EN   EN  
 EUROPEAN  
COMMISSION 
Brussels, XXX   
SANTE/10346/2020 Rev. 1 ANNEX 
(POOL/E2/2020/10346/10346R1-EN 
ANNEX.docx) […](2020) XXX  draft 
ANNEXES 1 to 4 
 
ANNEXES 
to   
the Commission Implementing Regulation 
on the conditions gov erning imports of  f ood and feed originati ng in third countries 
following the accident at the Chernobyl nuclear  power station  
 EN 1  EN ANNEX I  
List of third countries ref erred to in Article 1(1) 
Albania Belarus Bosnia and Herzegovina Kosovo
1 
North Macedonia Moldova Montenegro Russia Serbia Switzerland Turkey Ukraine United Kingdom of Great Brita in excluding Northern Ireland 
2 
 
1 This designation is without prejudice to positions on status, and is in line with UNSCR 1244/1999 and 
the ICJ Opinion on the Kosovo declaration of independence. 
2 Applicable as from the day following that on which Union law c eases to apply to and in the United 
Kingdom pursuant to the Withdrawal Agreement. EN 2  EN ANNEX II 
List of products to which the co nditions laid down in Article 3 (3) apply  
CN code  Description 
ex 0709 51 00 mushrooms of the genus Agaricus, fresh or chilled, other than cultivated 
mushrooms 
ex 0709 59 other mushrooms, fresh o r chilled, other than cultiv ated mushrooms  
ex 0710 80 61 mushrooms of the genus Agaricus (uncooked or cooked by steaming or 
boiling in water), f rozen, other than cultivated mushrooms 
ex 0710 80 69 other mushrooms (uncooked or c ooked by steaming or boiling in w ater), 
frozen, other than cultivated mushrooms 
ex 0711 51 00 mushrooms of the genus Agaricus provisionally preserved (for example, 
by sulphur dioxide gas, in brine, in sulphur water or in other preservative 
solutions), but unsuitable in that state for immediate consumpt ion, other 
than cultivated mushrooms 
ex 0711 59 00 other mushrooms provis ionally preserved (for exam ple, by sulphur 
dioxide gas, in brine, in sulphur water or in other preservativ e solutions), 
but unsuitable in that state fo r immediate consumption, other t han 
cultivated mushrooms 
ex 0712 31 00 mushrooms of the genus Agaricus, dried, whole, cut, sliced, broken or in 
powder, but not further prepare d, other than cultivated mushroo ms 
ex 0712 32 00 wood ears ( Auricularia spp.) dried, whole, cut, sliced, broken or in 
powder, but not further prepare d, other than cultivated mushroo ms 
ex 0712 33 00 jelly fungi ( Tremella spp.) dried, whole, cut, s liced, broken or in powder, 
but not further prepared, other than cultivated mushrooms 
ex 0712 39 00 other mushrooms, dried, whole, cut, sliced, broke n or in powder, but not 
further prepared, other th an cultivated mushrooms 
ex 2001 90 50 mushrooms prepared or preserved by vinegar or ace tic acid other than 
cultivated mushrooms 
ex 2003  mushrooms and truffles, pr epared or preserved otherwis e than by vinegar 
or acetic acid, other than  cultivated mushrooms 
ex 0810 40 wild cranberries, wild b ilberries and other wild fru its of the genus 
Vaccinium , fresh 
ex 0811 90 50 wild fruits of the species Vaccinium myrtillus , uncooked or cooked by 
steaming or boiling in water, frozen, whether or not containing  added 
sugar or other sw eetening matter  EN 3  EN ex 0811 90 70 wild fruits of the species Vaccinium myrtilloides  a n d  Vaccinium 
angustifolium , uncooked or cooked by steaming or boiling in water, 
frozen, whether or not containing a dded sugar or other sweeteni ng matter 
ex 0812 90 40 wild fruits of the species Vaccinium myrtillus , provisionally preserved 
(for example, by sulphur dioxide gas, in brine, in sulphur wate r or in 
other preservative solutions), but  unsuitable in that state for  immediate 
consumption 
ex 2008 93 wild cranberries ( Vaccinium macrocarpon, Vaccinium oxycoccos, 
Vaccinium vitis-idaea ), otherwise prepared or p reserved, whether or not 
containing added sugar or other  sweetening matter or spirit, no t elsewhere 
specified or included 
ex 2008 99 other wild fru its of the genus Vaccinium , otherwise prepared or 
preserved, whether or not contai ning added sugar or other sweet ening 
matter or spirit, not elsewh ere specified or included 
ex 2009 81 cranberry juices of wild fruits ( Vaccinium macrocarpon, Vaccinium 
oxycoccos, Vaccinium vitis-idaea ), unfermented and not containing added 
spirit, whether or not containi ng added sugar or other sweeteni ng matter 
ex 2009 89 other juices of wild fruits of the genus Vaccinium , unfermented and not 
containing added spirit, whethe r or not containing added sugar or other 
sweetening matter EN 4  EN ANNEX III  
MODEL OFFICIAL CERTIFICATE REFE RRED TO IN ARTIC LE 4 OF COMMISSI ON 
IMPLEMENTING REGULATION (EU) …/… ON THE CONDITIONS GOVERNING 
IMPORTS OF FOOD AND FEED ORIGINA TING IN THIRD COUNTRIES FOLLOWI NG 
THE ACCIDENT AT THE CHERNOBYL NUCLEAR POWER STATION     
COUNTRY Official certificate to the EU Part 1 : Details of dispatched consignment I.1. Consignor/Exporter 
  Name  
  Address 
   Tel. No I.2. Certificate reference No I.2.a  IMSOC reference No 
I.3. Central Competent Authority 
I.4. Local Competent Authority 
I.5. Consignee/Importer 
  Name 
 
