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)