Seed Lot Import Health Declaration
Importer:
Address:
Country of Origin:
Date of Import:
Consignment/Shipment No.:
Port of Entry:
Seed Lot Details
Species/Variety
Lot Number
Quantity (kg)
Origin
Producer
Health Declaration
I hereby declare that the seed lot(s) described above:
Lab Test Report Ref No.:
Date of Test:
Additional Information
Name:
Signature:
Date: