FSIS 9060-6 Application for Export Certificate

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valid OMB control number. The valid OMB control number for this information collection is 0583-0153. The time required to complete this information collection is estimated to average
20 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 of information.
U.S. DEPARTMENT OF AGRICULTURE
FOOD SAFETY AND INSPECTION SERVICE

APPLICATION FOR EXPORT CERTIFICATE
3. CERTIFICATE NO.

APPLICATION TYPE
1.

ORIGINAL

2.

REPLACEMENT APPLICATION / REASON FOR REPLACEMENT

4. SHIPMENT TYPE

LOST CERTIFICATE

IMPORTING COUNTRY BORDER CLOSURE

COMMERCIAL SALE

AIRLINE

INCORRECT CERTIFICATE

SPLIT SHIPMENT

U.S. MILITARY

IMPORTER/EXPORTER CHANGED

CONSOLIDATED SHIPMENT

PERSONAL
CONSUMPTION
SHIP'S STORE

CERTIFICATE MISSING REQUIRED INFORMATION
5. DATE OF REQUEST (mm/dd/yyyy)

6. COUNTRY OF DESTINATION

SAMPLES
U.S. EMBASSY

7. COUNTRY OF FINAL DESTINATION

8. CONSIGNOR/EXPORTER (Applicant's name and address)

9. CONSIGNEE/IMPORTER (name and address)

10. EXPORT EST. NO.

11. EXPORT MARK TO BE USED:
USDA EXPORT MARK
UNIQUE IDENTIFIER

12.
DESCRIPTION OF PRODUCT
(including Product Code)

13.
HACCP
CAT.

14.
SPECIES

22. TOTAL NET WEIGHT

15.
16.
MATURITY FROZEN/
LESS
SHELFTHAN
STABLE
30 MOS.

17.
NET
WEIGHT
OF LOT

19.
20.
18.
TYPE
SHIPPING/
NO. OF
OF
PACKAGES PACKAGES IDENTIFICATION
MARKS
IN LOT
IN LOT

21.
EST. NO.
ON
PRODUCT

23. TOTAL NO. OF PACKAGES

24. ADDITIONAL STATEMENT

Under penalty of law, I certify that the products covered by this application for export meet the inspection requirements for the country of destination. I will provide
documentation to FSIS program employees upon request.
26 PRINTED NAME
27. DATE
25. APPLICANT SIGNATURE
I certify that the product was examined in accordance with Agency policy.

28. CERTIFYING OFFICIAL'S SIGNATURE AND TITLE

FSIS FORM 9060-6 (05/04/2017)

29. PRINTED NAME AND TITLE

30. DATE

Instructions for Completing the Application for Export Certificate
1.

Original: Select if the application is original and not a replacement.

2.

Replacement Application/Reason for Replacement: Select if the application is for a replacement certificate. For a one-to-one
replacement certificate, select the reason for the replacement. If the replacement is for a split or consolidated certificate, select the
appropriate box (split or consolidated) and the reason for the replacement.

3.

Certificate Number: Enter the certificate number from the FSIS 9060-5 Meat/Poultry Export Certificate of Wholesomeness,
FSIS 9060-5EP, Egg Products Export Certificate of Wholesomeness or FSIS Form 9060-5S, Siluriformes Fish and Fish Products
Export Certificate of Wholesomeness.

4.

Shipment Type: Select the type of shipment to be certified.

5.

Date of Request: Include the Month, Day, Year (Example 07/11/2017)

6.

Country of Destination: Enter the common country name.

7.

Country of Final Destination: Enter the country of final destination, if that country is different from the Country of Destination in
block 6 and a letterhead/additional certificate is required by the Export Library.

8.

Consignor/Exporter: Enter the name and address (street, city, state, and zip code divided by commas and on separate lines
in the field) of the person or entity applying for the export certificate. If desired, the applicant can also include a phone number and email
address.

9.

Consignee/Importer: Enter the name and address (street, city, state/province, zip code, (as appropriate) divided by commas
and on separate lines in the field) of the person or entity to whom the consignment is shipped in the country of destination. If desired, the
applicant can also include a phone number and email address.

