E-mail: [email protected]
Tel: (808) 483-7151
ANIMAL QUARANTINE STATION y99-951 HALAWA VALLEY STREET yAIEA, HAWAII 96701
Fax: (808) 483-7161
APPLICATION NUMBER
DOG & CAT IMPORT FORM
AQS - 279
1. PLANNED DATE OF ARRIVAL:
TOTAL NUMBER of DOGS and CATS ARRIVING in HAWAII on that DATE:
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 -
9 SELECT ONLY ONE PROGRAM FROM THE LIST BELOW AND CHECK THE APPROPRIATE BOX
FEES
DAR DIRECT AIRPORT RELEASE - IN HONOLULU
DOCUMENTS RECEIVED & QUALIFIED
10 DAYS OR MORE BEORE PET ARRIVES
----------------------------------------- $ 185
5 DAY OR LESS QUARANTINE UP TO 5 DAYS
DOCUMENTS RECEIVED AND/OR QUALIFIED FROM
9 DAYS BEFORE TO 5 DAYS AFTER ARRIVAL
--------------------------------------- $ 244
EARLY QUARANTINE FOR 6 TO 119 DAYS
QUARANTINE UNTIL PET IS ELIGIBLE TO RELEASE
UNDER THE 5 DAY OR LESS PROGRAM
-----
$ 14.30 for Each Day Early
+ $244 (with limit at $1,082)
NEIGHBOR ISLAND INSPECTION PERMIT - NIIP DAR
FOR DAR ON THE ISLAND OF
HAWAII, MAUI & KAUAI
------------------------------------------------------------ $ 165
SUBSEQUENT ENTRY
------------------------------------------------------------------------------------------------------------------------------------------------------ $ 98
120 DAY QUARANTINE
-------------------------------------------------------------------------------------------------------------------------------------------------- $ 1,080
TRANSIT
PET TRAVELING THRU HAWAII TO ANOTHER DESTINATION
Call Animal Port (808) 479-1308 for stays less than 24 hours in duration
-----------------------------------------
$ 14.30 for Each
Day + $ 45
5. DOCUMENTS - SEND ALL DOCUMENTS IN TOGETHER AS A SET WITH A COMPLETED DOG AND CAT IMPORT FORM
CHECK 9ENCLOSED
Prior Rabies Vaccine Certificate Current Rabies Vaccine Certificate
PAYMENT AMOUNT
ENCLOSED
¾
Health Certificate Issued in Hawaii
(For Pets located in HI that are departing and returning)
Cashier's Check
Money Order
Health Certificate *
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 µTerms & 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)
PERSON IS:
CO-OWNER or HANDLER >
COMPANY NAME (IF HANDLER)
NAME
LAST
FIRST
M.I.
IDENTIFICATION NO.
(LAST 4 DIGITS ONLY)
TYPE
STATE
EXPIRATION DATE
CO-OWNER Date of BIRTH
CURRENT ADDRESS
NUMBER and STREET
CITY
STATE
ZIP
TELEPHONE
PRIMARY #
ALTERNATE #
COUNTRY (ADDRESS)
E-MAIL ADDRESS
HAWAII ADDRESS
OTHER E-MAIL ADDRESS
NUMBER and STREET
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)
PERSON IS:
CO-OWNER or HANDLER >
COMPANY NAME (IF HANDLER)
NAME
LAST
FIRST
M.I.
IDENTIFICATION NO.
(LAST 4 DIGITS ONLY)
TYPE
STATE
EXPIRATION DATE
CO-OWNER Date of BIRTH
CURRENT ADDRESS
NUMBER and STREET
CITY
STATE
ZIP
TELEPHONE
PRIMARY #
ALTERNATE #
COUNTRY (ADDRESS)
E-MAIL ADDRESS
HAWAII ADDRESS
OTHER E-MAIL ADDRESS
NUMBER and STREET
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)
DOG & CAT IMPORT FORM
AQS-279 VERSION 08/2019
2
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 ³HAR´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
(For use when form is presented in-person)
Date
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,
For information on how to file a complaint, go to: http://hdoa.hawaii.gov/blog/main/discriminationcomplaints/.
