This document is a bilingual form with 19 fields to fill out.
Original
1. Exporter
2. Importer
3. Certificate Number
Country Name, Country Crest/Seal, Name of Competent Authority for Meat Inspection System.
OFFICIAL MEAT INSPECTION CERTIFICATE FOR EXPORTING MEAT PRODUCTS TO CANADA
4. Slaughtered at (Establishment Number, Name and Country)
5. Carrier
6. Port of Loading
7. Date of departure
8. Processed at (Establishment No., Name and country)
9. Port of Landing
10. Exporting Establishment No.
11. Shipping Marks
12. No. And Kind of Packages/nombre et nature des colis
13. Description of meat Products and Label Reg. No. (if applicable)
14. Net Weight lb or kg
15. Container number
16. Seal No.(s)
17. Additional Certification (if requested)
18. I hereby certify that the meat products specified above have been prepared in an establishment certified for export to Canada and are derived from animals that have been examined and found, by antemortem and postmortem inspection at the time of slaughter, to be free from disease and that meat products are suitable in every way for human consumption and are otherwise in compliance with requirements at least equal to those in the Canadian Meat Inspection Act and Regulations.
19. Official Stamp
This day of 20
Signature of The Official Veterinarian
Printed Name