別記様式2-1 記載 declaration for the import into ......(別記様式2-1) declaration for...
TRANSCRIPT
(別記様式2-1)
Declaration for the import into …………… (name of country or region)
………… Products from Japan
Invoice Number…………………… Declaration Number ..........................................................
.................................................................................................................................................................. ...............................................................................................................................(competent authority ) DECLARES that the ........................................................ (products ) of this consignment composed of: .................................................................................................................................................................. ..................... (description of consignment, product, number and type of packages, gross or net weight) embarked at .............................................................................................................. (embarkation place) on …………………………………………………………………… ……..(date of embarkation) by ................................................................................................................ (identification of transporter) going to ............................................................................................... (place and country of destination) which comes from the establishment ....................................................................................................... ........................................................................................................ (name and address of establishment)
is originating from a prefecture of …………………
(date) in the ......................................... (name of laboratory), to determine the level of the radionuclides, iodine-131, caesium-134 and caesium-137. Analytical report is attached.
Exporter (name, address, country) ................................................................................................................................................................. Consignee (name, address, country) ..................................................................................................................................................................
Done at ............................................... on .................................................................................................
authorised representative of competent authority
インボイスナンバーを記載 整理番号を記載 (証明書発給機関で記載)
証明書発給機関名を記載
例:FISHERIES AGENCY MINISTRY OF AGRICULTURE, FORESTRY AND FISHERIES, GOVERNMENT OF JAPAN
具体的な品目名、包装形態、重量等を記載 (品目数が多い場合は「See Annex」等と記載し、各々を記載したリストを添付。
日本の出港地を記載
日本からの出国日を記載
運送方法を記載(船便名、航空便名等)
到着港及び輸出先国・地域を記載
どちらかひとつを チェック
産地となる都道府県名を記載(複数の場合は「See Annex」等と記載し、各々の情報を記載したリストを添付)
検査サンプル採取日を記載
⑯ 検査機関名を記載
輸出者(名称、住所、国名)について記載
輸入者(名称、住所、国名)について記載
証明書発給年月日を記載 (証明書発給機関で記載)
例:○○ Apr. 2012(証明書発給機関で記載)
例:Director of Fisheries Processing Industries and Marketing Division Fisheries Agency The Government of Japan
印 農林 太郎
食品の場合は「food」、飼料の場合は「feed」と記載
輸出先国・地域を記載①
②
③ ④
⑤
⑥
⑧
⑨
⑩
⑪
⑬⑰
⑱
⑲
⑳ 証明書発給権者の役職名を記載し、押印・署名
食品は「food」と、飼料は「feed」と記載
⑦
has been sampled on ............... (date), subjected to laboratory analysis on .........................
検査実施日を記載⑮
㉑
⑫生産地又は加工施設の名称・所在地を記載。 ………………………………………………………………………………………….(name and address of establishment)
(生産地等が複数の場合は「See Annex」等と記載し、各々の情報を記載したリストを添付。)
⑭