COUNTRY:

Certificate to EU

Part I: Details of dispatched consignment

I.1. Consignor

Name

Address

Tel.

I.2. Certificate reference No

I.2.a.

I.3.

I.4.

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 of seeds and/or sprouts

Name

Address

I.12.

I.13. Place of loading

I.14. Date of departure

I.15. Means of transport

Aeroplane Ship Railway wagon

Road vehicle Other

Identification

Documentation references

I.16.

I.17.

I.18. Description of commodity

I.19. Commodity code (HS code)

I.20. Quantity (Kgs)

I.21. Temperature of product

Ambient Chilled

I.22. Number of packages

I.23. Seal/Container No

I.24. Type of packaging

I.25. Commodities declared for:

Human consumption

I.26.

I.27.

I.28. Identification of the commodities

Manufacturing plant Number of packages Nature of commodity Net weight Batch number

COUNTRY

Certificate for the import of sprouts or seeds intended for the production of sprouts

II. Health information

II.a Certificate reference No

II.1.1. I, the undersigned official inspector, hereby declare that I am aware of the relevant provisions of Regulation (EC) No 852/2004 and certify that:

( 1 ) either [II.1.1. the seeds described above were produced under conditions which comply with Regulation (EC) No 852/2004 and in particular with the general hygiene provisions for primary production and associated operations set out in Part A of Annex I thereto];

(1) or [II.1.1. the seeds have been sampled and tested for Enterobacteriaceae and the results did not exceed the level of 1 000 cfu/g ( 2 ). The laboratory performing the analyses is accredited according to ISO 17025 for the analyses].

II.1.2. the sprouts were produced in establishments approved in accordance with the requirements laid down in Article 2 of Commission Regulation (EU) No 210/2013 ( 3 );

II.1.3. the sprouts were produced under conditions which comply with the traceability requirements laid down in Commission Implementing Regulation (EU) No 208/2013 ( 4 ) and respect the microbiological criteria laid down in Annex I to Commission Regulation (EC) No 2073/2005 ( 5 ).

Notes

Part I:

— Box reference I.7: Insert the ISO code of the country of origin of the seeds.

— Box reference I.11: Name of the place of origin which must be the same as the country of origin in box 1.7. Please indicate the name and address of the establishment collecting seeds and/or sprouts. Delete as appropriate.

— Box reference I.15: Registration number (railway wagons or container and road vehicles), flight number (aircraft) or name (ship). In the case of transport in containers, the total number of containers and their registration number and where there is a serial number of the seal it must be indicated in box I.23. In case of unloading and reloading, the consignor must inform the competent authorities of the appropriate place of controls in the EU (optional).

— Box reference I.19: Use the appropriate Harmonised System (HS) code of the World Customs Organisation: 0704 90, 0706 90, 0708 10, 0708 20, 0708 90, 0713 10, 0713 33, 0712 34, 0712 35, 0713 39, 0713 40, 0712 50, 0712 60, 0713 90, 0910 99, 1201 10, 1201 90, 1207 50, 1207 99, 1209 10, 1209 21,1209 91, 1214 90.

— Box reference I.20: Indicate total gross weight and total net weight in kg.

— Box reference I.23: for containers or boxes, the container number and the seal number (if applicable) must be included.

— Box reference I.28: Manufacturing plant: insert the name of the establishments of production of seeds.

Part II:

( 1 ) Delete as appropriate.

( 2 ) For the sampling and testing, a representative sample of at least 0,5 % of the weight of the batch of seeds has been taken in sub samples of 50 g. From this sample, 5 sub-samples of 25 g, have been prepared according to ISO 6887-4:2003 and have been analysed for Enterobacteriaceae according to ISO 21528-2.

( 3 ) Commission Regulation (EU) No 210/2013 of 11 March 2013 on the approval of establishments producing sprouts pursuant to Regulation (EC) No 852/2004 of the European Parliament and of the Council (OJ L 68, 12.3.2013, p. 24).

( 4 ) Commission Implementing Regulation (EU) No 208/2013 of 11 March 2013 on traceability requirements for sprouts and seeds intended for the production of sprouts (OJ L 68, 12.3.2013, p. 16).

( 5 ) Commission Regulation (EC) No 2073/2005 of 15 November 2005 on microbiological criteria for foodstuffs (OJ L 338, 22.12.2005, p. 1).

— The colour of the signature shall be different to that of the printing. The same rule applies to stamps other than those embossed or watermark.

Part II: Certification

Official inspector

Name (in capital letters): Qualification and title:

Date: Signature:

Stamp’