Permit application to export Ontario-grown American ginseng

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.

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):
_______________________________________________________

Type of business or organization:

□ grower (farmer) □ Wholesaler □ Retailer □ Other

if other, specify:
_______________________________________________________
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:

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

Indicate the names and full addresses of ALL of the Suppliers (OGGA growers and/or wholesalers) from which you are purchasing the ginseng:
Ogga Growers List Wholesalers
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2.3 Supporting documents

Based on the suppliers provided in Section 2.2, submit copies of the applicable supporting documents as indicated in the table below:
Supplier Written attestation certifying American ginseng from OGGA growers OGGA growers list provided by wholesaler Other documents (agreements, receipts etc.)
OGGA Growers blank blank
Wholesalers

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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