Sanitary Certificate Request - Argentina

Form Approved OMB No. 0581-NEW

U. S DEPARTMENT OF AGRICULTURE AGRICULTURAL MARKETING SERVICE SANITARY CERTIFICATE REQUEST-ARGENTINA				According to the paperwork reduction act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a valid OMB control number. This valid OMB control number for this collection is 0581-NEW. The time required to complete this information collection is estimated to average 12 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection information.
I acknowledge that by checking this box that the information provided is factual and accurate.
CONTACT NAME		     			MAIL CERTIFICATE TO:
CUSTOMER NUMBER		     			7. COMPANY	     
BILLING REFERENCE		     			8. CONTACT	     
E-MAIL ADDRESS		     			9. STREET	     
CONTACT PHONE		     			10. CITY	     
FAX		     			11. STATE	     	12. ZIP	     
EXPORTER
13. NAME	     
14. ADDRESS	     
15. CITY, STATE	     
IDENTIFICATION OF DAIRY PRODUCTS
16. ANIMAL SPECIES					     
17. DESCRIPTION OF COMMODITY					     
18. KIND OF HEAT TREATMENT (HTST; PAST.)					     
19. TYPE OF PACKAGING					     
20. NUMBER OF PACKAGING UNITS					0
21. NET WEIGHT					     
22. REQUIRED TEMPERATURE DURING STORAGE AND TRANSPORTATION					     
23. PRODUCT LOT(S)AND/OR DATE OF MANUFACTURE					     
MANUFACTURER
24. PLANT NUMBER			     ;      ;      
PLACE OF LOADING
25. CITY, STATE			     
DESTINATION
26. TO			     
27. TRANSIT COUNTRIES			     
28. METHOD OF TRANSPORT			     
29. CONTAINER/COACH			     
30. NAME OF RECEIVER			     
31. CITY			     
32. SIGNATURE OF AGENT FOR APPLICANT					33. DATE
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