Declaration of Biological Shipments
Consignee
DATE:
Air Waybill #
Shipper:
Fax No.:( )
Phone: ( )
FedEx Account No .:
Selection 1:
Remarks:
-
Biological specimen of bovine, sheep, goat, pig, chicken, horse origin.
You need a certificate of origin and health certificate for animal products to be obtained from the USDA.
bovine:________________
sheep:________________
goat:________________
pig:__________________
chicken:_______________
horse:_______________
Please note that consignee needs to provide import license for the above commodities.
Selection 2:
Biological specimen of hamster, rabbit, rat, mouse, monkeys, dogs and cats.
You don’t need a special export paper. Fill in correct name of specimen, (i.e., DNA of rabbit)
hamster:_________________ rabbit:________________
rat:________________
mouse:__________________ dog:_________________
cat:________________
monkey:_________________
Selection 3:
Specimen of culture of microorganism. Fill in the correct name: Candida albicans
Are the microorganism components in a solution of animal origin?
NO
Check, if you need special papers. See under Section 1 or 2.
hazard:
No
harmful:
No
infectious:
No
Selection 4:
Specimen of synthetic or chemical objects. Fill in the correct name of the specimen and the CAS RN
(Chemical Abstracts Service Registry Numbers)
__________________________________________________________________
Selection 5:
Reserved for other not name biological specimen:____.
Selection 6:
Please provide Latin name: Candida albicans
Reason for export:
Sample: only for research [X]
Special handling:
freeze (Dry Ice) [ ]
For human usage 
keep cool (+2-8 )
[]
not used by humans [X]
room temperature
Please attach this information on outer packaging. All information is correct and true.
(Signature and company stamp)____________________________________________
[x]