FSIS 9060-5EP Egg Products Export Certificate

OMB Control Number: 0583-0153
Expiration Date: 11/30/2026
U.S. DEPARTMENT OF AGRICULTURE
FOOD SAFETY AND INSPECTION SERVICE

EGG PRODUCTS EXPORT CERTIFICATE OF
WHOLESOMENESS
2. ISO Code:

1. Country of Destination:

A knowingly false entry or alteration of any entry on the certificate may result in
a fine of not more than $10,000 or imprisonment for not more than five years or
both (18 USC 1001). Additional Prohibited Acts and Penalties exist under the
Egg Product Inspection Act [21 USC 1037 (e) (2), (3), and (6), 21 USC 1041]
for an unauthorized or false alteration or misuse of this certificate.
6. Certificate Type:

5. Certificate Number:

EPB-

Original
Replacement

3. Consignor/Exporter: (Applicant's name and address)

PRODUCT EXPORTED FROM:
7. Export Est. Number: (Name and address)

4. Consignee/Importer: (Name and address)

9. Total Number of Packages:

8. Total Net Weight:

10.
Description of Product
(Name of product)

11.
Net Weight of
Lot¹

12.
Species

13.
Number of
Packages
in Lot¹

14.
Type of
Packages
in Lot¹

15.
Shipping/
Identification
Marks¹

16.
Est. Number
on
Product

¹ As stated by applicant or contractor

17. Remarks:

18. I CERTIFY that the egg products specified on this form have been inspected and passed in accordance with the applicable laws and regulations
of the United States Department of Agriculture and are wholesome and fit for human consumption.
NOT VALID UNLESS SIGNED BY A CERTIFYING OFFICIAL OF EGG PRODUCT INSPECTION PROGRAM
19. Certifying Official's Name and Title:

20. Date Signed: (mm/dd/yyyy)

By order of the
Secretary of Agriculture
This certificate is receivable in all courts of the United States as prima facie evidence of the truth of the statements therein contained.
This certificate does not excuse failure to comply with any of the regulatory laws enforced by the United States Department of Agriculture.
FSIS 9060-5EP (01/12/2024)

REPLACES FSIS 9060-5EP (08/15/2015) PREVIOUS EDITION OBSOLETE

ORIGINAL

DISTRIBUTION:

ORIGINAL
DUPLICATE
TRIPLICATE
QUADRUPLICATE

FSIS 9060-5EP (01/12/2024)