1 
 EN 
 
ANNEX  
PART 1  
Model of official certificate accompanying consignment s of products of animal origin, 
germinal products , animal by -products , derived products,  hay and straw and composite 
products  from third countries which are delivered to vessels leaving the Union or to 
NATO or U nited States’  military bases   
EUROPEAN UNION   
Official Certificate for goods delivered to vessels leaving the Union  
or to NATO or U nited States’  military bases  
I.1 Border control post/ Competent authority  I.2 Certificate reference number  
 I.2.a IMSOC reference number   
TRACES reference 
number     
I.3 Consignor   I.4 Operator responsible for the 
consignment   
 Name    Name   
 Address    Address   
 Registration/ Approval No     
 Country  ISO country code   Country  ISO country code  
I.5 Place of destination  (vessel)  I.6 Place of destination (NATO/U nited States’  military base)  
Vessel n ame   Name of NATO/U nited States’  
military base  
NATO/U nited States’  military base 
TRACES reference number   
Vessel IMO number   Address   
Port  Country  ISO country code  
Country  ISO country code  BCP of exit   
I.7 Means of transport  Identification number(s)  Container No  Seal No  
I.8 Description of goods  
 CN code  Product type  Country of origin  Number of 
packages  Net weight(kg)  Reference  of CHED of 
origin  
       
       
        
2 
        
       
       
 Supporting document: ____________________________________  
I.9 Total number of packages  
  
 I.10 Total net weight  (kg) 
 
I.11 Date of departure    
II.1 Declaration:  
(1)  I, the undersigned certifying officer confirm that the products described above are authorised to be dispatched to the vessel leaving the 
Union  
(1)  I, the undersigned certifying officer confirm that the products described above are aut horised to be d ispatched to a NATO/U nites States’  
military base  
II.2 Name (in capital letters)   Qualification and title  
    
 Competent authority /BCP   Competent authority /BCP TRACES registration No 
 Date  Stamp(2) Signature(2) 
III.1  Confirmation of the arrival and compliance of the 
consignment     
I confirm delivery of the consignment : 
 (1)  on board the vessel specified in Box I. 5 
(1)  to a NATO/U nited States’  military base specified in Box I. 6  
  (1)  BCP of exit 
 Compliance of consignment  Yes No  
III.2  (1) Competent 
authority   Official representative of the master of 
vessel   Competent authority responsible for controls at the 
NATO/U nited States’  military  base 
 Name (in capital letters)   Position  
Competent authority  Competent authority  TRACES registration No  
Place    
Date  Stamp(2) Signature(2) 
 (1) Keep as appropriate  
  
EN 3  EN PART  2 
Notes for the completion of the model official certificate  
General  
To positively indicate any option, please tick or mark the relevant box with a cross (X).  
“ISO  code ” refers to the international standard two -letter code  used to refer to  a country, in 
accordance with the international standard ISO 3166 alpha -21.  
Whenever a box allows for the choice of one or more options , only those options will be 
displayed in the electronic version of the official certificate.  
Part I: Details of the dispatched consignment  
Box I.1.  Border control post/Competent authority: indicate the name of the border 
control post  (BCP)  or of the competent authority issuing the official 
certificate , as appropriate , and their TRACES reference number . 
Box I.2.  Certificate reference number : the unique mandatory code  assigned by the 
competent authority issuing the official certificate in accordance with its 
own classification. This box is compulsory for all certificates not 
submitted in IMSOC.  
Box I.2.a  IMSOC ref erence number : the unique reference code automatically 
assigned by IMSOC if the certificate is registered in IMSOC. Do not 
complete this box  if the certificate is not submitted in IMSOC.  
Box I.3.  Consignor: in the case of dispatch from a warehouse, indica te the name 
and address (street, city and region, province or state, 
registration/approval No, as appropriate) of the warehouse from which the 
consignment is dispatched. Do not complete this box if the consignment is 
dispatched directly from a border control post.  
Box I.4.  Operator  responsible for the consignment : the name and address (street, 
city and region, province or state, registration/approval No, as 
appropriate) of the natural or legal person who is responsible in the Union 
for the delivery of  the consignment to the place of destination . 
Box I. 5. Place of destination (vessel): indicate the name of the vessel for which  the 
consignment is intended , vessel International Maritime Organisation 
(IMO) number, name of port, name and ISO code of the Member State  of 
destination of goods. Do not complete t his box if  the official certificate is 
issued for delivery  of the consignment  to the NATO or United States’  
military base located in the Union territory  or in a third country.  
Box I. 6. Place of destination (NATO/U nited States’  military base): indicate the 
name of the NATO/  United States’  military base of destination situated in 
the Union territory , the name and ISO code of the Member State  where 
the NATO or United States’  military base of destina tion is located.   
If the destination is a NATO/  United States’  military base located in a 
third country , only the border control post of exit from the Union must be 
indicated in this box.  
Do not complete this  box if the official certificate is issued for delivery to 
                                                 
1 List of country names and code elements under: http://www.iso.org/iso/country_codes/iso -3166 -
1_decoding_table.htm    
EN 4  EN vessels leaving the Union . 
Box I. 7. Means of transport:  
Identification number(s): for aeroplanes ; indicate  the flight number, for 
vessels ; the ship name(s), for railways ; the train identity and w agon 
number, for road transports ; the registration number plate with the trailer 
number plate if appropriate.  For containerized consignment s, the trailer 
number plate is not obligatory if the container number has been indicated.   
In the case of transport b y ferry, indicate the identification of the road 
vehicle, the registration number plate with trailer number plate if 
appropriate, and the name of the scheduled ferry.  
Container No:  if applicable, corresponding numbers. The container number must be 
indicat ed if the goods are transported in closed containers.  
Seal No : 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 competent authority issuing the c ertificate.  
Box I. 8. Description of goods:  
Description of goods and product type: indicate the relevant Combined 
Nomenclature (CN) code,  and the title as referred to in Council 
Regulation (EEC) No 2658/87 of 23 July 1987 on the tariff and statistical 
nomenclature and on the Common Customs Tariff  2. 
Country of origin: indicate the country of origin of the goods . 
Reference of CHED of origin: indicate the reference of the CHED for the 
consignment from which the relevant number of boxes of the product are 
derived.  
The information under this box may also be provided in a  supporting 
document to be attached to the official certificate. In such a case, the box 
“Supporting documents” must be filled in , including the reference number 
of the supporting document(s) . 
Box I. 9. Total number of packages: indicate the number of boxes or of packages of 
goods. In the case of bulk consignments, this box is optional.  
Box I.1 0. Total net weight  in kilogrammes : this is defined as the mass of the goods 
themselves without imme diate containers or any packaging.  
Box I.1 1. Date and time of departure: indicate the date and time of the intended 
departure  of the means of transport from the border control po st or 
warehouse.  
Part II: Declaration  
This part must be completed by an official veterinarian or an official inspector  of the 
competent authority at the border control post or at the warehouse.  
                                                 
2 Council Regulation (EEC) No 2658/87 of 23 July 1987 on the tariff and statistical nomenclature and on 
the Common Customs Tariff (OJ L 256, 7.9.1987, p. 1).   
EN 5  EN Part III: Confirmation of arrival of consignment  
This part must be completed by : 
– in case the destination is a vessel leaving the Unio n; the competent authority at the 
port of destination or by the official representative of the master of the vessel;  
– in case the destination is a NATO/  United States’  military base situated in the Union 
territory ; the competent authority responsible for controls at the NATO/  United 
States’  military base;  
– in case the destination is a NATO/  United States’  military base located in a third 
country ; the competent authority at the border control post of exit.