PHYTOSANITARY CERTIFICATE
VIDA DIVISION OF AGRICULTURAL DEVELOPMENT
Date
*
/
Month
/
Day
Year
ie. 03/02/2021
Email
*
example@example.com
DESCRIPTION OF THE CONSIGNMENT
Name & Address of Exporter
*
Who is sending this/these item(s)?
Street Address Line 2
City
State / Province
Postal / Zip Code
Name & Address of Consignee
*
Who is receiving this/these item(s)?
Street Address Line 2
City
State / Province
Postal / Zip Code
Means of Conveyance
*
How is it being transported?
Port of Entry
*
Where is it going?
Quantity & Name of Produce
*
Including Botanical Name If Required by Importing Country
Number and Description of Packages
*
Distinguishing Marks
*
Describe Specific Characteristics
Origin of Item
*
As Certified by Shipper
Quantity & Name of Produce - Item 2
Including Botanical Name If Required by Importing Country
Number and Description of Packages - Item 2
Distinguishing Marks - Item 2
Describe Specific Characteristics
Origin of Item 2
As Certified by Shipper
Quantity & Name of Produce - Item 3
Including Botanical Name If Required by Importing Country
Number and Description of Packages - Item 3
Distinguishing Marks - Item 3
Describe Specific Characteristics
Origin of Item 3
As Certified by Shipper
Please describe the requirements for the requested Port of Entry.
*
Please upload copies of supporting materials for the requirements.
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ie. any guidelines, fumigation or disinfection requests or treatment.
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NOTICE:
NO LIABILITY SHALL ATTACH TO THE DEPARTMENT OF AGRICULTURE OF THE GOVERNMENT OF THE VIRGIN ISLANDS OR TO ITS OFFICERS OR REPRESENTATIVES WITH RESPECT TO THE ISSUANCE OF THIS CERTIFICATE.
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