S.L. 437.46 Art. 1719. Conform to Conforms Does NOT 21. For Internal Human consumption Animal feedingstuffs Pharmaceutical uses Technical use Other 23. Declaration I, the my knowledge complete and I Directive consignment destruction if Place and date Name of Signature CVED

Transhipment to 18. For transit to 3rd country EU BIP to 3rd Country ANIMO unit no.: +ISO code

3rd country Exit BIP 3rd country ISO code ANIMO unit No. EU requirements 20. For re-import conform

Market 22. For NON-conforming consignments Customs warehouse

Registered No. Free zone or free warehouse

Registered No. Ship supplier

Registered No.

Ship Name Port undersigned person responsible for the load detailed above, certify that to the best of and belief the statements made in section I of this document are true and agree to comply with the legal requirements of European Union Council 97/78/EC, including payment for veterinary checks, for repossession of any rejected after transit across the EU to a third country (article 11.1.c) or costs of necessary. of declaration signatory

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Part 2: Decision on Consignment EUROPEAN COMMUNITY The Common Veterinary Entry Document,