Form AQS-279 "Dog & Cat Import Form" - Hawaii

What Is Form AQS-279?

This is a legal form that was released by the Hawaii Department of Agriculture - a government authority operating within Hawaii. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on August 1, 2019;
  • The latest edition provided by the Hawaii Department of Agriculture;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form AQS-279 by clicking the link below or browse more documents and templates provided by the Hawaii Department of Agriculture.

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Download Form AQS-279 "Dog & Cat Import Form" - Hawaii

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E-mail: rabiesfree@Hawaii.Gov
Tel: (808) 483-7151
ANIMAL QUARANTINE STATION 99-951 HALAWA VALLEY STREET AIEA, HAWAII 96701
Fax: (808) 483-7161
DOG & CAT IMPORT FORM
APPLICATION NUMBER
AQS - 279
TOTAL NUMBER of DOGS and CATS ARRIVING in HAWAII on that DATE:
1. PLANNED DATE OF ARRIVAL:
COMPLETE A "DOG & CAT IMPORT FORM" AQS-279 FOR EACH PET
2. PET INFORMATION
PET NAME
SPECIES
COUNTRY FROM
AGE
MICROCHIP NUMBER
BREED
SEX SPAY/NEUTERED?
COLOR
OTHER MICROCHIP NUMBER
YES
NO
AIRPORT FLYING TO (*KOA, OGG & LIH REQUIRE A NIIP - SEE SECTION 4)
OTHER MICROCHIP NUMBER
HONOLULU-HNL
KONA-KOA*
KAHULUI-OGG*
LIHUE-LIH*
3. PRIMARY OWNER INFORMATION - LEGAL OWNER OF PET REQUIRED (Authorized Handler Information Use Section 7)
NAME
LAST
FIRST
M.I.
IDENTIFICATION NO.
(LAST 4 DIGITS ONLY) TYPE
STATE
EXPIRATION DATE
OWNER DATE of BIRTH
NUMBER and STREET
CURRENT ADDRESS
CITY
STATE
ZIP
TELEPHONE
PRIMARY #
ALTERNATE #
COUNTRY (ADDRESS)
E-MAIL ADDRESS
OTHER E-MAIL ADDRESS
NUMBER and STREET
HAWAII ADDRESS
CITY
ISLAND
ZIP
OWNER GROUP
Civilian
Army
Navy
Marines
Coast Guard
Air Force
Other
4. PROGRAM YOU ARE APPLYING FOR
-REFER TO TERMS AND INFORMATION ON PAGE 4 FOR MORE DETAILS -
SELECT ONLY ONE PROGRAM FROM THE LIST BELOW AND CHECK THE APPROPRIATE BOX
FEES
DOCUMENTS RECEIVED & QUALIFIED
DAR DIRECT AIRPORT RELEASE - IN HONOLULU
----------------------------------------- $ 185
10 DAYS OR MORE BEORE PET ARRIVES
DOCUMENTS RECEIVED
QUALIFIED FROM
AND/OR
5 DAY OR LESS QUARANTINE UP TO 5 DAYS
--------------------------------------- $ 244
9 DAYS BEFORE TO 5 DAYS AFTER ARRIVAL
QUARANTINE UNTIL PET IS ELIGIBLE TO RELEASE
$ 14.30 for Each Day Early
EARLY
QUARANTINE FOR 6 TO 119 DAYS
-----
UNDER THE 5 DAY OR LESS PROGRAM
+ $244 (with limit at $1,082)
FOR DAR ON THE ISLAND OF
NEIGHBOR ISLAND INSPECTION PERMIT - NIIP DAR
------------------------------------------------------------ $ 165
HAWAII, MAUI & KAUAI
SUBSEQUENT ENTRY
------------------------------------------------------------------------------------------------------------------------------------------------------ $ 98
120 DAY QUARANTINE
-------------------------------------------------------------------------------------------------------------------------------------------------- $ 1,080
PET TRAVELING THRU HAWAII TO ANOTHER DESTINATION
$ 14.30 for Each
TRANSIT
-----------------------------------------
Call Animal Port (808) 479-1308 for stays less than 24 hours in duration
Day + $ 45
5. DOCUMENTS - SEND ALL DOCUMENTS IN TOGETHER AS A SET WITH A COMPLETED DOG AND CAT IMPORT FORM
CHECK
ENCLOSED
PAYMENT AMOUNT
Prior Rabies Vaccine Certificate
Current Rabies Vaccine Certificate
ENCLOSED
Money Order
Health Certificate Issued in Hawaii
Cashier's Check
Health Certificate *
(For Pets located in HI that are departing and returning)
The original health certificate may be submitted upon arrival in Hawaii to State Inspectors if not submitted w/ this form
Except for the original health certificate or Official Govt. Issued Health Certificate, all documents must be received by the Animal
Quarantine Station along with this completed form no less than 10 days before arrival for direct airport release.
