Regulations of 1 December 2000 no 1333 on plants ... - Mattilsynet

Annex 5C.
Model for phytosanitary certificates for re-export according to
the International Plant Protection Convention, IPPC
No. _________________
Plant Protection Organization <strong>of</strong> _________________
(contracting party <strong>of</strong> re-export)
TO: Plant Protection Organization(s) <strong>of</strong> __________________
(contracting party(ies) <strong>of</strong> import)
I. Description <strong>of</strong> Consignment
Name and address <strong>of</strong> exporter: __________________
Declared name and address <strong>of</strong> consignee: __________________
Number and description <strong>of</strong> packages: __________________
Distinguishing marks: __________________
Place <strong>of</strong> origin: ___________________
Declared means <strong>of</strong> conveyance: ___________________
Declared point <strong>of</strong> entry: ___________________
Name <strong>of</strong> produce and quantity declared: ___________________
Botanical name <strong>of</strong> plants: ____________________
This is to certify that the plants, plant products or other regulated articles described above ______
were imported into (contracting party <strong>of</strong> re-export) _______ from ______________ (contracting
party <strong>of</strong> origin) covered by Phytosanitary certificate No. _____, *original certified true copy
<strong>of</strong> which is attached to this certificate; that they are packed repacked in original
*new containers, that based on the original phytosanitary certificate and additional
inspection , they are considered to conform with the current phytosanitary requirements <strong>of</strong> the
importing contracting party, and that during storage in _______________ (contracting party <strong>of</strong> reexport),
the consignment has <strong>no</strong>t been subjected to the risk <strong>of</strong> infestation or infection.
*Insert tick in appropriate boxes
II. Additional Declaration
III. Disinfestation and/or Disinfection Treatment
Date __________________
Treatment __________________
Chemical (active ingredient) __________________
Duration and temperature __________________
Concentration __________________
Additional information __________________
__________________
Place <strong>of</strong> issue _______ __________________
(Stamp <strong>of</strong> Organization)
Name <strong>of</strong> authorized <strong>of</strong>ficer ___________________
Date ___________ _______ ____________
(Signature)
No financial liability with respect to this certificate shall attach to ____________ (name <strong>of</strong> Plant
Protection Organization) or to any <strong>of</strong> its <strong>of</strong>ficers or representatives.**
**Optional clause
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