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Description of image - Importer's Statement of Compliance for U.S. Processed Pet Food and Treats containing Animal Products and by-Products
In compliance with section 16(1) and 16(2) of the Health of Animals Act, this is to certify that I am importing the products below:
Product description:
- Simple pet chews
Products obtained from untanned hides and skins of ungulates or other animal tissues for pet animals to chew; they have no nutritional value and may contain flavorings, colorants, and preservatives.
Name of importer 
Address
City
Province
Zip Code
Declaration:
I (print name above) do hereby declare importing the pet chews of US origin:
1. with the Commercial Invoice Number(s),
2. and linked to the enclosed culture and sensitivity results for Salmonella and Enterobacteracieae,
and certify that the information provided on this form is complete, correct and accurately describes the product contained in the shipment.
Signature:
Date: y-m-d
For the Broker or Importer
Transaction Number
Exporter Reference Number (optional)
Total Gross Weight
Container(s) and Seal number(s)
Shipping Date
Lot Number(s)
Production Facility Name