Page 1 of 2

Veterinary Health Certificate for Export of Dogs and Cats from the United States of America to the Cote d’Ivoire (Ivory Coast)

Veterinary Authority

UNITED STATES DEPARTMENT OF AGRICULTURE

Date Of Issue Certificate Number

1. Consignor: 2. Consignee:

3. Country Of Origin: 

United States of America 

 4. State Of Origin:

 

5. Country Of Destination:

Cote d’Ivoire (Ivory Coast)

6. Zone of Destination:

**************************************************************************************

7. Place Of Origin:

**************************************************************************************

**************************************************************************************

**************************************************************************************

8. Port of Embarkation / Border Crossing: 

**************************************************************************************

**************************************************************************************

**************************************************************************************

9. Estimated Date Of Shipment:

 

10. Means Of Transport:

 

11. 

**************************************************************************************

**************************************************************************************

12. CITES Permit Number:

**************************************************************************************

 ************************************************************************************** 13. Description Of Commodity:

 DOG(S) CAT(S)

14. 

 **************************************************************************************

 **************************************************************************************

15. Total Quantity: 16. Total Number Of Packages/Containers:

**************************************************************************************

**************************************************************************************

17. Additional Information: 

***********************************************************************************************************************************************************************************

*********************************************************************************************************************************************************************************** 18. Identification / Seal Numbers: 

**************************************************************************************************************************************************************************************

**************************************************************************************************************************************************************************************

19. Commodities Intended Use: Pet (Personal) 20. Type Of Admission:

**************************************************************************************

**************************************************************************************

21. Identification Of Commodities:

Microchip Number 

and/or Name of Animal Species Breed Age Sex Color or Distinctive Markings

• NOTE: An import permit issued by the Directorate of Veterinary Services of Cote d’Ivoire is required.
Page 2 of 2

Veterinary Authority

UNITED STATES DEPARTMENT OF AGRICULTURE

Date Of Issue Certificate Number

 Certification Statements:

1. I have verified the presence of any microchips listed in box 21.

2. I certify that the animals described in box 21 have been inspected by me on this date and appear to be free of any infectious or 

contagious diseases and, to the best of my knowledge, exposure thereto, which would endanger the animals or other animals or 

would endanger public health.

3. To my knowledge, the animals have been free of mange for at least the last 6 (six) months.

4. To my knowledge, the animals described in box 21 originated from an area not quarantined for rabies and have not been exposed to 

rabies.

5. Pets are current on rabies vaccinations (If the booster dose is inoculated during the period of validity of the previous vaccination, there 

is no waiting period before the importation of the animals. If primary vaccination is needed, or if booster does not occur during the 

period of validity of the previous vaccination, this booster should be considered a primary vaccination, and animals are required to 

wait at least 21 days prior to importation).

6. The animals have been vaccinated for rabies, as below:

Microchip Number and/or Name Date of Rabies 

Vaccination Name of Vaccine Vaccine Batch Number

End Date of Period 

of Validity

7. Other vaccinations, treatments, and/or tests and results (optional - line-out unused boxes):

Microchip 

Number/Name

Date

Performed

Other vaccinations, 

treatments, and/or tests 

and results

Date 

Performed

Other vaccinations, 

treatments, and/or tests 

and results

Date 

Performed

Other vaccinations, 

treatments, and/or tests 

and results

This certificate is valid for 10 days after issuance.

******************************************************************************************************************************************************************

****************************************************************************************************************************************************************** Name of USDA-Accredited Veterinarian Name of USDA Veterinarian

Signature of USDA-Accredited Veterinarian Signature of USDA Veterinarian

Date Date