Veterinary Health Certificate for Live Fish, Fertilized Eggs, and Gametes of 

Tilapia Lake Virus (TiLV) – Susceptible Species to the United States 

Veterinary Authority:* Date Of Issue:* 

1. Consignor (Name & Address):* 

3. Country of Origin:* 

5. City/ Region of Origin: 

7. Port Of Embarkation / Border Crossing:* 

9. Estimated Date of Shipment:* 

11. Description of Commodity: 

13. Total Quantity of Animals:* 

15. Commodities Intended Use:* 

Certificate Number:* 

U.S. Import Permit Number:* 

2. Consignee (Name & Address):* 

4. Destination in United States (Name & Address):* 

6. Route of Travel:* 

8. Means of Transport:* 

10. Estimated Date of Arrival:* 

12. Date Of Veterinary Inspection in Country of Origin:* 

14. Total Number Of Packages/Containers:* 

BREEDING CULTURE/GROW OUT RESEARCH 

16. Identification Of Commodities:* 

Scientific Name (Genus species) Common Name Sex Quantity 

*Indicates required information 

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Veterinary Health Certificate for Live Fish, Fertilized Eggs, and Gametes of

Tilapia Lake Virus (TiLV) – Susceptible Species to the United States 

Veterinary Authority* Date Of Issue* Certificate Number*

I, the undersigned veterinarian of the competent authority, certify that the live animals described above 

meet the following conditions: 

1. EITHER A. Tilapia from this population to be exported tested negative for TiLV within thirty (30) 

days prior to export per the World Organization for Animal Health (OIE) OR a laboratory 

testing method reviewed and approved by the USDA prior to export. Sampling 

procedures used an assumed pathogen prevalence of two (2) percent, with a 

corresponding confidence level of ninety-five (95) percent. AND 

B. Samples were collected by an official veterinarian, or certifying official, representing the 

Competent Authority. 

OR A. The facility of origin participates in an ongoing TILV monitoring program for species 

susceptible to TILV, by testing negative twice annually for a minimum of two (2) 

consecutive years, with at least three (3) months between tests. AND 

B. Populations were sampled utilizing an assumed pathogen prevalence of two (2) percent, 

with a corresponding confidence level of ninety-five (95) percent, and found negative for 

TILV. AND 

C. Samples were collected by an official veterinarian, or certifying official, representing the 

Competent Authority, and tested per the World Organization of Animal Health (OIE) OR a 

laboratory testing method reviewed and approved by the USDA prior to export. 

2. No OIE-listed disease(s) affecting tilapia was/were reported at the premises of origin within sixty 

(60) days prior to export. 

3. The tilapia originate in the exporting country OR were legally imported and verified to be of equal 

health status before entering the population for export. 

4. The tilapia were inspected by an official veterinarian of the exporting country’s Competent Authority 

within seventy-two (72) hours prior to export, and showed no clinical signs of disease. 

5. All shipping containers are new, OR have been properly cleaned and disinfected prior to use. 

6. The shipment will ship directly to the United States with no stops en route other than those 

provided for on the USDA import permit. 

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

After the animal inspection, this health certificate is valid for seventy-two (72) hours prior to export. 

Printed Name of Official Veterinarian: 

Signature of Official Veterinarian: 

Date: 

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