Official Govt. Issued Health Certificate* For Exempt Areas:
Guam
Australia
New Zealand
British Isles
E-mail: rabiesfree@Hawaii.Gov
Tel: (808) 483-7151
ANIMAL QUARANTINE STATION 99-951 HALAWA VALLEY STREET AIEA, HAWAII 96701
Fax: (808) 483-7161
DOG & CAT IMPORT FORM
APPLICATION NUMBER
AQS - 279
TOTAL NUMBER of DOGS and CATS ARRIVING in HAWAII on that DATE:
1. PLANNED DATE OF ARRIVAL:
COMPLETE A "DOG & CAT IMPORT FORM" AQS-279 FOR EACH PET
2. PET INFORMATION
PET NAME
SPECIES
COUNTRY FROM
AGE
MICROCHIP NUMBER
BREED
SEX SPAY/NEUTERED?
COLOR
OTHER MICROCHIP NUMBER
YES
NO
AIRPORT FLYING TO (*KOA, OGG & LIH REQUIRE A NIIP - SEE SECTION 4)
OTHER MICROCHIP NUMBER
HONOLULU-HNL
KONA-KOA*
KAHULUI-OGG*
LIHUE-LIH*
3. PRIMARY OWNER INFORMATION - LEGAL OWNER OF PET REQUIRED (Authorized Handler Information Use Section 7)
NAME
LAST
FIRST
M.I.
IDENTIFICATION NO.
(LAST 4 DIGITS ONLY) TYPE
STATE
EXPIRATION DATE
OWNER DATE of BIRTH
NUMBER and STREET
CURRENT ADDRESS
CITY
STATE
ZIP
TELEPHONE
PRIMARY #
ALTERNATE #
COUNTRY (ADDRESS)
E-MAIL ADDRESS
OTHER E-MAIL ADDRESS
NUMBER and STREET
HAWAII ADDRESS
CITY
ISLAND
ZIP
OWNER GROUP
Civilian
Army
Navy
Marines
Coast Guard
Air Force
Other
4. PROGRAM YOU ARE APPLYING FOR
-REFER TO TERMS AND INFORMATION ON PAGE 4 FOR MORE DETAILS -
SELECT ONLY ONE PROGRAM FROM THE LIST BELOW AND CHECK THE APPROPRIATE BOX
FEES
DOCUMENTS RECEIVED & QUALIFIED
DAR DIRECT AIRPORT RELEASE - IN HONOLULU
----------------------------------------- $ 185
10 DAYS OR MORE BEORE PET ARRIVES
DOCUMENTS RECEIVED
QUALIFIED FROM
AND/OR
5 DAY OR LESS QUARANTINE UP TO 5 DAYS
--------------------------------------- $ 244
9 DAYS BEFORE TO 5 DAYS AFTER ARRIVAL
QUARANTINE UNTIL PET IS ELIGIBLE TO RELEASE
$ 14.30 for Each Day Early
EARLY
QUARANTINE FOR 6 TO 119 DAYS
-----
UNDER THE 5 DAY OR LESS PROGRAM
+ $244 (with limit at $1,082)
FOR DAR ON THE ISLAND OF
NEIGHBOR ISLAND INSPECTION PERMIT - NIIP DAR
------------------------------------------------------------ $ 165
HAWAII, MAUI & KAUAI
SUBSEQUENT ENTRY
------------------------------------------------------------------------------------------------------------------------------------------------------ $ 98
120 DAY QUARANTINE
-------------------------------------------------------------------------------------------------------------------------------------------------- $ 1,080
PET TRAVELING THRU HAWAII TO ANOTHER DESTINATION
$ 14.30 for Each
TRANSIT
-----------------------------------------
Call Animal Port (808) 479-1308 for stays less than 24 hours in duration
Day + $ 45
5. DOCUMENTS - SEND ALL DOCUMENTS IN TOGETHER AS A SET WITH A COMPLETED DOG AND CAT IMPORT FORM
CHECK
ENCLOSED
PAYMENT AMOUNT
Prior Rabies Vaccine Certificate
Current Rabies Vaccine Certificate
ENCLOSED
Money Order
Health Certificate Issued in Hawaii
Cashier's Check
Health Certificate *
(For Pets located in HI that are departing and returning)
The original health certificate may be submitted upon arrival in Hawaii to State Inspectors if not submitted w/ this form
Except for the original health certificate or Official Govt. Issued Health Certificate, all documents must be received by the Animal
Quarantine Station along with this completed form no less than 10 days before arrival for direct airport release.
