Re-Export Plant Health Certificate
1. Certificate Details
Certificate Number
Date of Issue
Export Reference Number
2. Consignment Information
Name and Address of Exporter
Name and Address of Consignee
Country of Origin
Country of Re-Export
Country of Destination
3. Means of Conveyance
Declared Means of Conveyance
Point of Entry
Declared Point of Entry
4. Description of Consignment
Description of Plants/Plant Products
Botanical Name
Quantity/Weight
Distinguishing Marks
Packaging
5. Additional Declaration
6. Re-Export Details
Original Certificate Number
Place of Issue
Date of Issue
Reference Documents (Quarantine treatment, etc)
Name and Signature of Authorized Officer
Date