ANNEX IVSupplementary provisions
ANNEX IV DETAILED INFORMATION ON THE COSTS AS MENTIONED IN ARTICLE 3(b) Text of image COMPENSATION - REQUEST FOR PAYMENT Submission deadline: Upon adoption of Financing Decision, 6 months after the end date or confirmation of eradication of the disease, whichever is earlier Outbreak reference PIGS ADNS N° Date of confirmation of suspicion Holding identification number Farmer Holding location Animal owner Date of slaughter Slaughter Method of destruction Weight on date of destruction Number of animals per category Amount paid for the value of the animal, by category Average unit value by category Total compensation (excluding VAT) Date of payment Name Name Farm Slaughter-house Rendering plant On-site incineration Other (specify) Cows Boars Piglets pigs Sows Boars Piglets pigs Sows Boars Piglets pigs Total CATTLE ADNS N° Date of confirmation of suspicion Holding identification number Farmer Holding location Animal owner Date of slaughter Slaughter Method of destruction Weight on date of destruction Number of animals per category Amount paid for the value of the animal, by category Average unit value by category Total compensation (excluding VAT) Date of payment Name Name Farm Slaughter-house Rendering plant On-site incineration Other (specify) Cows Heifers Calves Bulls Cows Heifers Calves Bulls Cows Heifers Calves Bulls Total Text of image OVINES and CAPRINES ADNS N° Date of confirmation of suspicion Holding identification number Farmer Holding location Animal owner Date of slaughter Slaughter Method of destruction Weight on date of destruction Number of animals per category Amount paid by category Total compensation (excluding VAT) Date of payment Sheep Goats Others Sheep Goats Others Name Name Farm Slaughter-house Rendering plant On-site incineration Other (specify) Ewes Lambs Rams Goats Billy goats Kids Ewes Lambs Rams Goats Billy goats Kids Total POULTRY ADNS N° Date of confirmation of suspicion Holding identification number Farmer Holding location Animal owner Date of slaughter Slaughter Method of destruction Weight on date of destruction Number of animals per category Amount paid by category Total compensation (excluding VAT) Date of payment Poultry Poultry Name Name Farm Slaughter-house Rendering plant On-site incineration Other (specify) Laying hens Broiler Breeders Ducks Geese Turkeys Others Laying hens Broiler Breeders Ducks Geese Turkeys Others Total Text of image PRODUCTS ADNS N° Date of confirmation of suspicion Holding identification number Farmer Holding location Product owner Date of destruction Method of destruction Number of products per category Amount paid by category Total compen-sation (excluding VAT) Date of payment Name Name Rendering plant On-site (specify) Other (specify) Eggs Milk Semen Embryos Eggs Milk Semen Embryos Total Text of image OPERATIONAL — REQUEST FOR REIMBURSEMENT Submission deadline: Upon adoption of Financing Decision, 6 months after the end date or confirmation of eradication of the disease, whichever is earlier. Outbreak reference MS/DISEASE/YEAR Slaughtering and culling ADNS N° Holding No Amount of invoice excluding VAT Supplier's Name Payment date Total Cleaning desinsectisation and disinfection (holdings and equipment) ADNS N° Holding No Amount of invoice excluding VAT Supplier's Name Payment date Total Transport and destruction of the contaminated feeding stuffs and equipment ADNS N° Holding No Amount of invoice excluding VAT Supplier's Name Payment date Total Text of image Transport and disposal of carcasses ADNS N° Holding No Amount of invoice excluding VAT Supplier's Name Payment date Total Other costs essential for the eradication of the disease ADNS N° Holding No Amount of invoice excluding VAT Supplier's Name Payment date Total TOTAL Slaughtering and culling Cleaning desinsectisation and disinfection (holdings and equipment) Transport and destruction of the contaminated feeding stuffs and equipment Purchase, storage, administration or distribution of vaccines Transport and disposal of carcasses Other costs essential for the eradication of the disease (specify) Total