Part I: Details of consignment presented

EUROPEAN UNION

Intra trade certificate

I.1. Consignor

Name

Address

Postal code

I.2. Certificate reference No

I.2.a. Local reference No

I.3. Central competent authority

I.4. Local competent authority

I.5. Consignee

Name

Address

Postal code

I.6. No(s) of related original certificates

No(s) of accompanying documents

I.7.

I.8. Country of origin

ISO code

I.9. Region of origin

Code

I.10. Country of destination

ISO code

I.11. Region of destination

Code

I.12. Place of origin

Holding

Name

Approval/registration number

Address

Postal code

I.13. Place of destination

Holding

Establishment

Approved body

Name

Approval number

Address

Postal code

I.14. Place of loading

Postal code

I.15. Date and time of departure

I.16. Means of transport

Aeroplane

Ship

Railway wagon

Road vehicle

Other

Identification

I.17. Transporter

Name

Approval number

Address

Postal code

I.18. Description of commodity

I.19. Commodity code (CN code)

I.20. Quantity

I.21.

I.22. Number of packages

I.23. Seal/Container No

I.24.

I.25. Commodities certified for:

Breeding

Production

Artificial reproduction

Slaughter

Pets

Approved body

I.26. Transit through third country

Third country

ISO code

Exit point

Code

Entry point

BIP No

I.27. Transit through Member States

Member State

ISO code

Member State

ISO code

Member State

ISO code

I.28. Export

Third country

ISO code

Exit point

Code

I.29. Estimated journey time

I.30. Route plan

Yes

No

I.31. Identification of the commodities

Species

(scientific name)

Identification system

Identification number

Passport number

Sex

Age

Quantity

Part II: Certification

EUROPEAN UNION

92/65 EI Animals from holdings (ungulates, birds (2), lagomorphs, dogs, cats and ferrets)

II. Health information

II.a. Certificate reference No

II.b.

I, the undersigned official veterinarian (1)/veterinarian responsible for the holding of origin and approved by the competent authority (1) certify that:

II.1. the animals described in Box I.31 comply with the conditions of Article 4 of Council Directive 92/65/EEC and at the time of inspection were fit to be transported for the intended journey in accordance with the provisions of Council Regulation (EC) No 1/2005.

(1) either [II.2. the ruminant(s) (1)/suidae (1) other than that/those covered by Council Directive 64/432/EEC (1) or Council Directive 91/68/EEC (1)

(a) belong(s) to the species …;

(b) at the time of examination, do(does) not show any clinical sign of any disease to which it/they is/are susceptible;

(c) come(s) from an officially tuberculosis-free (1)/officially brucellosis-free (1) or brucellosis-free (1) herd (1)/holding (1) not subject to swine fever restrictions or from a holding where it/they was/were subjected with negative results to the tests laid down in Article 6(2)(b) (1)/the test laid down in Article 6(3)(d) (1) of Council Directive 92/65/EEC.]

(1) (2) or [II.2. the birds other than those referred to in Council Directive 2009/158/EC

(a) at the time of examination do not show any clinical sign of any disease to which they are susceptible;

(b) satisfy the requirements of Article 7 of Council Directive 92/65/EEC;

(c) conform to Commission Decision 2007/598/EC and were vaccinated against avian influenza on … (date) with vaccine … (name) and come from a holding on which vaccination against avian influenza was carried out during the past 12 months.]

(1) or [II.2. the lagomorphs

(a) at the time of examination do not show any clinical signs of disease to which they are susceptible;

(b) satisfy the requirements of Article 9 of Council Directive 92/65/EEC.]

(1) or [II.2. the dogs

(a) at the time of examination by a veterinarian authorised by the competent authority within 48 hours prior to the time of dispatch, showed no signs of diseases;

(b) are marked in accordance with Article 17(1) of Regulation (EU) No 576/2013 of the European Parliament and of the Council;

(1) either [(c) were at least 12 weeks old at the time of vaccination against rabies and at least 21 days have elapsed since the completion of the primary anti-rabies vaccination carried out in accordance with the validity requirements set out in Annex III to Regulation (EU) No 576/2013 of the European Parliament and of the Council, and any subsequent revaccination was carried out within the period of validity of the preceding vaccination];

(1) or [(c) are less than 12 weeks old and have not received an anti-rabies vaccination, or are between 12 and 16 weeks old and have received an anti-rabies vaccination, but 21 days at least have not elapsed since the completion of the primary vaccination against rabies carried out in accordance with the validity requirements set out in Annex III to Regulation (EU) No 576/2013 of the European Parliament and of the Council, and

(i) the Member State of destination has informed the public in accordance with point (b) of Article 37(2) of Regulation (EU) No 576/2013 of the European Parliament and of the Council that it authorises the movement of such animals into its territory; and they are accompanied by

(1) either [(ii) a declaration of the owner (3), attached to this certificate, stating that from birth until the time of dispatch the animals have had no contact with wild animals of species susceptible to rabies];

(1) or [(ii) their mother, on whom they still depend, and from the passport of their mother, it can be established that the mother received before their birth an anti-rabies vaccination which complied with the validity requirements set out in Annex III to Regulation (EU) No 576/2013 of the European Parliament and of the Council];

EUROPEAN UNION

92/65 EI Animals from holdings (ungulates, birds (2), lagomorphs, dogs, cats and ferrets)

II. Health information

II.a. Certificate reference No

II.b.

