Veterinary certificate to the EU

Part I: Details of dispatched consignment

I.1. Consignor

Name

Address

Tel.

I.2. Certificate reference number

I.2.a.

I.3. Central Competent Authority

I.4. Local Competent authority

I.5. Consignee

Name

Address

Postcode

Tel.

I.6.

I.7. Country of origin

ISO code

I.8. Region of origin

Code

I.9. Country of destination

ISO code

I.10.

I.11. Place of origin

Name

Approval/registration number

Address

I.12.

I.13. Place of loading

Address

I.14. Date of departure

I.15. Means of transport

Aeroplane Ship Railway wagon

Road vehicle Other

Identification:

Documentary references:

I.16. Entry BIP in EU

I.17.

I.18. Description of commodity

I.19. Commodity code (HS code)

I.20. Quantity

I.21. Temperature of product

Ambient Chilled Frozen

I.22. Number of packages

I.23. Seal/Container No

I.24. Type of packaging

I.25. Commodities certified as:

Human consumption

I.26.

I.27. For import or admission into EU

I.28. Identification of the commodity

Species (Scientific name)

Treatment type

Approval/registration number(s) of vessel(s) (*)

Number of packages

Net weight

COUNTRY

Fishery products transferred in third countries

II. Health information

II.a. Certificate reference number

II.b.

II.1. Public health attestation

I, the undersigned official inspector, declare that I am aware of the relevant provisions of Regulations (EC) Nos 178/2002, (EC) 852/2004, (EC) 853/2004 and (EC) 854/2004 and certify that the fishery products described above

— have been landed and unloaded hygienically from the approved/registered vessel(s) (indicate approval/registration number(s) and name of the flag Member State(s)) in compliance with the relevant requirements laid down in Chapter II of Section VIII, of Annex III to Regulation (EC) No 853/2004;

— if applicable, have been stored in approved coldstore(s) (indicate approval number(s)) in compliance with the relevant requirements of Chapter VII of Section VIII of Annex III to Regulation (EC) No 853/2004;

— if applicable, have been loaded hygienically on the approved vessel(s) (indicate approval number(s)) of the Member State(s) or third country(ies) and the name of the flag Member State(s) or third country(ies)) in compliance with the relevant requirements laid down in Chapter I and VIII of Section VIII of Annex III to Regulation (EC) No 853/2004;

— if applicable, have been loaded in a container (indicate container number) or in a truck (indicate registration number plate of truck and of trailer) or in an aeroplane (indicate the flight number) in compliance with the requirements laid down in Chapter VIII of Section VIII of Annex III to Regulation (EC) No 853/2004;

— are accompanied by the print out(s) (**) of the fishing logbook(s) or relevant parts thereof (**)

(**) Electronic format is also accepted.

Notes

Part I:

— Box reference I.7: Indicate the name of the third country of dispatch.

— Box reference I.11: Place of origin: indicate the name, address and approval number of the cold store in the third country of dispatch or, if no storage in a coldstore takes place, indicate the name and approval or registration number of the Member State flagged vessel of origin.

— Box reference I.15: Indicate the means of transport leaving the third country of dispatch. In case of freezer/reefer vessels, indicate the name of the vessel, approval number and flag State, in case of fishing vessel the registration number and flag State. If the means of transport are containers, trucks or aeroplanes the same indications provided for in the fourth indent of part II.1 must be indicated.

— Box reference I.19: Use the appropriate Harmonised System (HS) codes of the World Customs Organisation of the following headings: 0302, 0303, 0304, 0305, 0306, 0307, 0308, 1504, 1516, 1518, 1603, 1604, 1605, 2106

— Box reference I.23: Identification of container/seal number: The serial seal number must only be indicated if the seal was affixed to the container under the supervision of the competent authority issuing the certificate.

— Box reference I.28: Treatment type: Specify whether chilled, frozen or processed.

(*) includes fishing vessel, factory vessel, freezer and reefer vessel as applicable.

Official inspector

Name (in capital letters): Qualification and title:

Date: Signature:

Stamp: