CCSBT Southern BFT re-export certificate

Annex 3
DOCUMENT NUMBER
CCSBT SOUTHERN BLUEFIN TUNA RE-EXPORT CERTIFICATE
RE-EXPORT SECTION:
1. RE-EXPORTING COUNTRY/FISHING ENTITY
2. POINT OF EXPORT (CITY, STATE OR PROVINCE AND COUNTRY/FISHING ENTITY)
3. PROCESSING ESTABLISHMENT (if applicable)
NAME AND ADDRESS
4. DESCRIPTION OF IMPORTED FISH
Product (a)
Type (b)
F/FR
RD/GG/DR/FL/OT

Weight
(kg)

Flag Country/
Fishing Entity

Imported Date

(a) F=Fresh, FR=Frozen
(b) RD=Round, GG=Gilled and Gutted, DR=Dressed, FL=Fillet, OT=Other (describe the type of product; ___________.)
5. DESCRIPTION OF RE-EXPORTING FISH
Product (a)
Type (b)
Weight
F/FR
RD/GG/DR/FL/OT
(kg)

(a) F=Fresh, FR=Frozen
(b) RD=Round, GG=Gilled and Gutted, DR=Dressed, FL=Fillet, OT=Other (describe the type of product; ___________.)
6. RE-EXPORTER CERTIFICATION I certify that the above information is complete, true, and correct
to the best of my knowledge and belief.
Name
Address
Signature
Date
Licence Number
(if applicable)
7. VALIDATION BY AUTHORITY I validate that the information listed above is complete, true, and correct
to the best of my knowledge and belief.
Name & Title
Signature
Date
Official Seal

IMPORT SECTION:
IMPORT SECTION I certify that the above information is complete, true, and correct to the best of my knowledge and belief.
Importer Certification (Intermediate Country) (if applicable)
Date
Licence no (if applicable)
Name
Address
Signature
Importer Certification (Intermediate Country) (if applicable)
Name
Address
Signature

Date

Licence No (if applicable)

Importer Certification (Final Destination of Shipment)
Name
Address

Date

Licence No (if applicable)

Final Point of Import: City

State or Province

Signature

Country/Fishing Entity

NOTE 1: The organization/person which validates the Re-export Certificate should verify the copy of original CCSBT
Southern Bluefin Tuna Statistical Document. Such a verified copy of original Southern Bluefin Tuna Statistical
Document must be attached to the Re-export Certificate. When southern bluefin tuna is re-exported more than twice, all
verified copies of concerned Re-export Certificates must be also attached to a Re-export Certificate.
NOTE 2: If a language other than English is used in completing this form, please add the English translation on this
Document.