Official Govt. Issued Health Certificate* For Exempt Areas:
Guam
Australia
New Zealand
British Isles
MICROCHIP NUMBER
OWNER: LAST NAME
PET: NAME
APPLICATION NUMBER
6. SUBMITTING DOCUMENTS - SEND ALL DOCUMENTS IN TOGETHER AS A SET WITH A COMPLETED DOG AND CAT IMPORT FORM
MAIL TO: ANIMAL QUARANTINE STATION, 99-951 HALAWA VALLEY STREET, AIEA, HAWAII 96701
Pets will be assessed the higher $244 5-Day Or Less fee rather than $185 for DAR if all required documents were not received 10 days or more
before arrival; documents are presented for review on arrival; or pets are not picked up the same day when arriving during normal inspection
hours.
SUBSEQUENT ENTRY: If pet is entering Hawaii again refer to Terms & Information Pet must meet requirements for this lower Subsequent
Entry fee. Fees revert when either the FAVN test or Rabies vaccine is updated. Subsequent entry DAR is $98, Subsequent entry 5DOL = $130
DOGS and CATS LOCATED in HAWAII that will be departing and returning for the 5-day-or-less program must also submit the original health
certificate issued in Hawaii used for departure that contains the pet's Hawaii address and date of departure from Hawaii to qualify under the
Hawaii pet program.
7. CO - OWNER or AUTHORIZED HANDLER/AGENT INFORMATION (CO-OWNERS ARE ALSO RECOGNIZED AS LEGAL OWNERS)
COMPANY NAME (IF HANDLER)
PERSON IS:
>
CO-OWNER or
HANDLER
NAME
LAST
FIRST
M.I.
IDENTIFICATION NO.
(LAST 4 DIGITS ONLY) TYPE
STATE
EXPIRATION DATE
CO-OWNER Date of BIRTH
NUMBER and STREET
CURRENT ADDRESS
CITY
STATE
ZIP
TELEPHONE
PRIMARY #
ALTERNATE #
COUNTRY (ADDRESS)
E-MAIL ADDRESS
OTHER E-MAIL ADDRESS
NUMBER and STREET
HAWAII ADDRESS
CITY
ZIP
OWNER GROUP
Civilian
Army
Navy
Marines
Coast Guard
Air Force
Other
7B. CO - OWNER or AUTHORIZED HANDLER/AGENT INFORMATION (CO-OWNERS ARE ALSO RECOGNIZED AS LEGAL OWNERS)
COMPANY NAME (IF HANDLER)
PERSON IS:
>
CO-OWNER or
HANDLER
NAME
LAST
FIRST
M.I.
IDENTIFICATION NO.
(LAST 4 DIGITS ONLY) TYPE
STATE
EXPIRATION DATE
CO-OWNER Date of BIRTH
NUMBER and STREET
CURRENT ADDRESS
CITY
STATE
ZIP
TELEPHONE
PRIMARY #
ALTERNATE #
COUNTRY (ADDRESS)
E-MAIL ADDRESS
OTHER E-MAIL ADDRESS
NUMBER and STREET
HAWAII ADDRESS
CITY
ZIP
OWNER GROUP
Civilian
Army
Navy
Marines
Coast Guard
Air Force
Other
8.
