Application for permit to export american ginseng or goldenseal

If you need assistance in completing this form, the Convention on International Trade in Endangered Species (CITES) Management Authority Office can be contacted by email or by telephone at 1-855-869-8670.

Important Instructions for the Applicant
Please read carefully - Be sure to fill-in all related questions on the application form. An incomplete application may cause delays in processing.

  • Attach all required documents pertaining to the animal (such as foreign CITES permits, hunting permits, birth certificate, etc.)
  • Send the completed signed CITES application form by email, regular mail or fax, to the CITES Management Authority or the appropriate CITES Permitting Office (refer to the form submission page).

    CITES Permitting Office
    Canadian Wildlife Service
    Environment Canada
    351, St. Joseph Blvd
    Gatineau, Quebec K1A 0H3
    Email: cites@ec.gc.ca
    Fax: 1-855-869-8671
  • If the application is approved, the permit and instructions will be sent by mail to the applicant. If you would like to receive your permit by courier, please provide a pre-paid envelope or your courier account number. The permit will be sent to the address provided in Part 1, unless otherwise specified by the applicant.
  • Some animals and products must also meet the requirements of the Canadian Food Inspection Agency (CFIA). Please refer to their site or contact their regional offices by phone.

Type of application

New Application

Replacement

Reason for replacement:
__________________________________
Number of the CITES permit being replaced:
__________________________________

How should the CITES permit be sent to you?

Regular mailCourier service

For the permit to be sent by courier, indicate the courier company name and your account number:

Courier company name:
_______________________________________________________
Courier company name:
_______________________________________________________

Part 1: Contact information

1.1 Applicant information

Name:
_______________________________________________________
Name of business or organization
(if applicable):
_______________________________________________________
Address (number and street):
_______________________________________________________
Post Office Box:
_______________________________________________________
City:
_______________________________________________________
Province/Territory:
_______________________________________________________
Country:
_______________________________________________________
Postal Code:
_______________________________________________________
Email address:
_______________________________________________________
Daytime phone:
_______________________________________________________
Alternate phone:
_______________________________________________________
Fax:
_______________________________________________________

To which address should the permit be sent?

Applicant's addressOther address (please specify below)

Address (number and street):
_______________________________________________________
Post Office Box:
_______________________________________________________
City:
_______________________________________________________
Province/Territory/State:
_______________________________________________________
Country:
_______________________________________________________
Postal/Zip Code:
_______________________________________________________

1.2 - Broker information (if applicabale)

Name:
_______________________________________________________
Name of business or organization
(if applicable):
_______________________________________________________
Address (number and street):
_______________________________________________________
City:
_______________________________________________________
Province/Territory/State:
_______________________________________________________
Country:
_______________________________________________________
Postal/Zip Code:
_______________________________________________________
Email address:
_______________________________________________________
Daytime phone:
_______________________________________________________
Work Phone:
_______________________________________________________
Alternate Phone:
_______________________________________________________
Fax:
_______________________________________________________

1.3 - Consignee information (the foreign importer)

Name:
_______________________________________________________
Name of business or organization
(if applicable):
_______________________________________________________
Address (number and street):
_______________________________________________________
City:
_______________________________________________________
Province/Territory/State:
_______________________________________________________
Country:
_______________________________________________________
Postal/Zip Code:
_______________________________________________________
Email address:
_______________________________________________________
Daytime phone::
_______________________________________________________
Work Phone:
_______________________________________________________
Alternate Phone:
_______________________________________________________
Fax:
_______________________________________________________

Part 2: Description of specimens, origin & legality, and supporting documents

2.1 Description of specimens

Indicate the type of American ginseng to be exported:

□ American ginseng OR □ Goldenseal

_________________________________

Live plants
Whole roots:
DryFresh
Sliced roots:
DryFresh
Other

If other, please specify:
_______________________________________________________

Shipment Information

1. Is this shipment being sent in order to be sold in the country of import?
YesNo

2. Maximum possible quantity of ginseng exported per shipment:

_____________________________________________________ Kgs

3. Expected number of shipments to be exported during the next 6 months:

_______________________________________________________

2.2 Origin and legality

GinsengGoldenseal

Name:
_______________________________________________________
Name of business or organization
(if applicable):
_______________________________________________________

Type of business or organization:

□ grower (farmer) □ Wholesaler □ Retailer □ Other

if other, specify:
_______________________________________________________
Address (number and street):
_______________________________________________________
Post Office Box:
_______________________________________________________
City:
_______________________________________________________
Province/Territory/State:
_______________________________________________________
Country:
_______________________________________________________
Postal/Zip Code:
_______________________________________________________
Email address:
_______________________________________________________
Daytime phone:
_______________________________________________________
Alternate phone:
_______________________________________________________
Fax:
_______________________________________________________

Origin of Material Used to Grow Crop

□ Wild seed
□ Wild root
□ Cultivated seed
□ Cultivated root
□ Other

If other, please specify:
_______________________________________________________

Growing Environment

□ Woods where wild ginseng/goldenseal grows already
□ Field
□ Woods
□ Other

If other, please specify:
_______________________________________________________

Cultivation Intensity/Degree of Human Intervention

□ None

Low:

□ Seeds and/or roots are planted, no other work is done
□ Soil is perpared (rocks removed, beds prepared)
□ Plants are harvested by hand
□ Other

If other, please specify:
_______________________________________________________

High:

□ Seeds and/or roots are planted
□ Fertilizers/pesticides/fungicides are used
□ Plants are harvested with a machine
□ Other

If other, please specify:
_______________________________________________________

Origin of Live Plant or Plant Part/Product

□ Grown in Canada
□ Other

If other, please specify:
_______________________________________________________

Member of the Ontario Ginseng Association (OGGA)

□ Yes
□ No

2.3 Supporting documents

Check the pertinent boxes and submit copies of all supporting documents included with this application:

□ Annex A: Propagation Questionnaire for each grower/supplier
□ Other documents (agreements, receipts etc.)

Part 3: Current location of the specimen(s)

In which country is the specimen located?

_______________________________________________________

If the animal(s) is detained, please indicate where it is detained.

□ Canada Customs
□ Foreign Customs

Provide the Customs file number as well as all copies of the documents pertaining to the detention:

_______________________________________________________

□ I understand that it is my responsibility to be informed of all other requirements with regard to possession, care and transport of my animal(s) and have or will obtain any additional authorizations or permits required by other jurisdictions, federal government agencies, or foreign countries.

I hereby certify that I am authorized to submit this application and that the information submitted is complete and accurate to the best of my knowledge.

(sign with dark ink)
_______________________________________________________
(dd/mm/yyyy)
_______________________________________________________

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