I. IDENTIFICATION OF HORSES

II. SOURCE OF ANIMALS

NAME AND ADDRESS OF EXPORTER: 

NAME AND ADDRESS OF PREMISES OF ORIGIN:

NAME AND ADDRESS OF ISOLATION FACILITY: 

III. DESTINATION OF ANIMALS

NAME AND ADDRESS OF CONSIGNEE:

MEANS OF TRANSPORT:

SANITARY INFORMATION

I, Dr ………………………………, a duly authorised government veterinary officer, hereby certify that:

1. Has/have been in Australia since birth, or for a continuous period of at least 60 days prior to shipment;
2. Emanate from premises which have been free of Equine Infectious Anaemia, Equine Encephalomyelitis, Contagious Equine Metritis, Borna disease, Surra, and Glanders for at least 12 months prior to the removal of the animals to the port of shipment, and in the case of Contagious Equine Metritis, for two (2) years since the commencement of the previous breeding season.
3. Were not vaccinated against West Nile Virus.
4. Was/were examined by the Official Veterinarian within 7 days prior to shipment and found to be clinically healthy and free from external parasites, treated for internal parasites and free from communicable disease to which the species is susceptible; and that the animals do not show any clinical signs of Equine Influenza on the day of shipment;
5. Australia is free of dourine (Trypanosoma equiperdum) and glanders
6. Has/have passed with negative results the agar gel immuno-diffusion (AGID) or Coggins test for Equine Infectious Anaemia within 45 days prior to shipment;
   Date of blood collection: ………………. Result: ……………..
7. Australia has officially been declared free of Contagious Equine Metritis for at minimum period of 12 months.
8. Three guarded nasopharyngeal swabs must be taken at 7 days intervals and subjected to culture for Streptococcus equi. The last swab must be taken in the last 10 days before shipment. All results must be negative.
   Date of test: ………………. Result: ……………..
9. Has/have been subjected to two (2) negative serological tests for Equine Viral Arteritis with an interval of 21 days within 45 days prior to shipment.
   Date of test: ………………. Result: ……………..
10. Has/have in the case of mares been subjected to a pregnancy test and certified as not pregnant or if pregnant she is less than 8 (eight) months/240 days pregnant at the time of embarkation; In the case of pregnant mares the last service date must be specified and this date may not be more than 240 days prior to date of embarkation.
11. Animals was/were examined within 7 days of shipment by the authorised veterinarian and were free of clinical signs of strangles and as far as can be determined, have not been on premises where strangles occurred for the last 6 months before shipment.
12. Has/have been vaccinated twice at an interval recommended by the manufacturer against equine influenza type A Equi I, with an approved vaccine, or once as a booster to a certified primary course of vaccination, not less than 14 days and not more than 8 weeks prior to export;
13. Has/have been kept in isolation for a minimum of 30 days prior to shipment; no horses were introduced during isolation and no horse showed any clinical sign of an infectious disease during isolation;
14. The animals are fit to travel.
15. The certificate to be signed, dated and stamped with the official stamp of the veterinary authorities, also indicating the full name and designation of the certifying officer.