Vs Form 16-4 - Export Certificate For Animal Products - Department Of Agriculture Animal And Plant Health Inspection Service - 2010

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0579-0256

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Port:

FOR OFFICIAL USE ONLY

UNITED STATES DEPARTMENT OF AGRICULTURE

Date:

ANIMAL AND PLANT HEALTH INSPECTION SERVICE

EXPORT CERTIFICATE FOR

Certificate Number:

ANIMAL PRODUCTS

This certificate is for veterinary purposes only. It is valid for 30 days after the date of signature (in the case of transport by ship or rail, the time is prolonged by the time of the

voyage).

This is to certify that rinderpest, foot-and-mouth disease, classical swine fever, swine vesicular disease, African swine fever, and contagious bovine pleuropneumonia do not

exist in the United States of America.

ADDITIONAL DECLARATIONS

SIGNATURE OF ENDORSING OFFICIAL:

TYPED NAME:

TITLE OF ENDORSING OFFICIAL:

DESCRIPTION OF THE CONSIGNMENT

NAME AND ADDRESS OF EXPORTER:

NAME AND ADDRESS OF CONSIGNEE:

PRODUCT (type of product, quantity, unit of measure, and animal product species of origin):

IDENTIFICATION:

CONVEYANCE:

VS Form 16-4