Declaration of Biological Shipments

Declaration of Biological Shipments

DATE:
Air Waybill #
Shipper:
Fax No.:( ) Phone: ( ) -
FedEx Account No .: / Consignee

Selection 1: Biological specimen of bovine, sheep, goat, pig, chicken, horse origin.

You need a certificate of origin and health certificate for animal products to be obtained from the USDA.

bovine:______sheep:______goat:______
pig:______chicken:______horse:______

Remarks: Please note that consignee needs to provide import license for the above commodities.

Selection 2: Biological specimen of hamster, rabbit, rat, mouse, monkeys, dogs and cats.

You don’t need a special export paper. Fill in correct name of specimen, (i.e., DNA of rabbit)
hamster:______rabbit:______rat:______
mouse:______dog:______cat:______
monkey:______

Selection 3: Specimen of culture of microorganism. Fill in the correct name: Candida albicans

Are the microorganism components in a solution of animal origin? NO

Check, if you need special papers. See under Section 1 or 2.

hazard: No harmful: No infectious: No

Selection 4: Specimen of synthetic or chemical objects. Fill in the correct name of the specimen and the CAS RN (Chemical Abstracts Service Registry Numbers) ______

Selection 5: Reserved for other not name biological specimen:____.

Selection 6: Please provide Latin name: Candida albicans

Reason for export: Sample: only for research [X] For human usage o not used by humans [X]

Special handling: freeze (Dry Ice) [ ] keep cool (+2-8¡ ) [ ] room temperature [ x ]

Please attach this information on outer packaging. All information is correct and true.

(Signature and company stamp)______