Semen Collection Centre Health Declaration

For semen which legally imported to Australia and may be used to create bovine embryos (IVD & IVP) in Australia for export to New Zealand.

I, ……………………....…………………………………………….………………………………………

SCC Veterinarian Of ………………………………………….………….

(Full name and address must be shown in BLOCK LETTERS).

Declare that the particulars given in this declaration are true:

I am the VETERINARIAN in care of the semen donor/s detailed below.

I have detailed knowledge of the herd health history of the semen donor/s.

The identification number and particulars of the semen donor/s to which this declaration refers are set out in the box below.

Animal name	Registration number	Breed / Sex	Date of Birth	Date entered Collection Centre	Date of collection

In relation to each semen donor listed above I declare that there have been no cases of BHV5 (suspected or diagnosed) in the twelve months prior to date of collection on all centres of residence of the donor.

Declared at………………………………….on …………../……….../……….

Signature of SCC Veterinarian…………………………………………………………………………………….