Application for authorisation to issue plant passports; and Fireblight Buffer Zone status● Please complete this form in BLOCK CAPITALS and send it to your local

APHA Plant Health and Seeds Inspector, to whom any enquiries should be made.

● A new application must be submitted each year or when your authorisation details change.

PART I – APPLICANT’S DETAILS1. Name or

company name2. Full postal

address

3. E-mail address

4. PHSI Registration No. 5. Applicant’s reference

PART II – AUTHORISATION DETAILS6. Name in Full, of person who will

be responsible for inspecting plants, issuing plant passports and keeping records.

Please tick the boxes next to the plant material which you would like to plant passport.

Section A:Theseplantsrequireaplantpassportatallstagesofgrowthdowntothefinalretailer. For further details of the relevant hosts or pests and diseases consult the QPD Index which is available from your local plant heath inspector.

Host plants of Fireblight, intended for planting and pollen for pollination excluding fruit and seedsAmelanchier Chaenomeles Cotoneaster Crataegeus Cydonia Eriobotrya Malus1 Mespilus Photinia davidiana Pyracantha Pyrus1 Sorbus

Do you intend to passport these plants to a protected zone (ZP)? Yes No

Note1 – Also regulated for Apple proliferation mycoplasm and Pear decline mycoplasm respectively.

Fireblight Buffer Zone Status

Do you wish to apply for Fireblight Buffer Zone Status? Yes No If yes, please provide:

Land Parcel Reference no. or Ordinance Survey Grid Reference of your production site.

Do you wish to be excluded from the public register of Fireblight Buffer Zone nurseries?

PostcodeTelephone No. (including national dialling code)Fax No.

PHAR 3 (Vers 11.01.18) 1

Llywodraeth CymruWelsh Government

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Section A continued...

Host plants of Phytophthora ramorum, intended for planting, other than seeds and cut foliageCamellia Rhododendron2 Viburnum Phytophthora ramorum hosts originating in the USA3

Note2 – excluding Rhododendron simsii (Azalea indica). Note3– For further details of the relevant hosts or pests and diseases (P&D) consult the QPD Index. (The list of USA Phytophthora hosts differs from the UK.)

Host plants of several regulated pest and disease (P&D3) intended for planting other than seeds Actinidia Beta vulgaris Humulus lupulusPalmae3 Prunus including P. laurocerasus and P. lusitanica

Do you intend to passport Beta vulgaris to a ZP? Yes No Host plants of several regulated pest and disease (P&D3) intended for planting, including seeds and conesPinus Pseudotsuga Platanus Quercus Castanea

Do you intend to passport these plants to a ZP? Yes No

Host plants of several regulated pest and disease (P&D3), intended for planting of stolon or tuber forming species including tubers of:Solanum or their hybrids

Do you intend to passport these plants to a ZP? Yes No

Host plants of Anoplophora chinensis originating outside the EU3 intended for planting, other than seed, with a stem diameter> 1cm

Host plants of several regulated pest and disease (P&D3), excluding fruit and seedsVespris Vitis

Vitis to ZP Zanthoxylum

Fruit with leaves and peduncles of:Citrus & hybrids Fortunella & hybrids Poncirus & hybrids

Host plants of Beet Necrotic Yellow Vein Virus, intended for industrial processingBeta vulgaris to and within protected zones

Soil and unsterilised waste from:Beta vulgaris to and within protected zones

Seeds intended for plantingDolichos Gossypium Phaseolus vulgaris Beta vulgaris (Sugar and Fodder Beet seed and Vegetable seed)

Do you intend to passport these seeds to a ZP? Yes No

Fruit of (to/within protected zone):Gossypium Vitis

Section B: Aplantpassportisonlyrequiredwhenmaterialissoldtopersonsprofessionallyengagedinplantproduction.

Host plants of several regulated pest and disease (P&D3) intended for planting, excluding seeds Dendranthema Dianthus Fragaria Pelargonium Rubus

Host plants of Xylella fastidiosa intended for planting, other than seed. See appendix 'PHAR3 - Xylella fastidiosa'.

PHAR 3 (Vers 11.01.18)

Ulmus

Casimiroa Citrus & hybrids Clausena Choisya

Eucalyptus to ZPFortunella & hybrids

Poncirus & hybridsMurraya

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Section B continued...

Host plants of Poplar Rust and/or Canker Stain intended for planting, excluding seeds

Abies4 Larix4 Picea4 Populus4 Tsuga Do you intend to passport these plants to a ZP? Note 4 – Where ZP status is appropriate plant passport is required down to final retailer.

Host plants of Tomato Spotted Wilt Virus (TSWV) intended for planting, excluding seedsApium graveolens Capsicum anuum Cucumis melo Nicotiana tabacum

Lactuca sativa Solanum lycopersicum Impatiens x New Guinea Hybrids Note: These plants must be free from TSWV at the point of marketing, but site freedom is not required.

Solanaceae plants, hosts of several P&D3, intended for planting but excluding seeds and other plants of stolon or tuber forming species of Solanum tuberosum.

Herbaceous plants including vegetable plants (host to Liriomyza huidobrensis & trifolii,) other than plants of the family Gramineae intended for planting, and excluding bulbs, corms, rhizomes, seeds and tubers. A list of Herbaceous species can be found in the Plant Health Guide to Plant Passporting which is available on the Gov.UK website.

Host plants of Radophilus similis, rooted or with growing media attached or associated, of:Araceae Musaceae Persea spp Marantaceae Streliziaceae

Plants intended for planting of: Allium porrum

Seeds and Bulbs intended for planting of: Allium cepa Allium ascalonicum Allium schoenoprasum Note – These plants must be free from Ditylenchus dipsaci at the point of marketing, but site freedom is not required.

Seeds intended for plantingHelianthus annuus5 Medicago sativa Phaseolus4 Solanum lycopersicum5

Seeds of Mangifera originating 3rd countries Note5: Where ZP status is appropriate a plant passport is not required down to the final retailer.

Plants intended for planting and grown in soil, of the following genera Allium porrum, Asparagus officinalis, Beta vulgaris, Brassica pp, Fragaria

Hosts plants of Bemisia tabaci intended for planting, excluding seeds

Bulbs, intended for planting and grown in soil of the following genera: Allium ascolonicium, Allium cepa, Dahlia, Gladiolus, Hyacinthus, Iris, Lilium, Narcissus, Tulipa

And these items require a plant passport, but do not require site freedom from Ditylenchus spp.

Camassia Chionodoxa Crocus flavus cv 'Golden Yellow'

Galanthus Galtonia candicans Hyacinthus Iris

Ismene Muscari Ornithogalum Puschkinia

Scilla Tigridia

Miniature cultivars and their hybrids of the genus Gladiolus

PHAR 3 (Vers 11.01.18)

Note. The UK is a protected zone (ZP) for Bemisia tabaci (Tobacco Whitefly), so you are required to include a ZP statement in your Plant Passport no. ie ZPa2

Dipladenia Hibiscus Mandevilla Poinsettia Nerium oleanderBegonia (excluding corms, seeds and tubers)

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PART III – PLANTS GROWN IN SOIL7. Do you grow plants in soil? Yes No (If no go to Part IV)

a. Are the plants or bulbs going to be planted on the same place of production as that on which theyraised? Yes No

b. Are the plants for planting going to be subject to a PCN disinfestations process before being moved,such that there is no risk of PCN being spread? Yes No

c. Are the harvested bulbs or plants for planting going to be washed or brushed practically free of soilsuch that there is no risk of PCN being spread? Yes No

d. Does the field on which the plants or bulbs are to be grown have a history of Potato cyst nematode(PCN) freedom during the last 12 years based on the results of testing? Yes No

e. Does the field on which the plants are to be grown have a known cropping history in which noPotatoes, Peppers, Aubergines or Tomatoes have been grown in the field in the last 12 years?

Yes No ● If you answered ‘yes’ to any one of the above 5 questions – Your obligations in regard of the PCN Directive

and plant passporting are fulfilled and your application can proceed.● If you did not answer ‘yes’ to any one of the 5 questions above – PHSI will need to take a soil sample

before your application can proceed.

● Is there any history of Potato Ring Rot (Clavibacter michiganensis ssp sepedonicus) or Potato WartDisease (Synchitrium endobioticum) on site? Yes No

Field Plans are required for all field grown crops. Please show the growing area, marking where the different genera and varieties of plants will be grown. Separate plans are needed for each site including the full site name and address

Field Plan attached? Yes No

PART IV – DECLARATION● I declare that the information that I have given on this form is correct.● I understand that authorisation to issue plant passports will impose certain obligations in England under the

Plant Health (England) Order 2015 (as amended) and in Wales, under the Plant Health (Wales) Order2006 and the Plant Health (Phytophthora ramorum) (Wales) Order 2006 and that certain officialinspections will be made in order to confirm those obligations are met which will be charged for accordingto the fees schedule on the Gov.UK website.

● Any invoices for payment in connection with this application should be sent to me and I understand thatI will be liable to pay the sums due.

Signature Date

Name in CompanyBLOCK CAPITALS Position

Please note that further information is contained in the ‘Plant Health Guide to Plant Passporting and Marketing Requirements’ available on the Gov.UK website. Information on legislation and inspection fees is also available through this site.

PHAR 3 (Vers 11.01.18)

FAIR PROCESSING NOTICEDefra, the Scottish Government, the Welsh Government and the Food Standards Agency are Data Controllers in Common in respect of personal data processed by the Animal and Plant Health Agency (APHA). For the purposes and usage of the data by APHA and the data sharing arrangements, please see the full Personal Information Charter on the APHA .Gov.uk website: A hard copy of this can be provided if required; please contact your local APHA Field Service office. APHA will not permit any unwarranted breach of confidentiality or act in contravention of their obligations under the Data Protection Act 1998. APHA is an Executive Agency of the Department for Environment, Food and Rural Affairs and also works on behalf of the Scottish Government, Welsh Government and Food Standards Agency.

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