(d) are accompanied by a passport drawn up in accordance with Commission Implementing Regulation (EU) No 577/2013;

(1) and [(e) due to their scheduled destination indicated in Box I.10, or in Box I.11 where regionalisation is applied, have been treated against Echinococcus multilocularis in accordance with Commission Delegated Regulation (EU) No 1152/2011]];

(1) or [II.2. the cats (1)/ferrets (1)

(a) at the time of examination by a veterinarian authorised by the competent authority within 48 hours prior to the time of dispatch, showed no signs of diseases;

(b) are marked in accordance with Article 17(1) of Regulation (EU) No 576/2013 of the European Parliament and of the Council;

(1) either (c) were at least 12 weeks old at the time of vaccination against rabies and at least 21 days have elapsed since the completion of the primary anti-rabies vaccination carried out in accordance with the validity requirements set out in Annex III to Regulation (EU) No 576/2013 of the European Parliament and of the Council, and any subsequent revaccination was carried out within the period of validity of the preceding vaccination];

(1) or [(c) are less than 12 weeks old and have not received an anti-rabies vaccination, or are between 12 and 16 weeks old and have received an anti-rabies vaccination, but 21 days at least have not elapsed since the completion of the primary vaccination against rabies carried out in accordance with the validity requirements set out in Annex III to Regulation (EU) No 576/2013 of the European Parliament and of the Council, and

(i) the Member State of destination has informed the public in accordance with point (b) of Article 37(2) of Regulation (EU) No 576/2013 of the European Parliament and of the Council that it authorises the movement of such animals into its territory; and they are accompanied by

(1) either [(ii) a declaration of the owner (3), attached to this certificate, stating that from birth until the time of dispatch the animals have had no contact with wild animals of species susceptible to rabies];

(1) or [(ii) their mother, on whom they still depend, and from the passport of their mother, it can be established that the mother received before their birth an anti-rabies vaccination which complied with the validity requirements set out in Annex III to Regulation (EU) No 576/2013 of the European Parliament and of the Council];

(d) are accompanied by a passport drawn up in accordance with Commission Implementing Regulation (EU) No 577/2013.]

(1) or [II.2. the dogs (1)/cats (1)/ferrets (1) are destined for a body, institute or centre described in Box I.13 and approved in accordance with Annex C to Council Directive 92/65/EEC, and

(a) at the time of examination by a veterinarian authorised by the competent authority within 48 hours prior to the time of dispatch, showed no signs of diseases;

(b) are marked in accordance with Article 17(1) of Regulation (EU) No 576/2013 of the European Parliament and of the Council;

(c) are accompanied by a passport drawn up in accordance with Commission Implementing Regulation (EU) No 577/2013.]

II.3. The additional guarantees regarding diseases listed in Annex B (4) to Council Directive 92/65/EEC are as follows (1):

Disease

Decision

Disease

Decision

Disease

Decision

Notes

Part I:

Box I.6: No(s) of accompanying documents: CITES, if applicable.

Box I.19: Use the appropriate CN code: 01 06 19, 01 06 31, 01 06 32, 01 06 39.

Box I.31: Identification system: individual identification must be used wherever possible but in the case of small animals, batch identification may be used. In the case of dogs, cats and ferrets, select passport.

Identification number: in the case of dogs, cats and ferrets, indicate the alphanumeric code of the tattoo or transponder.

Passport number: in the case of dogs, cats and ferrets, indicate the unique alphanumeric code of the passport.

EUROPEAN UNION

92/65 EI Animals from holdings (ungulates, birds (2), lagomorphs, dogs, cats and ferrets)

II. Health information

II.a. Certificate reference No

II.b.

Part II:

(1) Delete as necessary.

(2) Certification requirements only apply to birds that have been vaccinated against avian influenza under a preventive vaccination plan approved by Commission Decision 2007/598/EC.

(3) The declaration referred to in point II.2 to be attached to the certificate shall be drawn up in accordance with Annex I to Commission Implementing Regulation (EU) No 577/2013.

(4) As requested by a Member State benefiting from additional guarantees under Union legislation.

The colour of the stamp and signature must be different from that of the other particulars in the certificate.

This certificate is valid for 10 days from the date of signature of the official veterinarian or of the veterinarian responsible for the holding of origin and approved by the competent authority.

Official veterinarian

Name (in capital letters):

Qualification and title:

Local veterinary unit:

LVU No:

Date:

Signature:

Stamp:’