Phytosanitary Certificate

Application for Phytosanitary Certificate for Export

Phyto Sanitary No.

Phyto Certificate Status

PLANT PROTECTION ORGANISATION OF

TO: PLANT PROTECTION ORGANISATION(S) OF

I. DESCRIPTION OF CONSIGNMENT

1. Name and address of exporter:

2. Declared name and address of consignee:

3. Number and Description of packages:

4. Distinguishing Marks:

5. Place of Origin:

6. Declared means of conveyance:

7. Declared point of entry:

8. Name of produce, Quantity declared and Purpose:

9. Botanical Name of Plants:

This is to certify that the plants, plant product or other regulated articles described herein have been inspected and/or tested according to appropriate official procedures and are considered to be free from the quarantine pests, specified by the importing contracting party and to conform with the current phytosanitary requirements of the importing contracting party including those for regulated non- quarantine pests. They are deemed to be practically free from other pests

II. ADDITIONAL DECLARATION

III. DISINFESTATION AND/OR DISINFECTION TREATMENT

10. Date:

11. Treatment:

12. Chemical (Active Ingredient):

13. Duration and Temperature:

14. Concentration:

15. Additional Information:

Date of issue:

Place of issue:

Name of authorized officer: