APPLICATION FOR THE ISSUANCE OF AN ORANGE INTERNATIONALCERTIFICATE (OIC)

1)INFORMATION SUPPLIED BY APPLICANT: All information as supplied by the applicant will appear on the OIC’s. If re-issuance is requested due to an error in this information, an additional certificate tariff will be charged.

Date of application: / Name of contact person:
Full name and address of applicant:
Tel. No.: / Fax No.:
Full name and address of exporter to appear on the OIC (only if different from the applicant):
The name and address to appear on the OIC may be omitted at request of the applicant. Do you require such an omittance? (Mark with a X) / Yes / No
Name of establishment and address (not postal) where sampling is to be undertaken:
Country of destination of seed to be exported to:
I, ……………………………………………………… hereby apply for the issuance of Orange International Certificate/s for the seed lot/s as indicated in section 4 hereof and declare that the information in this application is correct.
SIGNATURE OF APPLICANT:

2)INFORMATION SUPPLIED BY OFFICIAL SAMPLER:

Name of sampler: / Stationed at:
Date of sampling: / Sampling (mark with a X) / Original / Re-sampling
Name of establishment and address (not postal) where sampling was carried out:
Service rendered: / Hours: / Amount payable: / Invoice no.:
Seals:
SIGNATURE OF SAMPLER:

3)INFORMATION SUPPLIED BY SEED TESTING STATION:

Date of allocation of lot numbers: / Expiry date of this application:
Name of officer who allocated lot numbers: / SIGNATURE OF OFFICER:

4)SAMPLE PARTICULARS:

Information supplied by: Applicant / : Seed Testing Station / : Sampler
Seed kind / Variety / No. of con-tainers / Weight of lot (kg) / Code no. / Type of tests required * and requirements of buyer / Analysis tariff per sample / Lot no. ** / Checked by sampler (initial please)
Purity (%) / Germination (%) / Other (specify) e.g. moisture (12%)
*From one sampling operation, only one sample may be submitted for testing. This sample may be subjected to one or more tests as requested by the sender, but certain tests such as for moisture content require the submission of a separate sample from the same sampling operation, in special packaging to accompany the definitive sample.
**Each container must be marked (clearly legible) or furnished with an attached label, stating the allocated lot number.

4)SAMPLE PARTICULARS - SMALL PACKAGING [tins, cartons, packets (e.g. foil), etc.] SPECIFY TYPE OF PACKAGING: (e.g. tins packed into

boxes/plastic bags packed into polyprop bags) …………………………………………………………………………………………………………………

Information supplied by: Applicant / : Seed Testing Station / : Sampler
Seed kind / Variety / No. of con-tainers / Weight of lot (kg) / Code no. / Type of tests required * and requirements of buyer / Analysis tariff per sample / Lot no. ** / Checked by sampler (initial please)
Purity
(%) / Germination (%) / Other (specify) e.g. moisture (12%)
1)
2)
1)
2)
1)
2)
1)
2)
1)
2)
1)
2)
1)
2)
1)
2)
1)
2)
1)
2)
1)
2)
1)
2)
1)Small inner containers(e.g. 2kg– i.e. the small containers are 2kg paper bags)
2)Outer containers(e.g. 2 x25 = 50kg– i.e. there are 25 of the 2kg paper bags packed into a polyprop bag)
*From one sampling operation, only one sample may be submitted for testing. This sample may be subjected to one or more tests as requested by the sender, but certain tests such as for moisture content require the submission of a separate sample from the same sampling operation, in special packaging to accompany the definitive sample.
**Each container must be marked (clearly legible) or furnished with an attached label, stating the allocated lot number.