Part I: Details of dispatched consignment

COUNTRY

Veterinary certificate to EU

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

Postal code

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. Region of destination

Code

I.11. Place of origin

Holding Other

Name

Approval number

Address

Name

Approval number

Address

Name

Approval number

Address

I.12.

Holding Quarantine Approved body

Other

Name

Approval number

Address

Postal code

I.13. Place of loading

Address

Approval number

I.14. Date of departure Time of departure

I.15. Means of transport

Aeroplane

Ship

Railway wagon

Road vehicle

Other

Identification:

Documentary references:

I.16.

I.17. No(s) of CITES

I.18. Description of commodity

I.19. Commodity code (HS code)

I.20. Quantity

I.21.

I.22. Number of packages

I.23. Identification of container/seal number

I.24.

I.25. Commodities certified for:

Pets

Quarantine

I.26.

I.27. For import or admission into EU

Definitive import

I.28. Identification of the commodities

Species

(Scientific name)

Identification system

Identification number

Quantity

Part II: Certification

COUNTRY

Pet birds

II. Health information

II.a. Certificate reference number

II.b.

I, the undersigned official veterinarian of (insert name of third country) certify that:

1. The country of dispatch is a member country of the World Organisation for Animal Health (OIE and belongs to the OIE Regional Commission for (insert name of Regional Commission).

2. The birds described in point I.28 have been subjected today, within 48 hours or the last working day prior to dispatch, to a clinical inspection and found free of obvious signs of disease.

3. The birds comply with at least one of the following conditions:

either [for those third countries listed in Decision 79/542/EEC, they have been confined on the premises specified in point I.11 under official supervision for at least 30 days prior to dispatch and effectively protected from contact with other birds] (1)

or [they are destined, as indicated in point I.12 for a quarantine station approved in accordance with Article 3(4) of Decision 2000/666/EC] (1)

or [they have been vaccinated and at least on one occasion re-vaccinated within the last 6 months and not later than 60 days prior to dispatch, in accordance with the manufacturer’s instructions against avian influenza using an H5 vaccine approved for the species concerned] (1)

or [they have been isolated for at least 10 days prior to export and have been subjected to a test for the detection of H5N1 antigen or genome, as prescribed in Chapter 2.1.14 of the Manual of Diagnostic Tests and Vaccines for Terrestrial Animals, carried out on a sample taken not earlier than on the third day of isolation] (1)

4. The owner or the representative of the owner has declared:

4.1. The birds will be accompanied during the movement by a person that is responsible for the animals.

4.2. The animals are not intended for commercial purposes.

4.3. During the period between the pre-movement veterinary inspection and the factual departure the birds will remain isolated from any possible contact with other birds.

either [4.4. The animals have undergone the 30 days pre-movement isolation without coming into contact with any other birds not covered by this certificate.] (1)

or [4.4. I have made arrangements for the 30 days post-introduction quarantine at the quarantine premises of , as indicated in point I.12 of the certificate.] (1)

Notes:

(1) Delete as necessary.

(*) The certificate is valid for 10 days. In case of transport by boat the validity is prolonged by the time of the sea voyage.

Official veterinarian

Name (in Capitals):

Qualification and title:

Date:

Signature:

Stamp: