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FSIS Form 9060-5 Meat and Poultry Export Certificate of Wholesomeness
ICR 202609-0583-001 · OMB 0583-0153 · Object 173251900.
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Document Metadata
| File Type | application/pdf |
|---|---|
| File Title | FSIS Form 9060-5 Meat and Poultry Export Certificate of Wholesomeness |
| Subject | FSIS Form 9060-5 Meat and Poultry Export Certificate of Wholesomeness |
| Author | vgreen |
| Last Modified By | Designer 6.5 |
| File Modified | 2025-11-21 |
| File Created | 2025-11-21 |
| Conversion State | complete |
Extracted Text
OMB Control Number: 0583-0153 Expiration Date: 11/30/2026 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 25 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 MEAT AND POULTRY EXPORT CERTIFICATE OF WHOLESOMENESS 1. Country of Destination: 2. ISO Code: A knowingly false entry or false alteration of any entry on this certificate may result in a fine of not more than $10,000 or imprisonment for not more than 5 years or both (18 U.S.C. 1001). Additional penalties exist under the Federal Meat Inspection Act [21 U.S.C. 611(b) (1), (2); and (5), 21 U.S.C. 461] for an unauthorized or false alteration or misuse of this certificate. 5. Certificate Number: 6. Certificate Type: 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) 8. Total Net Weight: 10. Description of Product (Name of product) 11. Net Weight of Lot¹ 12. Species 13. Number of Packages in Lot¹ 9. Total Number of Packages: 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 meat, meat food product or meat byproduct specified hereon is from animals that received both antemortem and postmortem inspection and were found sound and healthy and that it has been inspected and passed as provided by law and regulations of the Department and is sound and wholesome. 19. I CERTIFY that the poultry, poultry products or poultry food products specified above came from birds that were officially given an antemortem and postmortem inspection and passed in accordance with 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 MEAT, POULTRY, AND EGG PRODUCT INSPECTION PROGRAM 20. Certifying Official's Name and Title: 21. 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 9060-5 (08/15/2025) REPLACES FSIS 9060-5 (08/14/2023) PREVIOUS EDITION OBSOLETE ORIGINAL