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21 2006 . N --2/3106

 

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Incident Report - Suspect Consignment

-

 

┌──────────────────────────────┐

1. Country of origin

└──────────────────────────────┘

 

┌──────────────────────────────┐

2. EU Member State of dispatch

- ,

└──────────────────────────────┘

 

┌──────────────────────────────┐

3. Description of product

└──────────────────────────────┘

 

┌──────────────────────────────┐

4. Means of transport/

(the number of the railway

carriage, truck, container,

flight-number, name of the

ship/N , ,

,

)

└──────────────────────────────┘

 

┌──────────────────────────────┐

5. Certificate number and date

of issue

(CVED No if applicable/ │

N , )

└──────────────────────────────┘

 

┌──────────────────────────────┐

6. Identification number/name of

official veterinarian

/

...

└──────────────────────────────┘

 

┌──────────────────────────────┐

7. Approval number of

establishment

N

└──────────────────────────────┘

 

┌──────────────────────────────┐

8. Official Seal Numbers/

Status of seal

N /

└──────────────────────────────┘

 

┌────────┐ ┌────────┐

8. Customs stamp applied to

certificate │ Yes/ │ No/

└────────┘ └────────┘

 

┌──────────────────────────────┐

10. Consignor

└──────────────────────────────┘

 

┌──────────────────────────────┐

11. Consignee

└──────────────────────────────┘

 

┌──────────────────────────────┐

12. Frontier post of entry to

the Russian Federation/

└──────────────────────────────┘

 

┌──────────────────────────────┐

13. Date of importation

└──────────────────────────────┘

 

┌──────────────────────────────┐

14. Nature of suspicion/

irregularity

/

└──────────────────────────────┘

 

 

 

 

 

/

Non-manipulation declaration

 

A. /Consignment details

 

1. /Consignment type ____________________________

 

2. /Country

of origin ____________________________

 

3. /Means of

transport ____________________________

(N , ,

, ,

/the number

of railway carriage,

truck, container,

flight-number, name

of the ship)

 

4. N /Seal No ____________________________

 

5. /Quantity of goods _______ /Weight _________

 

6. /Labelling ____________________________

 

7. N /Veterinary Certificate No _________

/date of issue ____________________________

 

8. /Issued by Competent

authority _____________________________________________________

 

9. , /Member state in

the EU from which consignment last dispatched _________________

 

10. /Consignment

corresponds to documents presented ___________________

(/) (yes-no)

 

11. /

Means of transport and regime of transportation meets the

relevant requirements ______________________

(/) (yes/no)

 

B. /Statement

 

, , /The consignment

mentioned above has been refused acceptance in ___________________

______________________________________________________________ <*>

/because it does not meet the following

Russian veterinary import requirements:

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

 

, , ,

,

N/I, the state veterinary inspector, confirm

that the returned consignment which entered the customs territory

of the Russian Federation with the seal No _____,

- , ,

/has not undergone any handling altering

its status including transport and storage.

 

, ,

N/The means of transport which contains the

returned consignment is resealed with the seal No ________________

 

, /Status of person

confirming the declaration

 

/Name in capital letters ____________________

 

/Signature ____________________

 

/Position ____________________

 

/Competent authority ____________________

 

/Date ____________________

 

--------------------------------

<*> /Indicate the customs entry point in the Russian Federation.


 

 




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