9060-5A Export Certificate Continuation Sheet

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. The valid
OMB control number for this information collection is 0583-0153. The time required to complete this information collection is estimated to average 10 minutes per response, including the time for reviewing instruction,
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
FIELD OPERATIONS

1. CERTIFICATE NUMBER

MEAT, POULTRY, AND EGG PRODUCT CERTIFICATE OF WHOLESOMENESS
(CONTINUATION SHEET)

2.
DESCRIPTION OF PRODUCT
(Name of product)

3.
NET WEIGHT OF
LOT¹

4.
SPECIES

6.
7.
5.
SHIPPING/
NUMBER OF TYPE OF
PACKAGES PACKAGES IDENTIFICATION
IN LOT¹
MARKS¹
IN LOT¹

8.
EST. NO.
ON
PRODUCT

NOT VALID UNLESS SIGNED BY A CERTIFYING OFFICIAL OF MEAT, POULTRY, AND EGG PRODUCT INSPECTION SYSTEM
9. CERTIFYING OFFICIAL'S NAME AND TITLE

10. DATE SIGNED (MM/DD/YY)

By order of the
Secretary of Agriculture

This certificate is receivable in all courts of the United States as prime facie evidence of the truth of the statement herein contained.
This certificate does not excuse failure to comply with any of the regulatory laws enforced by the United States Department of Agriculture.
¹ As stated by applicant or contractor
FSIS FORM 9060-5A (06/29/2018)

ALL PREVIOUS EDITIONS OBSOLETE