‘Appendix IV to Annex VIModel health certificate for imports of fishery products intended for human consumptionPart I: Details of dispatched consignmentVeterinary certificate to EUI.1. ConsignorNameAddressTel.I.2. Certificate reference NoI.2.a.I.3. Central competent authorityI.4. Local competent authorityI.5. ConsigneeNameAddressPostcodeTel.I.6.I.7. Country of originISO codeI.8. Region of originCodeI.9. Country of destinationISO codeI.10I.11. Place of originNameApproval numberAddressI.12.I.13. Place of loadingI.14. Date of departureI.15. Means of transportAeroplaneShipRailway wagonRoad vehicleOtherIdentificationDocumentation referencesI.16. Entry BIP in EUI.17.I.18. Description of commodityI.19. Commodity code (HS code)I.20. QuantityI.21. Temperature of productAmbientChilledFrozenI.22. Number of packagesI.23. Seal/Container NoI.24. Type of packagingI.25. Commodities certified for:Human consumptionI.26.I.27. For import or admission into EUI.28. Identification of the commoditiesSpecies(scientific name)Nature of commodityTreatment type of establishementApproval numberManufacturing plantNumber of packagesNet weightPart II: CertificationCOUNTRYFishery productsII. Health informationII.a. Certificate reference numberII.b.II.1. (1) Public health attestationI, the undersigned, declare that I am aware of the relevant provisions of Regulations (EC) No 178/2002, (EC) 852/2004, (EC) 853/2004 and (EC) 854/2004 and certify that the fishery products described above were produced in accordance with those requirements, in particular that they:come from (an) establishment(s) implementing a programme based on the HACCP principles in accordance with Regulation (EC) No 852/2004;have been caught and handled on board vessels, landed, handled and where appropriate prepared, processed, frozen and thawed hygienically in compliance with the requirements laid down in Section VIII, Chapters I to IV of Annex III to Regulation (EC) No 853/2004;satisfy the health standards laid down in Section VIII, Chapter V of Annex III to Regulation (EC) No 853/2004 and the criteria laid down in Regulation (EC) No 2073/2005 on microbiological criteria for foodstuffs;have been packaged, stored and transported in compliance with Section VIII, Chapters VI to VIII of Annex III to Regulation (EC) No 853/2004;have been marked in accordance with Section I of Annex II to Regulation (EC) No 853/2004;the guarantees covering live animals and products thereof, if from aquaculture origin, provided by the residue plans submitted in accordance with Directive 96/23/EC, and in particular Article 29 thereof, are fulfilled; andhave satisfactorily undergone the official controls laid down in Annex III to Regulation (EC) No 854/2004.II.2. (2) (4) Animal health attestation for fish and crustaceans of aquaculture originII.2.1. (3) (4) [Requirements for susceptible species to Epizootic haematopoietic necrosis (EHN), Taura syndrome and Yellowhead diseaseI, the undersigned official inspector, hereby certify that the aquaculture animals or products thereof referred to in Part I of this certificate:(5) originate from a country/territory, zone or compartment declared free from (4) [EHN (4) [Taura syndrome] (4) [Yellowhead disease] in accordance with Chapter VII of Directive 2006/88/EC or the relevant OIE Standard by the competent authority of my country,(i) where the relevant diseases are notifiable to the competent authority and reports of suspicion of infection of the relevant disease must be immediately investigated by the competent authority,(ii) all introduction of species susceptible to the relevant diseases come from an area declared free of the disease, and(iii) species susceptible to the relevant diseases are not vaccinated against the relevant diseases]II.2.2. (3) (4) [Requirements for species susceptible to Viral haemorrhagic septicaemia (VHS), Infectious haematopoietic necrosis (IHN), Infectious salmon anaemia (ISA), Koi herpes virus (KHV) and White spot disease intended for a Member State, zone or compartment declared disease free or subject to a surveillance or eradication programme for the relevant diseaseI, the undersigned official inspector, hereby certify that the aquaculture animals or products thereof referred to in Part I of this certificate:(6) originate from a country/territory, zone or compartment declared free from (4) [VHS] (4) [IHN] (4) [ISA] (4) [KHV] (4) [White spot disease] in accordance with Chapter VII of Directive 2006/88/EC or the relevant OIE Standard by the competent authority of my country,(i) where the relevant diseases are notifiable to the competent authority and reports of suspicion of infection of the relevant disease must be immediately investigated by the competent authority,(ii) all