PQ Form 15

APPLICATION FOR PLANT QUARANTINE INSPECTION AND CLEARANCE OF IMPORTED PLANTS/ PLANT PRODUCTS

[Plant Quarantine (Regulation of Import into India) Order, 2003]



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To:

_____________________________

_____________________________

_____________________________

For PQ Office use

Receipt No. :  ___________

Date of Receipt: ________

Registration No.:_____________

Date of
Regn. :___
_______

 

In accordance with the provisions of sub-clause (18) of clause 3 of the Plant Quarantine (Regulation of Import into India) Order,2003 issued under Destructive Insects & Pests Act,1914 (2 of 1914) , I/We file herewith an application for Plant Quarantine Inspection/treatment and clearance of the imported goods described below:

 

1. Name & address of Importer

2. Name & Address of Exporter

 Import Permit No. __________________

Date __________

 Phytosanitary Certificate No. __________

Date __________

 Fumigation Certificate if any

 Certificate of origin if any

 Bill Entry No. _________

Date __________

 Shipping/ Airway bill

 Invoice or packing list

N.B.: Tick out the documents enclosed.

3. Commodity (Common/Botanical name)

4. Quantity (Wt./Vol.)

 

 

5.No.of pieces/ packages/ containers

 

 

6. Distinguishing marks

7. Nature of packing material

 

8.Country of origin & Port of shipment

9. Means of conveyance & Date of Arrival

10. Point of Entry

 

11. Date and Place of Inspection

 

12. Shipping/ Airway Number and Date

For Plant Quarantine Office use:

The above documents submitted to this office have been scrutinized and found in order / not in order

Date:

Signature

13. Value of the Commodity

14. Purpose of import

Sowing/Planting/Consumption

 

Declaration

  1. I/We hereby declare that to the best of the knowledge and belief, the particulars given above are true and correct.
  2. I/We abide by the provisions of Plant Quarantine (Regulation of Import into India) Order, 2003 and the instructions issued by the officer of Plant Protection Adviser.                   

Date 
Place           

                                                          (Signature of Importer or his agent)

N.B: (1) Application should be submitted by the Importer/his authorized agent in duplicate duly filled and complete.

(2) Duplicate copy to be returned to the importer/ his authorized agent after endorsing the quarantine order and receipt of payment

(3) Payment should be made by bank draft or pay order drawn in favour of the concerned Pay and Accounts Officer.

 

PQ Form-15(2)
For PQ Office Use Only

Assessment of fee

Receipt of payment

Commodity

 

Wt.(Kg)/
No.of pieces

Particulars
of fee

     Rs.      P.

PEQ fee

Inspec
tion fee

Others


TOTAL

Received from M/s. ___________________________
__________________________
an amount of Rs. ____________
(Rupees_____________________
____________________________(in words)by cash /DD /BC /PO /T.R.No.____________________
dt: _________ drawn on ____________________(Name of the bank & branch)towards inspection fees/
outside inspection fees/other charges.

Rupees____________________________ _____________________________________(in words)

Date

Assessed by

Checked by

Sign. of staff

Sign. of S/O

Date

Sign. of Cashier


Sign. of DDO/
Accountant

 

        QUARANTINE ORDER NO.: _____________________

  1. The goods listed on this Plant Quarantine Entry form are ordered into Quarantine and are to be forwarded to this office under escort by Customs for inspection/treatment and further orders.
  2. The importer/authorized agent of the importer is hereby directed to present the goods/containers/vessel lying at _________________________________ for inspection/sampling on _______________ and at __________________ by the following designated staff/officers viz. _____________________________and arrange necessary facilities for the above purpose.
  3. The importer/authorised agent of the importer is advised to produce original copy of IP/PSC on or before _____________ to this office for record.
  4. The importer/authorised agent of importer is advised to contact this office after _____________________ day(s) for further orders.

Date

Place
                                                           

                                                                                (Sign. and Designation of Authority)