Name and Address of Exporter	Name and Address of Importer
AUSTRALIA	UNITED STATES OF AMERICA
Import Permit No
Description of Animal Reproductive Material
Number	Kind (Species and type; eg bovine semen)	Condition (Fresh/Frozen)	Identification (straw numbers, packing list)
BOVINE EMBRYOS	FROZEN STRAWS	SEE ATTACHED

I, Dr ……, an approved Embryo Transfer Veterinarian declare that the goods described in the following pages have complied with the importing country requirements.
Signature (pdf. doc only)	Date
Port of embarkation from Australia: Mode of transportation: Route of travel: Port of Entry in the United States: Australia is free of: foot-and-mouth disease (FMD), rinderpest, surra, contagious bovine pleuropneumonia, and bluetongue serotype 8 No cases of disease caused by Schmallenberg virus have been detected or reported in Australia Bovine tuberculosis is a notifiable disease in Australia. The donor dams have been part of Australia's national herd for a minimum of 60 days prior to collection, with no quarantine or movement restrictions. During the 60 days prior to the collection of embryos all donor dams were inspected by the Team Veterinarian and found clinically free of contagious diseases. Where natural breeding or fresh semen was used to inseminate the donor dam, all donor sires were inspected by the Team Veterinarian during the 60 days prior to collection and found to be clinically free of contagious diseases. During the 60 days prior to the collection of embryos for export to the United States, all donor dams (and sires where natural breeding or fresh semen is used) have not been corralled, pastured, or held with other animals of lesser health status or under restrictions which would make them ineligible for export to the United States. During the 12 months prior to the collection of embryos for export to the United States, there has been no evidence of bovine tuberculosis found in donor dams (or sires where natural breeding or fresh semen is used) or on any premises the donors have been on during that time. All donor dams (and donor sires, if the semen was collected in Australia or natural service was performed) were: Born and raised in Australia; or legally imported into Australia and has been released from any post-entry restrictions; and, Have been able to move freely within the National Herd of Australia. The ova were fertilized as follows: either; (strike out options that do not apply): Donor sires used for natural service were of an equivalent isolation and health status to the donor dams; or, Semen used for insemination was eligible for export to the United States in accordance with the provisions of AHC-011013/USA Bovine Semen 140714 ; or, Semen used for insemination was imported into Australia in accordance with Australia’s import conditions on Department of Agriculture import permit number: XXXXXX The donor dams (and donor sires, if the semen was collected in Australia or natural service was performed) showed no signs of bovine tuberculosis on the day of collection and either: Were kept in an embryo collection centre (ECC) free from bovine tuberculosis which only accepts animals from free herds; or showed negative results to tuberculin tests carried out annually and were kept in a herd free from bovine tuberculosis The embryos originate from an Embryo Collection Team that is approved by the Government of Australia Name and Address of the approved team veterinarian: Name, Address and Approval No. of the embryo collection team. Arboviruses - the donor dams either: were kept in a Department of Agriculture approved ECC located in a region certified free from bovine ephemeral fever, Akabane, and Aino for a minimum of 60 consecutive days before commencement of, and during, collection of the embryos. The dates of residence in the ECC are included in the “Attachment to Veterinary Certificate “, or; were tested negative for Akabane, Aino, and bovine ephemeral fever by a serum neutralization test, virus isolation test, or PCR on a blood sample collected on the day of collection, or; if collected on more than one occasion for this export, the donors were tested negative for Akabane, Aino, and bovine ephemeral fever by a serum neutralization test, virus isolation test, or a PCR on blood samples collected on the first and last day of collection, and at least every 7 days (for virus isolation) or at least every 28 days (for PCR assays) during embryo collection for this consignment. If natural breeding or fresh semen was used to conceive the embryos for export, then the donor sires have undergone the same tests as the donor dams as stated in paragraph 12. Dates of testing for each donor are recorded in the “Attachment to Veterinary Certificate” Testing conducted on donors was conducted at laboratories designated by the Department of Agriculture as laboratories approved to conduct the tests. Name: Address: The artificial insemination or natural breeding of the donor dams was performed under the direction of a Department of Agriculture approved veterinarian. The Department of Agriculture approved veterinarian personally observed the flushing of the embryos from the donor dams and the processing of the recovered embryos for shipment to the United States. Embryos were processed in accordance with the latest published edition of the Manual of the International Embryo Transfer Society (IETS), and in a facility approved by the Department of Agriculture (if separate from the ECC). Each embryo was washed at least 10 times. Each wash was accomplished by transferring the embryo into an aliquot of fresh medium that is 100 times the volume of the embryo, plus any fluid transferred from the previous wash. No more than 10 embryos from the same flush were washed together. A sterile micropipette was used for each transfer, and the embryos were well agitated throughout the entire volume of the wash before the next transfer. Embryos from different donors were not washed together. After the last wash, each embryo were microscopically examined over its entire surface at not less than 50x magnification and all zona pellucida were found to be intact and free from any adherent material. After washing and examination of the zona pellucida, embryos were individually packaged in sterile ampules or straws and frozen in liquid nitrogen. The donor dam's and sire's identification and breed, the date of embryo collection, the name and address of the place where the embryos were collected, and an identification number for the straw or ampule are recorded with indelible markings on each ampule or straw. If any of this information is provided in code, deciphering information is attached to the health certificate for the embryos. All equipment used to handle the embryos was replaced by new or sterilized equipment between each washing, and all standard sterile procedures were observed. The shipping container has been examined by the Team Veterinarian, was found empty of embryos and other biological materials, and is either new or cleaned and disinfected (strike out option that does not apply) prior to use for export of embryos to the United States. Only fresh liquid nitrogen has been used to export embryos to the United States. The embryos were maintained under lock and key or in the custody of the Team Veterinarian until they were placed in the shipping container and sealed with Government of Australia seals. The final audit of embryos in this consignment was performed under my supervision and the embryos have been placed in a sterilized shipping container. Seal No: XXXXXX

Donor Dam Identification:	Registration No:	Breed:
Donor Sire Identification:	Registration No:	Breed:
Dates of Residence at ECC:
Date of Embryo Collection	N˚ embryos for export	Health Testing (if required)
Test Type	Date(s)	Result
dd/mm/yyyy	####	Female Donor	Akabane	SNT, VI or PCR	dd/mm/yyyy
Aino	SNT, VI or PCR	dd/mm/yyyy
BEF	SNT, VI or PCR	dd/mm/yyyy
Male Donor (if fresh/natural mating)	Akabane	SNT, VI or PCR	dd/mm/yyyy
Aino	SNT, VI or PCR	dd/mm/yyyy
BEF	SNT, VI or PCR	dd/mm/yyyy
Straw ID:

Signature (pdf. doc only)	Date