AUTHORIZED VISITORS: (INDIVIDUAL YOU AUTHORIZE TO VISIT YOUR PET IN QUARANTINE BUT DOES NOT HAVE AUTHORITY TO
ACT ON YOUR BEHALF. MUST BE 18 YEARS OF AGE OR OLDER TO VISIT ALONE W/O OWNER OR AUTHORIZED ADULT.)
NAME: LAST
FIRST
M.I.
I.D. NUMBER (LAST 4 DIGITS)
2
DOG & CAT IMPORT FORM
AQS-279 VERSION 08/2019
MICROCHIP NUMBER
OWNER: LAST NAME
PET: NAME
APPLICATION NUMBER
APPROVED ANIMAL HOSPITAL (NOT REQUIRED FOR DIRECT AIRPORT RELEASE)
Owner(s) of pets that will be in quarantine more than a few days must register their pet at an approved veterinary hospital IN CASE
OF EMERGENCY when it is determined that your pet requires hospitalization. Owners must also provide the Animal Quarantine
Station with proof of registration. Hospitals will not accept or treat unregistered pets. Refer to the list of approved animal hospitals.
9. ACKNOWLEDGEMENT and AGREEMENT
I am the legal owner of the animal or animals represented on the Dog and Cat Import Form and associated documents
with this application. I intend to enter the above-described animal into the State of Hawaii in compliance with the
provisions of Hawaii Administrative Rules HAR Chapter 4-29. I hereby agree to pay to the Department of Agriculture,
in full at the time the animal enters Hawaii, or enters quarantine in Hawaii, whichever happens first, the total amount of
fees prescribed by those Rules for the required program. A summary of the fees is as follows: $185 for direct airport
release; $244 for 5-day-or-less quarantine; $165 for Neighbor Island Inspection Permit; or $1,080 for 120-day
quarantine. The prescribed fee for animals transiting to other destinations is $30 registration fee; $15 health record fee;
plus $14.30 per day. In addition, a fee will be assessed for animals that remain in quarantine beyond the scheduled
release date, at the rate of $17.80 per day. Arriving before the eligible date qualified for direct airport release and 5-day-
or-less quarantine will result in charges of $14.30 each day before qualified plus additional program fees. Any refund of
fees will be in accordance with HAR § 4-29-17. Allow six to eight weeks after the animal s release from quarantine for
any refunds.
I further agree to pay, prior to release of the animal, for any additional owner-approved services, and for any services
deemed necessary by the station veterinarian to ensure the health and safety of the animal including diagnostics and
treatment by private veterinary hospitals. I will immediately notify the animal quarantine station in writing of any changes
in address or contact information during the time the animal is in the custody of the HDOA; and I acknowledge that any
animal remaining in quarantine ninety (90) days or more after the scheduled release date, for any reason, shall be
deemed abandoned and may be disposed of at the discretion of the animal quarantine manager, including placement
by adoption or euthanasia, without further notice and without liability on the part of the State or the Department of
Agriculture. I acknowledge that the fees and requirements above are a summary of the exact requirements that are
established by HAR Chapter 4-29, and that those rules and applicable law govern all aspects of the animal quarantine
program. Additional summary information and references are posted at hawaii.gov/hdoa/ai/aqs/info.
I declare under penalty of law that the foregoing is true and correct. By signing below, I acknowledge and agree to
the terms and conditions of this agreement.
Signature of Primary Owner
Date
Print Name
Witness: HDOA Employee or Agent
Date
(For use when form is presented in-person)
HDOA is committed to maintaining an environment free from discrimination, retaliation, or harassment on the basis of race, color, sex, sexual
orientation, religion, national origin, age, or disability with respect to any employment, program or activity.
Should you feel you have been discriminated against, please contact the HDOA Title VI Coordinator at 1428 S. King Street, Honolulu, HI 96814,
(808) 973-9560 or via email at hdoa.info@hawaii.gov.
For information on how to file a complaint, go to: http://hdoa.hawaii.gov/blog/main/discriminationcomplaints/.
