AUS-QUAL PTY LTD
1/333 Queensport Road North
Murarrie Qld 4172
Phone (07) 3361 9219
Fax (07) 3361 9222
Email Organic@ausqual.com.au
AUS-QUAL ORGANIC
LIVESTOCK TRANSFER DECLARATION
A) PRODUCER/SUPPLIER DETAILS
Enterprise Name:
Trading Name:
Location Address:
Contact Name:
Contact Number:
Email:
Organic Certification No.:
B) TRANSACTION DETAILS
Departure date:
Description of certified livestock (breed,
type, number & sex):
Organic status of Livestock (National Std):
Organic status of Livestock (USDA NOP):
NVD Number:
Identification/Brand Marks:
Arrival date:
Type
Breed
NS Certified Organic
USDA NOP
Number
Sex
NS In Conversion
Invoice Number:
Tag Numbers:
C) PRODUCER/SUPPLIER DECLARATION
I hereby declare that all the information provided is true and correct. The product this Declaration represents has
been produced without the use of sewage sludge and/or Genetically Modified Organisms in compliance with:
the Australian National Standard for Organic and Bio-Dynamic Produce
the USDA National Organic Program
Print Full Name Clearly:
Signature:
Date:
D) TRANSPORT DETAILS (only applies if using a Transport Company or if NOP Certified)
Transport Company name:
Truck Registration:
Trailer Registration:
Was the truck clean for organic transport?
YES
If no, was the truck cleaned prior to loading?
YES
Were any non-certified livestock loaded on this transport?
YES
If yes, were they segregated from the organic livestock?
YES
Was the delivery pen clearly identified as organic?
YES
Was a delivery number/docket issued?
YES
If yes, please detail
Authorised by Transporter:
Print Full Name Clearly:
Signature:
Date:
NO
NO
NO
NO
NO
NO
E) BUYER’S DETAILS (delivery to)
Enterprise Name:
Trading Name:
Location Address:
Contact Name:
Contact Number:
Form AQT884 AUS-QUAL Organic –Livestock Transfer Declaration
Email:
Organic Certification No.:
Issue 6 – 23/07/2015
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