ee AS 
Form No. 4. 
Application for Inspection of Plant Diseases (Injurious Insects) to be 
Imported (Transported). 
The undersigned, desiring to import (transport) plant diseases (injurious 
insects) of the following descriptions, hereby requests your authorities to inspect 
the same. 
AGOTeSS: ssinsessacse: Secvecasisveaaeecenasdaeiees 
Occupation .....c.ccccessecdaree 
Dated i vvecssarsersiveaces (Signature of the applicant, Seal.) 
To or : 
The Imperial Plant Quarantine The,.....,......5ub-Station, the Imperial 
Station. Plant Quarantine Station. 
Number and date of the permission from the 
Minister of Agriculture and Ci ce. 
Common and scientific names of the plant 
diseases (injurious insects.) 
Number cf cases or packages. 
Name of the port of entry for which permis- 
elon 38 given by the Minister of Agriculture 
Registered country of vessel; kinds of vessel ; 
name of vessel ; date of the vessel’s entry to 
Form No, 5. 
Application for Inspection of Plants Imported (transported) through 
Mail. 
The undersigned has imported (transported plants of the following descrip- 
tions, and hereby requests your authorities to inspect the same. 
LS GA AATESS sui siensiusdovncuis vunvineaavencevadics 
; Occupation ........... east 
Date......... ete at (Signature of the applicant, Seal.) 
To or 
The Imperial Plant Quarantine  The......,.....Sub-Station, the Imperial 
Station. Plant Quarantine Station. 
Date of the delivery of mail matter. 
Kinds of mail. 
Name and address of the sender. 
if parcel is opened or the wrappings thereof 
is! changed, the reason for the same must 
aa eae 
