Export Health Certificate Request Forms

OMB 0581-0283

The forms requested will provide a format for exporters to provide information on consignments they wish to export so that the Dairy Grading Branch can issue the proper health certificate with the information required by the importing country.

The latest form for Export Health Certificate Request Forms expires 2022-03-31 and can be found here.

Latest Forms, Documents, and Supporting Material

Document Name
Form DA-253 Export Certificates Form
AMS-71 11-05-21 Rev. WGF.xlsx Supplementary Document
SuptStmnt 2-28-2022 .docx Supporting Statement A
Export Certificates Form

All Historical Document Collections

202203-0581-001 Approved with change	Revision of a currently approved collection	2022-03-29
201812-0581-003 Approved without change	Revision of a currently approved collection	2019-02-05
201510-0581-001 Approved without change	Extension without change of a currently approved collection	2015-12-14
201509-0581-003 Approved without change	No material or nonsubstantive change to a currently approved collection	2015-09-17
201503-0581-001 Approved without change	No material or nonsubstantive change to a currently approved collection	2015-04-03
201210-0581-002 Approved without change	New collection (Request for a new OMB Control Number)	2012-12-13