introduction of species susceptible to the relevant diseases come from an area declared free of the disease, and(iii) species susceptible to the relevant diseases are not vaccinated against the relevant diseases]II.2.3. Transport and labelling requirementsI, the undersigned official inspector, hereby certify that:II.2.3.1. the aquaculture animals referred to above are placed under conditions, including with a water quality, that do not alter their health status;II.2.3.2. the transport container or well boat prior to loading is clean and disinfected or previously unused; andCOUNTRYFishery productsII. Health informationII.a. Certificate reference numberII.b.II.2.3.3. the consignment is identified by a legible label on the exterior of the container, or when transported by well boat, in the ship's manifest, with the relevant information referred to in boxes I.7 to I.11 of Part I of this certificate, and the following statement:"(4) [Fish] (4) [Crustaceans] intended for human consumption in the Union".NotesPart I:Box reference I.8: Region of origin: For frozen or processed bivalve molluscs, indicate the production area.Box reference I.11: Place of origin: name and address of the dispatch establishment.Box reference I.15: Registration number (railway wagons or container and lorries), flight number (aircraft) or name (ship). Separate information is to be provided in the event of unloading and reloading.Box reference I.19: Use the appropriate Harmonised System (HS) codes of the World Customs Organisation of the following headings: 0301, 0302, 0303, 0304, 0305, 0306, 0307, 0308, 05.11, 15.04, 1516, 1518, 1603, 1604, 1605 or 2106.Box reference I.23: Identification of container/Seal number: Where there is a serial number of the seal it has to be indicated.Box reference I.28: Nature of commodity: Specify whether aquaculture or wild origin.Treatment type: Specify whether live, chilled, frozen or processed.Manufacturing plant: includes factory vessel, freezer vessel, cold store, processing plant.Part II:(1) Part II.1 of this certificate does not apply to countries with special public health certification requirements laid down in equivalence agreements or other Union legislation.(2) Part II.2 of this certificate does not apply to:(a) non-viable crustaceans, which means crustaceans no longer able to survive as living animals if returned to the environment from which they were obtained,(b) fish which are slaughtered and eviscerated before dispatch,(c) aquaculture animals and products thereof, which are placed on the market for human consumption without further processing, provided that they are packed in retail-sale packages which comply with the provisions for such packages in Regulation (EC) No 853/2004,(d) crustaceans destined for processing establishments authorised in accordance with Article 4(2) of Directive 2006/88/EC, or for dispatch centres, purification centres or similar businesses which are equipped with an effluent treatment system inactivating the pathogens in question, or where the effluent is subject to other types of treatment reducing the risk of transmitting diseases to the natural waters to an acceptable level,(e) crustaceans which are intended for further processing before human consumption without temporary storage at the place of processing and packed and labelled for that purpose in accordance with Regulation (EC) No 853/2004.(3) Parts II.2.1 and II.2.2 of this certificate only apply to species susceptible to one or more of the diseases referred to in the heading of the point concerned. Susceptible species are listed in Annex IV to Directive 2006/88/EC.(4) Keep as appropriate.(5) For consignments of species susceptible to EHN, Taura syndrome and/or Yellowhead disease this statement must be kept for the consignment to be authorised into any part of the Union.COUNTRYFishery productsII. Health informationII.a. Certificate reference NoII.b.(6) To be authorised into a Member State, zone or compartment (boxes I.9 and I.10 of Part I of the certificate) declared free from VHS, IHN, ISA, KHV or Whitespot disease or with a surveillance or eradication programme drawn up in accordance with Article 44(1) or (2) of Directive 2006/88/EC, one of these statements must be kept if the consignment contain species susceptible to the disease(s) for which disease freedom or programme(s) apply(ies). Data on the disease status of each farm and mollusc farming area in the Union are accessible at http://ec.europa.eu/food/animal/liveanimals/aquaculture/index_en.htm.The colour of the stamp and signature must be different to that of the other particulars in the certificate.Official inspectorName (in capital letters):Qualification and title:Date:Signature:’Stamp: