ANNEX I
MODEL HEALTH CERTIFICATE
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European Union
Veterinary certificate to EU
Part I: Details of dispatched consignment
I.1. Consignor
Name
Address
Country
I.2. Certificate reference No
I.2.a. TRACES reference number:
I.3. Central competent authority
I.4. Local competent authority
I.5. Consignee
Name
Address
Country
I.6. Person responsible for the consignment in EU
I.7. Country of origin
ISO code
I.8.
I.9. Country of destination
ISO code
I.10.
I.11. Place of origin
Name Approval number
Address
I.12. Place of destination
Name Approval number
Address
Postal code
I.13. Place of loading
Name
Postal code/Region
I.14. Date and time of departure
I.15. Means of transport
Aeroplane Ship Railway wagon
Road vehicle Other
Identification:
Number(s):
I.16. Entry BIP in EU
Name BIP unit no
I.17.
I.18. Temperature of products
Ambient Chilled Frozen
I.19. Total Gross Weight
I.20. Total number of packages
I.21. Seal/Container numbers
I.22. Commodities certified for:
Slaughter
Breeding
Fattening
Human consumption
Approved body
Quarantine
Registered equidae
Game restocking
Pets
Circus/exhibition
Relaying
Other
Further process
Animal feedingstuff
Technical use
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I.23. For transit through EU to 3rd Country
3rd country ISO code
I.24. For import or temporary admission into EU
I.25. Identification of the commodities
Custom code (HS code) and title:
Species (Scientific name)
Nature of commodity
Establishment
Batch number
Number of packages
Type of packages
Net weight (kg)
Species (Scientific name)
Breed/ Category
Identification of the donor
Identification of the straw
Collection date
Approval number of the centre/team
Quantity
Species (Scientific name)
Breed/ Category
Identification method
Identification number
Age
Sex
Quantity
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COUNTRY
II. Health attestation
II.a. Certificate reference No
II.b.
The live animal(s) or animal product(s) herein described, complies/y with the relevant New Zealand standards and requirements that have been recognized as equivalent to the European Union standards and requirements as prescribed in the European Union-New Zealand Agreement on sanitary measures (Decision 97/132/EC).
(1) III. Additional attestations
either
(1) [III.1. The live animal(s) or animal product(s) herein described complies/y with the relevant special conditions laid down in Chapter 28 of Section 5 of Annex V to Decision 97/132/EC: [insert relevant attestation].]
and/or
(1) [III.2. The live animal(s) or animal product(s) herein described complies/y with the relevant certification provisions laid down in Annex II to Commission Implementing Decision (EU) 2015/1901: [insert relevant attestation].]
and/or
(1) [III.3. The live animal(s) or animal product(s) herein described complies/y with the additional conditions laid down in Chapter 29.B. of Section 5 of Annex V to Decision 97/132/EC in the event of the occurrence of a specific disease: [insert relevant attestation].]
and/or
(2) [III.4. The animal products are derived from animals that have been handled in the slaughterhouse before and at the time of slaughter or killing under conditions at least equivalent to the Union standards and requirements.]
and/or
(3) (4) [III.5. The undersigned officer certifies this consignment on the basis of Eligibility Document(s) (ED) issued on , which were ascertained by him or her and were issued prior to the departure of the consignment.]
Notes
This health certificate is for veterinary purposes only.
Part I
Box I.6: Complete only in case of transit through the Union.
Box I.8: Region of origin: if applicable, otherwise must be crossed out: for animal species or for products affected by the regionalisation measures or by the setting up of approved zones in accordance with Union decisions. The names of the approved regions and the zones (production areas in case of frozen or processed bivalve molluscs) must be entered as published in the Official Journal of the European Union.
Box I.12: Complete only in case of storage of products in transit: name and address (street, town and postal code) and the approval or registration number of the warehouse in a free zone, the customs warehouse or the ship supplier.
Box. I.14: For live animals: enter the date and the time at which the animals are scheduled to depart in their means of transport (aeroplane, ship, railway or road vehicle).
For animal products: indicate the date of departure of the means of transport (aeroplane, ship, railway or road vehicle).
Box. I.18: Complete only in case of animal products.
Box I.19: Enter the ‘Total gross weight (kg)’ and ‘Total net weight (kg)’.
Box I.22: Enter the purpose of import of live animals or intended use for animal products (the available options will vary in accordance with the specific certificate in the Union import requirements).
Box I.21: If applicable, enter the identification number of the container and the seal number.
Box I.23: Complete only in case of transit through the Union.
Part II: Certification
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COUNTRY
II. Health attestation
II.a. Certificate reference No
II.b.
Box I.24: Complete only in case of importation or temporary admission to the Union.
Box I.25: Use the appropriate Harmonised System (HS) code.
For animal products: Species, nature of commodity, approval number of establishments (e.g. abattoir, processing plant, cold store), batch number, number of packages, type of packages, net weight (the available options will vary in accordance with the specific certificate in the Union import requirements). Those products may, in accordance with the entry ‘Re-exports of imported animal products’ of Chapter 27 of Annex V to Decision 97/132/EC, come from establishments from third countries other than New Zealand.
For germinal products: Species, breed/category, identification number of the donor, identification number/code of the straw, collection date, approval number of the centre/team, quantity.
For live animals: species, breed/category, identification method, identification number, age, sex, quantity/net weight.
Titles and entries of the boxes may be aligned to the specific certificate in the Union import requirements.
Part II
(1) Only to be completed if special conditions apply. Otherwise delete.
(2) Only for animal products derived from animals covered by Regulation (EC) No 1099/2009. Otherwise delete.
(3) Only to be completed when the official health certificate is issued after the departure of the consignment. Specify reference to the appropriate Eligibility Document(s) (ED). Otherwise delete.
(4) Only to be completed when the health certificate has been issued after the departure of the consignment. Insert date. Otherwise delete.
(5) Delete as appropriate.
Official veterinarian/inspector (5)
Name (in capital letters): Qualification and title:
Date: Signature:
Stamp: