DECLARATION BY OWNER/AGENT OF THE ANIMALS 

 TO BE EXPORTED TO [country] 



I, [block letters] the owner/agent of the [number] of animals whose 



official metal tag identification numbers are listed below, hereby declare: 



Eartag 



Eartag 



[List the eartags of all animals covered by the certification statements. 



1 . The animals have resided at , the premise of origin since 



[date] or since birth, and no clinical evidence of contagious or 

 Infectious diseases has occurred on the premise during this time. 



2. During the 6 months preceding export, the animals to be exported have not 

 been subjected to any official quarantine for infectious or contagious diseases. 



Figure 1 — Sample certification form. 



Time Constraints 



Sufficient time must be allowed to arrange isolations, conduct treatments, obtain test 

 results, and meet other requirements for certification. Be sure that your client knows 

 and understands these time constraints. 



10-10 