  Address   Postal code   Tel. No I.6. Operator responsible for the consignment 
  Name 
 
  Address   Postal code 
I.7. Country of origin ISO I.8. Region of origin 
 I.9. Country of destination ISO I.10.  
 
I.11 Place of dispatch 
 
Name 
Address    I.12. Place of destination 
 
Name 
Address  
I.13. Place of loading I.14. D ate and time of departure 
I.15. Means of transport 
    
    Aeroplane 
     Road vehicle      Identification:  
  
 
Vessel 
 Railway  
  
 
Other  I.16. Entry BCP 
I.17. Accompanying documents 
 
       Laboratory report  
           No.            Date of issuance:          Other                     Type             No I.18. Transport conditions  Ambient    
  
 Chilled   
 Frozen   
I.19. Container No/Seal No 
I.20. Goods certified as 
     
Human consumption    
  
  
 
I.21.                     I.22. 
For internal market:  
I.23 Total number of packages I.24. Quantity 
        Total number  
Total net weight (Kg)  
Total gross weight (Kg) 
I.25. Description of goods           No                    Code and CN title 
 
Species (Scientific name) 
   Final consumer            Number of packages 
 
   
   
                              Net weight                                          Batch No  
    
Type of packaging EN 5  EN  
  COUNTRY Certificate for the entr y into the Union of food and fe ed 
 II. Health information II.a Certificate reference No  II.b IMSOC reference 
No 
   II.1.         I, the undersigned, declare that I am aware of the relevant pro visions of Regulation (EC) No 178/2002 
of the European Parliament and of the Council, Regulation (EC) No 852/2004 of the European 
Parliament and of the Council and Regulation (EU) 2017/625 of t he European Parliament and of the 
Council (Official Controls Regul ation), and I certify that: 
 
II.1.1.   the food of the consignment described above with the identific ation code … (indicate the identification 
code for the consignment referred to in Article 3(3) of Commiss ion Implementing Regulation (EU) 2020/…)  was 
produced in accordance with the requirements of Regulations (EC ) No 178/2002 and (EC) No 852/2004 and in 
particular:  
 - its primary production and associated operations listed in A nnex I to Regulation (EC) No 852/2004 
comply with the general hygiene provisions laid down in part A of Annex I to Regulation (EC) No 
852/2004; 
-   and, in the case of any stage of production, processing and  distribution after primary production and 
related operations: 
 - it has been handled and, where appropriate, prepared, packag ed and stored in a hygienic manner in 
accordance with the requirements of Annex II to Regulation (EC)  No 852/2004 and, 
-  it comes from (an) establishment(s) implementing a programme  based on the hazard analysis and 
critical control points (HACCP) principles in accordance with R egulation (EC) No 852/2004; 
and  
II.2       I, the undersigned certify, in accordance with Commissio n Implementing Regulati on (EU) 2020/…, that: 
-  from the consignment describe d above, samples were taken on …………………………………. (date), subject 
to laboratory analysis on .... ............. (date) in the …………… …………………………………………………… 
(name of the laboratory) with me thods for the analysis of caesi um-137; 
- the details of the methods of laboratory analysis and all res ults are attached and show compliance with the 
maximum levels established in Article 3(2) of Commission Implem enting Regulation (EU) 2020/…. 
 
