TM-11 Export Certificate

Instructions for Completion of an Export Certificate (TM TM-11) Under an Export
Arrangement Between the USDA and a Foreign Government
These instructions are designed to assist a Department of Agriculture (USDA) accredited
certifying agent (ACA) in completing an export certificate (TM-11) as required under an
export arrangement between the USDA and a foreign government.
1. Country of Destination: This box must contain the name of the country importing the
product. The country name must not be abbreviated but spelled out in full.
2. Date: This box must contain the date of data entry. This date may or may not be the same
as the signature date in box 18. The date format is at the discretion of the ACA.
3. Unique Identification Number: The ACA must assign a unique identification number to
each export certificate. The unique identification number must be inserted into the blank box
immediately to the right of the date box. The unique identification number must begin with an
acronym designating the accredited certifying agent and the country code for the specific
export arrangement.
Certifying agent acronyms will be provided by the NOP to each accredited certifying agent
authorized by USDA to issue export certificates. Official country codes will be based on ISO
3166, the International Country Code Standard. For example, for the hypothetical certifying
agent, "Farm Certified Organic," whose clients ship product to Japan, the unique
identification number on each applicable export certificate would begin with FCOJP. FCO
would represent the acronym for "Farm Certified Organic," and JP would represent the ISO
3166 two-digit code for Japan. Lists of both accredited certifying agent acronyms and official
country codes will be available on the NOP web site.
4. Exported By: This box must contain the name and address, including zip code, of the final
producer or handler of the product as applicable. For producers and handlers with multiple
locations, the address will be the common or corporate address.
5. Product Exported From: This box must contain the name and address of the port of
embarkation.
6. Consigned To: This box must contain the name and address of the individual or business
in the country of destination to which the product will be transferred, assigned or delivered.
7. Certifying Agent Issuing Certificate: This box must contain the name and address of the
ACA who authorizes the certificate through the signature of its designated representative.
8. Total Marked Net Weight: This box must contain the total net weight of the shipment
covered by the export certificate.
9. Total Containers: If applicable, this box must contain the total number of air or vessel
containers covered by the export certificate.
10. Product as Labeled: This box must contain the name of the raw product or packaged
products. For raw product, the name will be the common name of the product, e.g. rice,

wheat, oranges, apples. For packaged products, the name will be the name shown on the
principal display panel.
11. Lot Number: This box must contain the lot number assigned to product by the exporter
whose name and address, including zip code appears in box 4.
12. Marked Weight of the Lot: This box must contain the marked net weight of the lot
assigned to product by the exporter whose name and address, including zip code appears in
box 4.
13. Number of Packages in Lot: If applicable, this box must contain the number of
packages contained under the lot number shown in box 11.
14. Shipping Marks: This box must contain flight number, vessel name or number, or
container number as applicable for the products covered by the export certificate.
15. Producer: Use of this box is at the discretion of the ACA.
16. Remarks: This box must contain the applicable compliance statement as provided by the
National Organic Program.
17. Signature of the Accredited Certifying Agent: This box must contain the signature of
the staff person designated by the ACA to authorize the issuance of the export certificate and
attest to its authenticity. The designated person is responsible for all aspects of the issuance
of the export certificate, including ensuring security of blank export certificates and oversight
of the export certificate control log.
18. Date: This box must contain the date of affixing of the signature of the ACA’s designated
representative. This date may or may not be the same as the date of data entry in box 4. The
date format is at the discretion of the ACA.

FORM APPROVED

REPRODUCE LOCALLY. Include form number and date on all reproductions.

USDA

U.S. DEPARTMENT OF AGRICULTURE
AGRICULTURAL MARKETING SERVICE
NATIONAL ORGANIC PROGRAM

-

OMB NO. 0581-0191

A knowingly false entry or false alteration of any entry on this certificate
may result in a fine of not more than $11,000 or imprisonment for not
more than five years or both (18 USC 1001) and may result in revocation
of accreditation under the National Organic Program (7 U.S.C. 6519).

EXPORT CERTIFICATE
I

COUNTRY OF DESTINATION

DATE

EXPORTED BY (Name and address including ZIP Code)

PRODUCT EXPORTED FROM

CERT. NO.

CONSIGNED TO (Name and address including ZIP Code)

CERTIFYING AGENT ISSUING CERTIFICATE

TOTAL MARKED NET WEIGHT

TOTAL CONTAINERS
I

PRODUCT AS LABELED

LOT NUMBER 1 1

MARKED
WEIGHT OF
LOT 1 1

NUMBER OF
PACKAGES IN
LOT 1 1

SHIPPING
MARKS

PRODUCER

I1 As sfafed by exporter
REMARKS

that the agricultural products specified hereon have been certified by a USDA accredited organic certifying agent and
have been found to meet all applicable requirements of the National Organic Program.
SIGNATURE OF ACCREDITED CERTIFYING AGENT

DATE

NOT VALID UNLESS SIGNED BY A DESIGNATED REPRESENTATIVE OF A USDA ACCREDITED ORGANIC CERTIFYING AGENT

No financial liability shall attach to the United States Department of Agriculture or to any officer or representative ofthe
Department with respect to this certificate.
According t o the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to a coliection of information unless it displays a
valid OMB control number. The valid OMB control number for this information coliection is 0581-0191. The time required to complete this information collection is estimated to average
30 minutes per person, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the
collection of information.  
The U.S. Department of Agriculture (USDA) prohibits discrimination in all its programs and activities on the basis of race, coior, national origin, age, disability, and where applicable, sex,
marital status, familial status, parental status, religion, sexual orientation, genetic information, political beliefs, reprisal, or because all or part of an individual's income is derived from any public
assistance program (Not all prohibited bases apply to all programs.) Persons with disabilities who require alternative means for communication of program information (Braille, large print, audiotape,
etc.) should contact USDA's TARGET Center at (202) 720-2600 (voice and TDD). To file a complaint of discrimination, write to USDA, Director, Office of Civil Rights, 1400 Independence Avenue,
S.W., Washington, D.C. 20250-9410, or call (800) 795-3272 (voice) or (202) 720-6382 (TDD). USDA is an equal opportunity provider and employer.

TM-11 (07-10)