10. Export Est. No.: Enter the number of the establishment exporting the product.
11. Export Mark to Be Used: Select either the USDA Export Mark, or Unique Identifier. If Unique Identifier is selected, enter it in
the adjacent field.
12. Description of Product, including Product Code: Enter the labeled name of the product (i.e. commercial description) as it is to appear on
the export certificate, and the unique product code associated with the product if desired.
13. HACCP Cat.: Enter the HACCP category code for each lot of product on the application.

HACCP CATEGORIES
Raw Product - Ground (03B)

Heat Treated - Shelf Stable (03F)

Raw Product - Not Ground (03C)

Fully Cooked - Not Shelf Stable (03G)

Thermally Processed - Commercially
Sterile (03D)

Heat Treated but Not Fully Cooked Not Shelf Stable (03H)

Not Heat Treated - Shelf Stable (03E)

Product with Secondary Inhibitors Not Shelf Stable (03I)

14. Species: Enter the species of the product. If the product contains multiple species, enter the primary species of the product.
15. Maturity less than 30 mos.: This is required for all beef products. Enter “Y” if the products come from animals whose age at time
of slaughter was less than 30 months. Enter “N” if the products come from animals whose age at time of slaughter was 30 months
or older.
16. Frozen/Shelf-Stable: Enter "Y" if the product is frozen or shelf-stable. Enter "N" if the product is not frozen or shelf-stable.
17. Net Weight of Lot: Enter the net weight of each lot in pounds or kilograms, or pounds and kilograms. For pounds only, enter
the weight with “lbs” following the number. For kilograms only, enter the weight with “kgs” following the number. For pounds and
kilograms, enter the pound weight with “lbs” following the number, then below the pound weight in the same box, enter the
kilogram weight in with “kgs” following the numbers in parentheses, e.g. (22,000.00 kgs).
18. Number of Packages in Lot: Enter the number packages in the lot.

Instructions for Completing the Application for Export Certificate (continued)
19. Type of Packages in Lot: Enter the type of packages in lot, using the abbreviations below.

Abbreviation

Description

BX

Box

CS
CT
CX
DR
MB
PK
PO
BG
BI
BJ
CA
COM
JR
PAL
PL
PU
SW
TB
TN
TU
TY
VA
VP

Case
Carton
Can. Cylinder
Drum
Bag. Multi-ply
Package
Pouch
Bag
Bin
Bucket
Can. Rectangular
Combo Bins
Jar
Pallet
Pail
Tray or Tray Pack
Shrink Wrapped
Tub
Tin
Tube
Tank, Cylindrical
Vat
Vacuum-packed

20. Shipping/Identification Marks: If shipping/identification marks are required by the importing country as indicated in the
Export Library, those listed on the application should match those on the certificate.
21. Est. No. on Product: Enter the establishment number marked on the shipping cartons of the product intended for export.
22. Total Net Weight: Enter the total net weight in pounds or kilograms, or pounds and kilograms from all lots in the consignment
to be certified. For pounds only, enter the weight with “lbs” following the number. For kilograms only, enter the weight with
“kgs” following the number. For pounds and kilograms, enter the pound weight with “lbs” following the number, then next to
the pound weight in the same box, enter the kilogram weight in with “kgs” following the numbers in parentheses, e.g
(22,000.00 kgs).
23. Total Number of Packages: Enter the total number of packages from all lots in the consignment to be certified.
24. Additional Statement: Enter additional statement(s) if required by the export library to appear in the remarks section of the
export certificate of wholesomeness. This also includes replacement certificate statements for all original certificates generated
in paper-based system outside of PHIS.
25. Applicant Signature: Signature of person listed in block 26.
26. Printed Name: Printed name of person in block 25.
27. Date: Include the Month, Day, Year (Example 10/07/2018).
28. Certifying Official's Signature and Title: Signature and title of certifying official. (i.e. FSIS inspector and/or public health
veterinarian, depending on country requirements).
29. Printed Name and Title: Printed name and title of certifying official in block 28.
30. Date: Include the Month, Day, Year (Example 10/07/2018).