| Form 3 |
| SAINT LUCIA |
| Ministry of Agriculture, Lands, Fisheries & Forestry |
| Phytosanitary Certificate for Re-Export |
| Plant Protection Organization | No.__________ |
| of ................................................................................ (Country of re-export) |
| TO: Plant Protection Organization(s) |
| of ............................................................................. (Country(ies) of import) |
| Description of Consignment |
| Name and address of exporter:....................................................................... |
| Declared name and address of consignee:...................................................... |
| Number and description of packages:............................................................. |
| Distinguishing marks:..................................................................................... |
| Place of origin:................................................................................................ |
| Declared means of conveyance:...................................................................... |
| Declared point of entry:.................................................................................. |
| Name of produce and quantity declared:........................................................ |
| Botanical name of plants:............................................................................... |
| This is to certify that the plants or plant products described above were imported into (country of re-export) ........................ from (country of origin) .................... covered by Phytosanitary Certificate No:.........., *original [ ] certified true copy [ ] of which is attached to this certificate; that they are packed [ ] repacked [ ] in original [ ] *new [ ] containers, that based on the original phytosanitary certificate [ ] and additional inspection [ ], they are considered to conform with the current phytosanitary regulations of the importing country, and that during storage in ......................... (country of re-export) the consignment has not been subjected to the risk of infestation or infection. |
| *Insert tick in appropriate [ ] boxes |
| Disinfestation and/or Disinfection Treatment |
| Date:.................................... Treatment:......................................... Chemical |
| (active ingredient) ........................................................................................... |
| Duration and temperature:............................................................................... |
| Concentration:.................................................................................................. |
| Additional information:................................................................................... |
| Additional declaration:.................................................................................... |
| Place of issue: ..................................... |
| (Stamp of Organization) Name of authorised officer: .................................... |
| Date............................... | ................................. |
| (Signature) |
| Note: No liability with shall attach ..................................... or to any officer or representative of the Ministry with respect to this certificate. |