ANNEX VSupplementary provisions
ANNEX V Final financial report and payment application One table per survey in poultry/wild birds ( 1 ) Member State: Date: Reporting period from: to: Measures eligible for co-financing ( 2 ) Methods of laboratory analysis Number tests performed per method Costs Serological pre-screening ( 3 ) Haemagglutination-inhibition-test (HI) for H5/H7 Virus isolation test Other measures to be covered Specify activities Sampling Others TOTAL Herewith I certify that the data given above are correct and that no other Community contribution was asked for these measures. (Place, Date) (Signature) ( 1 ) Strike through as appropriate. ( 2 ) Data to be given in national currency, VAT excluded. ( 3 ) Please indicate test used.