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Transworld: 7 Volkner Place, Albany PO Box 302280 NHPC Auckland New Zealand

Tel 64 941 50755   Fax 64 941 50644  Email graham@transworld.co.nz  Graham Bell

Packer/Exporter/Origin Agent Letterhead

Quarantine Declaration for Containers

Vessel Name :

Voyage Number :

Container Number or Numbers :

Cleanliness and Restricted Packing and Packaging Declaration

1.         Cleanliness

            At the time of packing, the container/s were inspected internally and externally, and
            are clean and free from contamination with live organisms, material of plant or
            animal origin, soil and water……………………………………………………………      Yes         No

2.         Packaging Materials
            Has any soil, peat, raw green or contaminated moss, used sacking material, hay,
            straw, chaff or any packing material contaminated with the above been used within
            the container/s listed above?……………………………………………………………..   Yes         No

3.         Wood Packaging
            Has any wood packaging been used within the container/s such as cases, crates,
            pallets or wood used to separate, brace, protect or secure cargo in transit?…………….. Yes         No

            3a.  If yes to 3 above, has the wood been treated?……………………………………….                Yes No

            3b.  If yes to 3a above, how was the wood treated?……………………………………………………

            3c.   Is a certificate for the treatment of this wood available?……………………………                Yes No

                                  (attach a copy of the treatment certificate)

I certify that the above is true and correct.

Signed

Name

Designation

Date