

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OMB APPROVED
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
0579-0054/0088/0129/
unless it displays a valid OMB control number. The valid OMB control numbers for this information collection are 0579-0054, 0088, 0129, 0198, 0257, 0310, 0317,
0198/0257/0310/0317/
0322, 0337, 0346, 0363, and 0369. The time required to complete this information collection is estimated to average 1.25 hours per response, including the time
0322/0337/0346/0363/
for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.
0369 and 0383
UNITED STATES DEPARTMENT OF AGRICULTURE
COMPLIANCE AGREEMENT
ANIMAL AND PLANT HEALTH INSPECTION SERVICE
PLANT PROTECTION AND QUARANTINE
1. NAME AND MAILING ADDRESS OF PERSON OR FIRM
2. LOCATION
3. REGULATED ARTICLE(S)
4. APPLICABLE FEDERAL QUARANTINE(S) OR REGULATIONS
5. I / WE AGREE TO THE FOLLOWING:
6. SIGNATURE
7. TITLE
8. DATE SIGNED
9. AGREEMENT NUMBER
The affixing of the signatures below will validate this agreement which shall remain in
effect until canceled, but may be revised as necessary or revoked for noncompliance.
10. DATE OF AGREEMENT
11. PPQ/CBP OFFICIAL (NAME AND TITLE)
12. ADDRESS
13. SIGNATURE
14. U.S. GOVERNMENT/STATE AGENCY OFFICIAL (NAME AND TITLE)
15. ADDRESS
16. SIGNATURE
PPQ FORM 519
All p
revious editions are obsolete.
SEP 2012

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