ANNEX II
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European Union
Certificate to EU
Part I: Details of dispatched consignment
I.1. Consignor
Name
Address
Tel. No.
I.2. Certificate reference No
I.2.a.
I.3. Central competent authority
I.4. Local competent authority
I.5. Consignee
Name
Address
Postal Code
Tel. No.
I.6. Person responsible for the consignment in EU
Name
Address
Postal Code
Tel. No.
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.
I.13. Place of loading
I.14. Date of departure
I.15. Means of transport
Aeroplane Ship
Railway wagon Road vehicle
Other
Identification:
Document references:
I.16. Point of import in EU
I.17.
I.18. Description of commodity
I.19. Commodity code (HS code)
I.20. Quantity
I.21. Temperature of products
Ambient Chilled Frozen
I.22. Number of packages
I.23. Identification of container/Seal number
I.24. Type of packaging
I.25. Commodities certified for:
Human consumption Animal feeding stuff Further process
I.26.
I.27. For import into EU
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I.28. Identification of the commodities
Batch number Treatment type
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COUNTRY
PRE-EXPORT CHECK
II. Health information
II.a. Certificate reference No.
II.b.
In accordance with the provisions of Commission Implementing Regulation (EU) 2015/949 approving the pre-export checks carried out by on as regards the presence of , I undersigned, , authorised repre-sentative of the competent authority referred to in Article 1 of Implementing Regulation (EU) 2015/949 certifies that the commodities described in the Part I of this certificate have been produced, sorted, handled, processed, packaged and transported in line with good hygiene practices and have been subject to a pre-export check, as approved by Implementing Regulation (EU) 2015/949 and ensures that the commodities covered by this certificate will be transported to the European Union in a container, which is in line with good hygiene practices.
From this consignment samples for analysis were taken on (date), subjected to laboratory analysis on (date) in the (name of laboratory), and the details of sampling, methods of analysis used and all results are attached.
Notes
This certificate is valid for four months after issuance.
Part I:
— Box reference I.11: Approval number: only if applicable.
— Box reference I.19: Use the appropriate HS code of WCO or CN code.
— Box reference I.20: Indicate total weight.
— Box reference I.25: Further process means ‘subject to sorting or other physical treatment before human consumption’.
Part II: Certification
Official inspector
Name (in capital letters): Qualification and title:
Date: Signature:
Stamp: