McGill University
845 Sherbrooke Street West
Montreal, Quebec, Canada
H3A 2T5
Declaration for Import of Biological Products
Complete this form and fax it back to: (514) 398-1885
Date: ________________________
To: Canadian Food Inspection Agency – Government of Canada
Please find below the information needed to facilitate passage through customs.
Name and Address of Exporter:
Name and Address of Importer:
Name: ________________________________
Name: __________________________________
________________________________
__________________________________
________________________________
__________________________________
Street: ________________________________
Street: __________________________________
________________________________
__________________________________
City:
________________________________
Prov./State:
City:
_________________________
__________________________________
Prov./State:________________________________
Country: _______________________________
Country: _________________________________
Zip/Postal Code: _________________________
Zip/Postal Code: ___________________________
Country of Origin: ___________________________
Scientific Name and Common Name of the product: ________________________________________________
____________________________________________________________________________________________
Description of the product: _____________________________________________________________________
____________________________________________________________________________________________
Check one box
Infectious: !
Non-infectious: !
Check one box
Hazardous: !
Non-hazardous: !
Check one box
Animal origin: !
Non-animal origin: !
Check one box
Used in vitro: !
Used in vivo: !
Final Use of the product:_______________________________________________________________________
____________________________________________________________________________________________
Signature
Print name
Date
** This declaration does not replace at anytime an import permit and/or an official veterinary certificate **