Notes - See instructions for completi on in Annex IV to Commission Imple menting Regulation (EU) 2020/… .  
- Part II: The colour of the sign ature shall be different to th at of the printing. The same rule applies to stamps 
other than those th at are embossed or are a watermark. Part II Certification     
 
 Certifying officer:  
 Name (in capital letters): Qualification and title:  D a t e :  Signature: 
 S t a m p  EN 6  EN ANNEX IV  
INSTRUCTIONS FOR THE COMPLETION OF THE OFFICIAL CERTIFICATE  REFERRED TO 
IN ARTICLE 4 OF COMMISSION IMPLEMENTING REGULATION (EU) …/…  ON  THE 
CONDITIONS GOVERNING IMPORTS OF FOOD AND FEED ORIGINATING IN TH IRD 
COUNTRIES FOLLOWING THE ACCIDENT AT THE CHERNOBYL NUCLEAR POWER  
STATION  
General 
To positively select any option,  please tick or m ark the releva nt box with a cross (X).  
Whenever mentioned, ‘ISO’ means the international standard two- letter code for a country, in accordance with 
the international standard ISO 3166 alpha-23. 
Only one of the options may be se lected in boxes I.15, I.18, I. 20. 
Unless otherwise indicated , the boxes are compulsory.  
If the consignee, the entry border control post (BCP) or the tr ansport details (that is to say, the means and date) 
change after the certificate has been issued, the operator resp onsible for the consignment must advise the 
competent authority of the Member  State of entry. Such a change  shall not result in a request for a replacement 
certificate. 
In case the certificate is submi tted in IMSOC, the following ap plies: 
- the entries or boxes specified in Part I constitute the data di ctionaries for the electronic version of the official 
certificate; 
- the sequences of boxes in Part I of the model official certif icate and the size and shape of those boxes are 
indicative; 
- where a stamp is required, its  electronic equivalent is an el ectronic seal. Such seal shall comply with the rules 
for the issuance of electronic certificates referred to in poin t (f) of the first paragraph of Article 90 of Regulation 
(EU) 2017/625. 
  
Part I: Details of the dispatched consignment 
Country:  The name of the third country issuing the certificate . 
Box I.1. Consignor/Exporter: the name and address (street, city  and region, province or state, as 
appropriate) of the natural or l egal person dispatching the con signment that must be located in 
the third country. 
Box I.2. Certificate reference No: the unique mandatory code as signed by the competent authority of 
the third country in accordance with its own classification. Th is box is compulsory for all 
certificates not submitted in IMSOC. 
Box I.2.a IMSOC reference No: th e unique reference code automat ically assigned by IMSOC, if the 
certificate is registered in IMSOC. This box must not be comple ted if the certificate is not 
submitted in IMSOC. 
Box I.3. Central competent authority: name of the central autho rity in the third country issuing the 
certificate. 
Box I.4. Local competent authority: if applicable, the name of the local authority in the third country 
issuing the certificate. 
Box I.5. Consignee/Importer: name and address of the natural or  legal person to whom the consignment 
is intended in the Member State. 
 
3 List of country names and code elements under: http://www.iso.org/iso/country_codes/iso-3166-
1_decoding_table.htm .  EN 7  EN Box I.6. Operator responsible for the consignment:  the name and address of the person in the European 
Union in charge of the consignment when presented to the BCP an d who makes the necessary 
declarations to the competent authorities either as the importe r or on behalf of the importer. 
This box is optional.  
Box I.7. Country of origin: the name and ISO code of the countr y where the goods are originating from, 
grown, harvested or produced. 
Box I.9. Country of destination: the name and ISO code of the E uropean Union country of destination 
of the products. 
Box I.11. Place of dispatch: the n ame and address of the holdin gs or establishments from which the 
products come from. 
Any unit of a company in the food sector. Only the establishmen t shipping the products is to be 
named. In the case of trade involving more than one third count ry (triangular movement), the 
place of dispatch is the last third-country establishment of th e export chain from which the 
final consignment is transported to the European Union. 
Box I.12. Place of destination: t his information is optional. 
For the placing on the market: the place where the products are  sent for final unloading. Give 
the name, address and approval number of the holdings or establ ishments of the place of 
destination, if applicable. 
Box I.14. Date and time of depar ture: the date when the means o f transport departs (aeroplane, vessel, 
railway or road vehicle).  
Box I.15. Means of transport: means of transport leaving the co untry of dispatch. 
Mode of transport: aeroplane, ves sel, railway, road vehicle or other. ‘Other’ means modes of 
transport not covered by Council Regulation (EC) No 1/20054. 
Identification of the means of transport: for aeroplanes, the f light number, for vessels, the ship 
name(s), for railways, the train identity and wagon number, for  road transports, the registration 
number plate with trailer num ber plate if applicable. 
In the case of a ferry, the iden tification of the road vehicle,  the registration number plate with 
trailer number plate if applicab le, and the name of the schedul ed ferry must al so be provided. 
Box I.16. Entry BCP: state the na me of the BCP and its identifi cation code assigned by IMSOC. 
Box I.17. Accompanying documents: 
Laboratory report: indicate the reference number and the date o f issuance of the report/results 
of laboratory analysis referred to in Article 4(6) of Commissio n Implementing Regulation 
(EU) …/… . 
Other: the type and reference number of document must be stated  when a consignment is 
accompanied by other doc uments such as a commercial document (f or example, the airway bill 
number, the bill of lading number  or the commercial number of t he train or road vehicle). 
Box I.18. Transport conditions: category of required temperatur e during the transport of products 
(ambient, chilled, frozen). Only  one category may be selected. 
Box I.19. Container No/Seal No: if applicable, the correspondin g numbers. 
The container number must be provided if the goods are transpor ted in closed containers. 
Only the official seal number must  be stated. An official seal applies if a seal is affixed to the 
container, truck or rail wagon under the supervision of the com petent authority issuing the 
certificate.  
Box I.20. Goods certified as: st ate the intended use for produc ts as specified in the relevant European 
Union official certificate. 
 
4 Council Regulation (EC) No 1/2005 of 22 December 2004 on the p rotection of animals  during transport 
and related operations and amending Directives 64/432/EEC and 9 3/119/EC and Regulation (EC) No 
1255/97 (OJ L 3, 5.1.2005, p. 1). EN 8  EN Human consumption: concerns only products intended for human co nsumption. 
Box I.22. For internal market: for all consignments destined to  be placed on the market in the European 
Union. 
Box I.23. Total number of packag es: the number of packages. In the case of bulk consignments, this box 
is optional. 
Box I.24. Quantity: 
Total net weight: this is defined as the mass of the goods them selves without immediate 
containers or any packaging. 
Total gross weight: overall weight in kilograms. This is define d as the aggregate mass of the 
products and of the immediate containers and all their packagin g, but excluding transport 
containers and other transport equipment. 
Box I.25. Description of goods: State the relevant Harmonised S ystem code (HS code) and the title 
defined by the World Customs Organisation as referred to in Cou ncil Regulation (EEC) No 
2658/875. This customs description shall be supplemented, if necessary,  by additional 
information required to classify the products.  
Indicate the species, types of p roducts, the number of packages , type of packaging, batch 
number, net weight, and final con sumer (i.e. products are packe d for final consumer). 
Species: the scientific name or  as defined in accordance with E uropean Union legislation. 
Type of packaging: identify the type of packaging according to the definition given in 
Recommendation No 216 of UN/CEFACT (United Nations C entre for Trade Facilitation and  
Electronic Business). 
 
Part II: Certification 
This part must be completed by a certifying officer authorised by the competent authority of the third country to 
sign the official certificate, a s provided for in Article 88(2)  of Regulation (EU) 2017/625. 
Box II. Health information: please complete this part in accord ance with the specific European Union 
health requirements relating to the nature of the products and as defined in the equivalence 
agreements with certain third countries or in other European Un ion legislation, such as that for 
certification. 
In case the official certificate is not submitted in IMSOC, the  statements which are not relevant 
must be crossed out, initialled and stamped by the certifying o fficer, or completely removed 
from the certificate. 
In case the certificate is submitted in IMSOC, the statements w hich are not relevant must be 
crossed out or completely re moved from the certificate.  
Box II.a.  Certificate reference No: same reference code as in box I.2. 
Box II.b. IMSOC reference No: same reference code as in box I.2 .a. Mandatory only for official 
certificates issued in IMSOC. 
Certifying officer: Official of the competent authority of the third country authorised to sign official 
certificates by such authorities: Indicate the name in capital letters, qualification and 
title, where applicable, identification number and original sta mp of the competent 
authority and date of signature.  
 
5 Council Regulation (EEC) No 2658/87 of 23 July 1987 on the tar iff and statistical nomenclature and on 
the Common Customs Tariff (OJ L 256, 7.9.1987, p. 1). 
6 Last version: Revision 9 Annexes V and VI as published on: http://www.unece.org/ tradewelcome/un-
centre-for-trade-fac ilitation-and-e-business-uncefact/outputs/c efactrecommendations rec-index/list-of-
trade-facilitation-recommendations-n-21-to-24.ahtml .