[별지 2]

MINISTRY OF AGRICULTURE AND RURAL DEVELOPMENT ‐ SOCIALIST REPUBLIC OF VIET NAM

NATIONAL AGRO‐FORESTRY‐FISHERIES QUALITY ASSURANCE DEPARTMENT (NAFIQAD)

BRANCH ……….

Address:…………………………………………………………

Tel: ................	Fax:.............  ..	E‐mail: ..................

QUARANTINE / HEALTH CERTIFICATE

For fishery products originated from the Socialist Republic of Vietnam

and intended for export to Republic of Korea

Reference No:  ………

I. Consignment information :

Name of Consignor : Address : Tel :					Name of Consignee: Address : Tel :
Notify Party : Address : Tel :
Description of Goods : Weight Declared (kg) :						Temperature of product : Ambient □ Chilled □ Frozen □
Commodities certiﬁed for : Transplantation □ Ornamental Aquatic animal □ Research & Investigation □ Human consumption □
N o	Species (Scientiﬁc name)		Type of packages	Number of packages				Net weight (kg)		Date (period) of Production :
Name of the Establishment : Address : Approval Number :
Container No :		Bill of Lading No :					Seal No :		Mean of Conveyance :
Place of Dispatch (port) :							Place of Destination (port) :
Date of Dispatch :

II. Quarantine/Health Attestation :

This is to certify that :

1. The above fishery products were come from the establishment approved by National Agro‐Forestry‐Fishery Quality Assurance Department (NAFIQAD).

2. The products were produced, packed, stored and transported under sanitary condition, which were under the supervision and inspection of NAFIQAD.

3. The products were inspected and not found any disease regulated by the Aquatic Animal Disease Control Act of the Republic of Korea.

4. The products were inspected by NAFIQAD and not found any pathogenic bacteria and harmful substances regulated in the Republic of Korea.

Stamp	Date of issue :…………………………… (Signature )

Note : The certificate will have two sides in case the first side is filled out of the context.