DOG & CAT IMPORT FORM
AQS-279 VERSION 08/2019
3
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
DIRECT AIRPORT
RELEASE
Program where dogs and cats that are
qualified may be released at the airport
after passing an entry inspection. Also
known as DAR.
All DAR requirements must be completed
including all necessary documents
received by the AQS 10 days or more
before the arrival of the animal in
Honolulu. Refer to NIIP-DAR for Direct
Airport Release on the island of Hawaii,
Maui and Kauai.
$185 Pets are not
eligible for this DAR fee
when documents are not
received 10 days or more
before arrival. (See NIIP
-
DAR fees for Direct Airport
Release fee on the island
of Hawaii, Maui and Kauai.)
5 DAY OR LESS
Program where dogs and cats remain in
quarantine for up to 5 days. This
program may be selected by the owner
or there are issues with a pet's
qualification that must be resolved
before it can be released.
Examples include: owner or authorized
person is unable to pick up pet on arrival
date; documents submitted on arrival;
documents not received 10 days or more
before arrival; animal may have
discrepancies with original
documentation, microchip number, etc.
$244
EARLY for 5 DAY
OR LESS
Program where dogs and cats arrive in
Hawaii before the date they are
qualified and eligible for the 5 DAY OR
LESS program.
Quarantine period is from 6 to 119 days
until all requirements for the 5 DAY OR
LESS program completed. For example,
pet arrives before 30 days after FAVN test
sample was received by the laboratory,
etc.
$14.30 For each day the
pet arrives early before the
date it is eligible for the 5
DAY OR LESS program
PLUS $244. Limit of
$1,082.
NEIGHBOR
ISLAND
INSPECTION
PERMIT (NIIP ±
DAR)
This permit is required to fly direct, from
out -of-state, to Kona on the island of
Hawaii, Kahului on the island of Maui
and Lihue on the island of Kauai as
DAR.
No permit is required to fly into Honolulu.
A $35 fee is assessed for requests to
change a NIIP that is already issued.
Must be DAR qualified.
$165 for a NIIP-DAR.
Additional $35 for changes
to a NIIP-DAR
SUBSEQUENT
ENTRY
Successive DAR entry(s) during the
period the FAVN test and rabies
vaccines used for an initial DAR entry
are still valid. Also known as Re-Entry.
A current health certificate required for
each entry. Lower fee applies to Honolulu
arrivals only.
$98 Fees revert when either
FAVN test or Rabies vaccine
is updated. (Subsequent
entry 5DOL = $130)
120 DAYS
QUARANTINE
Program where dogs and cats remain in
quarantine for 120 days.
For dogs and cats that do not qualify for
alternate quarantine programs such as
the 5 DAY OR LESS program.
$1,080
TERMS
DESCRIPTION
IMPORTANT INFORMATION
AQS
ANIMAL QUARANTINE STATION
UPDATED DAR
When the FAVN test is or rabies
vaccine is repeated. Also known as
Updated Re-Entry DAR.
Example: repeated because the FAVN
test or rabies vaccines used for an initial
DAR entry will expire, or has expired.
$185
FAVN Test
Rabies Fluorescent Antibody Virus
Neutralization Test. A test that
measures antibody to rabies and uses a
standard method to determine adequate
level of rabies antibodies following
vaccination.
FAVN test form submission by your vet
must indicate Hawaii as destination. Refer
to Checklists at
http://hdoa.hawaii.gov/ai/aqs/animal
-
quarantine-information-page/
DOCUMENTS
DESCRIPTION
IMPORTANT INFORMATION
Rabies Vaccination
Certificate
An official document signed by a
licensed veterinarian that identifies the
animal vaccinated and includes specific
information about the vaccine and
administration.
Original current and prior rabies
vaccination certificate required for all
programs. See program checklists for
required administration/expiration at
http://hdoa.hawaii.gov/ai/aqs/animal
-
quarantine-information-page
Health Certificate
An official document written in English
that is certified, issued and signed by a
licensed, accredited veterinarian.
Original current document required for all
programs. See program Checklists at
http://hdoa.hawaii.gov/ai/aqs/animal
-
quarantine-information-page
DOG & CAT IMPORT FORM
AQS-279 VERSION 08/2019
4
