EN    EN 
 
 
 EUROPEAN  
COMMISSION   
Brussels, XXX   
SANTE/10575/2016 ANNEX CIS Rev. 
4 (POOL/G4/2016/10575/10575R4 -EN 
ANNEX CIS.doc)  
[…](2016) XXX  draft  
ANNEX 1  
  
ANNEX  
to the  
COMMISSION REGULATION (EU) …/…  
amending Regulation (EC) No 2074/2005 as regards official controls on fishery products 
caught by vessels flying the flag of a Member State and introduced into Union after 
being transferred in third countries and establishing a model health certificate for those 
products   EN 2   EN In Annex VI  to Regulation (EC) No 2074/2005, the following Appendix VIII is added : 
'Appendix VIII to Annex VI  
Model of health certificate f or fishery products intended for human consumption caught by 
vessels flying the flag of a Member State and transferred in third countries with or without 
storage  
 Veterinary certificate to the EU  Part I : Details of dispatched consignment  I.1. Consignor  
 Name  
 Address  
 
 Tel. I.2. Certificate reference number  I.2.a.  
I.3. Central Competent Authority  
I.4. Local Competent authority  
I.5. Consignee  
 Name  
 Address  
  
 
 Postcode  
 Tel. I.6. 
I.7. Country of 
origin  ISO code  I.8. Region of 
origin  Code  I.9. Country of 
destination  ISO code  I.10.  
        
I.11. Place of origin  
 
 Name                               Approval /registration  number  
 Address  
 I.12. 
I.13. Place of loading  
 Address   I.14. Date of departure   
 I.15. Means of transport  
 
 Aeroplane  Ship  Railway wagon  
 Road vehicle  Other   
 Identification:  
 Document references:  I.16. Entry BIP in EU  
 
 
I.17.  
 I.18. Description of commodity   I.19. Commodity code (HS code)  
 
 I.20. Quantity  
 I.21. Temperature of product  
 
Ambient  Chilled  Frozen  I.22. Number of packages  
 I.23. Seal/Container No  I.24. Type of packaging  
 I.25. Commodities certified as:  
 
 Human consumption  
 
 I.26. I.27. For import or admission into EU   
 I.28. Identification of the commodity  
 
Species (Scientific name ) ………… … Treatment type ..... Approval /registration  number (s) of vessel(s) * ..... Number of packages ..... Net weight  
….. 
  
 EN 3   EN COUNTRY  Fishery products transferred  in third  countries  
II. Health information  II.a. Certificate reference number  II.b. 
 
II.1. Public health attestation  
 
I, the undersigned official inspector, declare that I am aware of the relevant provisions of Regulations  (EC) No s 
178/2002, (EC) 852/2004, (EC) 853/2004 and (EC) 854/2004 and certify that the fishery products described above  
 
- have been landed and unloaded hygienically from the approved /registered  vessel (s) …………… ……… .(indicate 
approval /registration  number (s) and name of the flag Member State (s)) in compliance with the relevant requirements 
laid down in Chapter II of Section VIII,  of Annex III to Regulation (EC) No 853/2004;  
- if applicable, have been stored in approved coldstore (s) …………… .……. .(indicate approval number (s)) in 
compliance with the relevant requirements of Chapter VII of Section VIII  of Annex III to Regulation (EC) No 
853/2004;   
- if applicable , have been loaded hygienically on the approved vessel (s) …………… …………………. .(indicate 
approval number(s)) of the Member State(s)  or third country(ies) and  the name of the flag Member State(s)  or third 
country(ies))  in compliance with  the relevant requirements laid down in  Chapter I and VIII of Section VIII of Annex 
III to Regulat ion (EC) No 853/2004 ; 
- if applicable, have been loaded in a container .…………………. (indicate container number) or in a truck 
………………(indicate registration number plate with trailer number plate)  or in an a eroplane ……….  (indicate the 
flight number)  in complianc e with the requirements laid down in Chapter VIII of Section VIII of Annex III to 
Regulation (EC) No 853/2004;  
- are accompanied by the print out(s) ** of the fishing logbook (s) or relevant parts thereof ** 
 
** Electronic format is also accepted . 
 
 
Notes  
Part I:  
- Box reference I.7 : Indicate the name of the third country of dispatch.  
- Box reference I.11:  Place of origin: indicate the name, address and approval number of the cold store in the third 
country of  dispatch or, if no storage in a coldstore take s place, indicate the name and approval or 
registration number of the Member State flagged vessel  of origin . 
- Box reference I.15:  Indicate the means of transport leaving the third country of dispatch. In case of freezer/reefer  
vessels, indicate the name of  the vessel , approval number  and flag State, in case of fishing vessel the registration 
number and flag State . If the means of transport are containers, trucks or a eroplanes the same indications 
provided for in the fourth indent of part II.1 must be indica ted. 
- Box reference I.19:  Use the appropriate Harmonised System (HS) codes of the World Customs Organisation of the
 following headings: 0302, 0303, 0304, 0305, 0306, 0307, 0308, 1504, 1516, 1518, 1603, 1604,  1605, 
2106  
- Box reference I.23:  Identification  of container/ seal number: The serial seal number must only be indicated if  the 
seal was affixed to the container under the supervision of the competent authority  issuing  the certificate.  
- Box reference I.28:  Treatment type: Specify whether chilled, frozen or processed.  
 * includes fishing vessel, factory vessel, freezer  and reefer  vessel  as applicable . 
. 
 
 
 
Official inspector  
 Name (in capital letters):  Qualification and title:  
 Date:  Signature:  
 Stamp:  EN 4   EN '