Form HP-11 "Domestic Seed/Propagule Request Form" - Hawaii

What Is Form HP-11?

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 September 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 HP-11 by clicking the link below or browse more documents and templates provided by the Hawaii Department of Agriculture.

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Download Form HP-11 "Domestic Seed/Propagule Request Form" - Hawaii

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HP-11
9/2019
Hawaii Department of Agriculture
Licensee:
Industrial Hemp Pilot Program
Domestic Seed/Propagule Request Form
License no:
Email:
When to use this form:
• Use this form if requesting to use genetics coming from:
Phone:
(1) A licensed grower on another island.
(2) A licensed grower in another state.
• Licensees shall submit the Domestic Seed/Propagule Request form and all required attachments to
HDOA
at least three (3) weeks in advance of any proposed purchase or transfer of materials.
• Only one seed source is allowed per form; submit a separate form for each source.
Seed, propagules, or plants that are not reviewed and approved by HDOA are prohibited from use in
Hawaii. Any Licensee found using seed, propagules, or plants not reviewed and approved by HDOA may
be subject to revocation of their license, in addition to any civil or criminal liabilities that may exist.
Requirements
Compliance with Federal THC Threshold Licensees must use only seed, propagules, or plants that are
demonstrated to conform to the Federal threshold of 0.3% delta-9-tetrahydrocannabinol
concentration on a dry weight basis as measured by post-decarboxylation or other similarly reliable
methods. Documentation of measured delta-9-tetrahydrocannabinol concentration shall be submitted
to HDOA with this request. Documentation shall also include the name, address, email, and telephone
number of both the lab, and the seed source. Test results from states that utilize different timing and
methods of sampling and/or testing than HDOA’s program should include a compliant harvest-time or
post-harvest test result of mature flower material.
Intellectual Property Licensees are prohibited from using seed, propagules, or plants that are
protected by intellectual property rights without a license or written permission from the property
owner. A copy of any license or permission from the property owner shall be provided in writing to
HDOA upon request. The Department shall not approve a Domestic Seed/Propagule Request form
unless the Licensee affirms in writing that the planned activities will not infringe on the intellectual
property rights of any person.
Approved Sources Any seed, propagules, or plants used must originate from a current legal hemp
operation, authorized by the state of origin and in compliance with federal laws. It is the Licensee’s
responsibility to ensure that the purchase and transfer of any industrial hemp material complies with all
applicable laws and regulations, including federal laws and regulations, the laws and policies of the
originating state, and the laws and policies of Hawaii.
HP-11
9/2019
Hawaii Department of Agriculture
Licensee:
Industrial Hemp Pilot Program
Domestic Seed/Propagule Request Form
License no:
Email:
When to use this form:
• Use this form if requesting to use genetics coming from:
Phone:
(1) A licensed grower on another island.
(2) A licensed grower in another state.
• Licensees shall submit the Domestic Seed/Propagule Request form and all required attachments to
HDOA
at least three (3) weeks in advance of any proposed purchase or transfer of materials.
• Only one seed source is allowed per form; submit a separate form for each source.
Seed, propagules, or plants that are not reviewed and approved by HDOA are prohibited from use in
Hawaii. Any Licensee found using seed, propagules, or plants not reviewed and approved by HDOA may
be subject to revocation of their license, in addition to any civil or criminal liabilities that may exist.
Requirements
Compliance with Federal THC Threshold Licensees must use only seed, propagules, or plants that are
demonstrated to conform to the Federal threshold of 0.3% delta-9-tetrahydrocannabinol
concentration on a dry weight basis as measured by post-decarboxylation or other similarly reliable
methods. Documentation of measured delta-9-tetrahydrocannabinol concentration shall be submitted
to HDOA with this request. Documentation shall also include the name, address, email, and telephone
number of both the lab, and the seed source. Test results from states that utilize different timing and
methods of sampling and/or testing than HDOA’s program should include a compliant harvest-time or
post-harvest test result of mature flower material.
Intellectual Property Licensees are prohibited from using seed, propagules, or plants that are
protected by intellectual property rights without a license or written permission from the property
owner. A copy of any license or permission from the property owner shall be provided in writing to
HDOA upon request. The Department shall not approve a Domestic Seed/Propagule Request form
unless the Licensee affirms in writing that the planned activities will not infringe on the intellectual
property rights of any person.
Approved Sources Any seed, propagules, or plants used must originate from a current legal hemp
operation, authorized by the state of origin and in compliance with federal laws. It is the Licensee’s
responsibility to ensure that the purchase and transfer of any industrial hemp material complies with all
applicable laws and regulations, including federal laws and regulations, the laws and policies of the
originating state, and the laws and policies of Hawaii.
HP-11
9/2019
Instructions
1) Attach independent third-party test results for each variety/strain of the plant, documenting the post
decarboxylation delta-9-THC concentration of 0.3% or less on a dry weight basis. Provide a harvest
time or post-harvest test of flower material only. Include contact information for the laboratory.
Test results must also identify the seed source and varietal name.
Check the following box to affirm that the test results attached are representative of the genetics
requested below. ☐
2) Attach documentation verifying the source as a current legal hemp operation in the state of origin
(registration, permit, license, etc.), with contact information included.
3) Complete the seed and/or plant variety information in the table below. Attach additional pages
if necessary (remember that a separate form must be submitted for each source).
NOTE: Participants are responsible for all seed costs including shipping, etc.
Variety/Strain
Quantity
Seed Source:
of Seed and/or
(weight in lbs. or
Number of
Company Name
Form of Material
Propagules
number
Packages
and State
Requested
Ex: 123 Hemp, CO
Hemp32
seed
1,500 lbs.
30 x 50 lb. bags
Ex: Hempy Green, OR
CBD54
seed
100 seeds
1 envelope
4) Check the following box to affirm that the activities planned under your research project with the
above described seeds/propagules will not infringe on the intellectual property rights of any person
or business. ☐
Date:
I hereby certify under penalty of perjury that all the information contained in this
application, including any attachments hereto, is true and complete. I understand that
any misrepresentation is grounds for denial or subsequent revocation of a license.
Signing Authority on License
:
(if business)
Signature:
HP-11
9/2019
Email Completed form to:
hemp@hawaii.gov
Or mail it to:
Hawaii Department of Agriculture
Industrial Hemp Pilot Program
1851 Auiki St.
Honolulu, HI
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