3
DOG & CAT IMPORT FORM
AQS-279 VERSION 08/2019
MICROCHIP NUMBER
OWNER: LAST NAME
PET: NAME
APPLICATION NUMBER
10. TERMS AND INFORMATION
FOR ALL FORMS, PROGRAM CHECKLISTS AND DETAILS SEE:
http://hdoa.hawaii.gov/ai/aqs/animal-quarantine-information-page
PROGRAMS
DESCRIPTION
IMPORTANT INFORMATION
FEES
$185
Pets are not
All DAR requirements must be completed
eligible for this DAR fee
including all necessary documents
Program where dogs and cats that are
when documents are not
received by the AQS 10 days or more
DIRECT AIRPORT
qualified may be released at the airport
received 10 days or more
before the arrival of the animal in
RELEASE
after passing an entry inspection. Also
before arrival. (See NIIP-
Honolulu. Refer to NIIP-DAR for Direct
known as DAR.
DAR fees for Direct Airport
Airport Release on the island of Hawaii,
Release fee on the island
Maui and Kauai.
of Hawaii, Maui and Kauai.)
Examples include: owner or authorized
Program where dogs and cats remain in
person is unable to pick up pet on arrival
quarantine for up to 5 days. This
date; documents submitted on arrival;
program may be selected by the owner
5 DAY OR LESS
documents not received 10 days or more
$244
or there are issues with a pet's
before arrival; animal may have
qualification that must be resolved
discrepancies with original
before it can be released.
documentation, microchip number, etc.
Quarantine period is from 6 to 119 days
$14.30 For each day the
Program where dogs and cats arrive in
until all requirements for the 5 DAY OR
pet arrives early before the
EARLY for 5 DAY
Hawaii before the date they are
LESS program completed. For example,
date it is eligible for the 5
OR LESS
qualified and eligible for the 5 DAY OR
pet arrives before 30 days after FAVN test
DAY OR LESS program
LESS program.
sample was received by the laboratory,
PLUS $244. Limit of
etc.
$1,082.
NEIGHBOR
This permit is required to fly direct, from
No permit is required to fly into Honolulu.
$165 for a NIIP-DAR.
ISLAND
out -of-state, to Kona on the island of
A $35 fee is assessed for requests to
INSPECTION
Hawaii, Kahului on the island of Maui
change a NIIP that is already issued.
Additional $35 for changes
PERMIT (NIIP
and Lihue on the island of Kauai as
Must be DAR qualified.
to a NIIP-DAR
DAR)
DAR.
$98 Fees revert when either
Successive DAR entry(s) during the
A current health certificate required for
FAVN test or Rabies vaccine
SUBSEQUENT
period the FAVN test and rabies
each entry. Lower fee applies to Honolulu
is updated. (Subsequent
ENTRY
vaccines used for an initial DAR entry
arrivals only.
entry 5DOL = $130)
are still valid. Also known as Re-Entry.
For dogs and cats that do not qualify for
120 DAYS
Program where dogs and cats remain in
alternate quarantine programs such as
$1,080
QUARANTINE
quarantine for 120 days.
the 5 DAY OR LESS program.
TERMS
DESCRIPTION
IMPORTANT INFORMATION
AQS
ANIMAL QUARANTINE STATION
When the FAVN test is or rabies
Example: repeated because the FAVN
UPDATED DAR
vaccine is repeated. Also known as
test or rabies vaccines used for an initial
$185
Updated Re-Entry DAR.
DAR entry will expire, or has expired.
Rabies Fluorescent Antibody Virus
FAVN test form submission by your vet
Neutralization Test. A test that
must indicate Hawaii as destination. Refer
measures antibody to rabies and uses a
FAVN Test
to Checklists at
standard method to determine adequate
http://hdoa.hawaii.gov/ai/aqs/animal-
level of rabies antibodies following
quarantine-information-page/
vaccination.
DOCUMENTS
DESCRIPTION
IMPORTANT INFORMATION
Original current and prior rabies
An official document signed by a
vaccination certificate required for all
licensed veterinarian that identifies the
Rabies Vaccination
programs. See program checklists for
animal vaccinated and includes specific
Certificate
required administration/expiration at
information about the vaccine and
http://hdoa.hawaii.gov/ai/aqs/animal-
administration.
quarantine-information-page
Original current document required for all
An official document written in English
programs. See program Checklists at
Health Certificate
that is certified, issued and signed by a
http://hdoa.hawaii.gov/ai/aqs/animal-
licensed, accredited veterinarian.
quarantine-information-page
4
DOG & CAT IMPORT FORM
AQS-279 VERSION 08/2019
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