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. |