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Golden Nematode Program Manual - Phytosanitary Resources

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Appendix A: Forms and Worksheets<br />

PPQ Form 540, Certificate of Federal/State Domestic Quarantines<br />

PPQ Form 540, Certificate of Federal/State Domestic Quarantines<br />

Need current 540 certificate xx<br />

FIGURE A-1-28 Example of PPQ Form 540, Certificate of Federal/State Domestic Quarantines<br />

Purpose<br />

PPQ Form 540, Certificate of Federal/State Domestic Quarantines, is<br />

used by the <strong>Golden</strong> <strong>Nematode</strong> <strong>Program</strong> to certify that the regulated<br />

articles (listed on the form) are certified free from golden nematode<br />

only. This permit is issued by xx.<br />

Instructions<br />

Complete PPQ Form 540 as shown in Table A-1-29.<br />

TABLE A-1-29 Instructions for Completing PPQ Form 540, Certificate of Federal/State Domestic Quarantines<br />

Block<br />

Instructions<br />

1 DATE ISSUED xx Need instructions<br />

2 VOID AFTER <br />

3 NAME OF CONSIGNOR <br />

4 SHIPPING POINT <br />

5 NAME AND ADDRESS OF CONSIGNEE <br />

6 VEHICLE LICENSE NO. & STATE <br />

7 R.R. CAR INITIALS & NO. <br />

8 DESCRIPTION <br />

QUANTITY A<br />

QUANTITY B<br />

QUANTITY C<br />

<br />

<br />

<br />

9 SIGNATURE OF INSPECTING OFFICER <br />

Distribution<br />

Distribute PPQ Form 540, Certificate of Federal/State Domestic<br />

Quarantines, as follows:<br />

A-1-38 <strong>Golden</strong> <strong>Nematode</strong> <strong>Program</strong> <strong>Manual</strong> 07/2008-01<br />

PPQ

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