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PI-005: Appendix B – Forms Used in Seed Potato Certification


In the present version of this appendix, contact information, references to specific organizations within the CFIA, and references to other documents or policies may not be current. This information will be updated at the time of the next revision of this appendix. Please contact the CFIA for any questions or further information

The following documents are intended for internal use. CFIA staff can access these documents using the internal tools noted below.

CFIA 0092 - Identification Tag of Seed Potato Lots
Tag used by the grower and the inspector to identify the variety and class of seed potato stored in the storage bin or bulk boxes. This tag must be completed at harvest time during bin inspection.

CFIA 1278 - Special Permission for Sale of Seed Potatoes Not Eligible for Official Tags
A document granting permission to a seed grower for the sale of seed potatoes of any class but having tuber damage (one defect) in excess of established standards. These defects include off-type, mechanical damage, growth cracks, pressure bruises, sunburn, and sprouts. The inspector signs this certificate with prior permission of program officer. This option should be only used for varieties in short supply or other special situations.

CFIA 1284 - Report of Field Inspection
Completed by the inspector for all fields entered for certification. Information contained therein must be complete and accurately reflect results of crop inspection. This is the official inspection report. Draws on information recorded in the Inspectors Field Notes (CFIA 1298).

CFIA 1298 - Inspectors Field Notes
Completed by the inspector for all fields entered for certification. The purpose is to record notes to serve as his/her reference. Individual sections of the form should be completed after each inspection in the field.

CFIA 1317 - Application for Seed Potato Crop Inspection Grower's Declaration
Completed by grower for consideration of inclusion in seed potato certification program. Special attention is given to signatures of grower or representative, varieties and tuber unit portion, hectares and source of seed being indicated on this form.

CFIA 1318 - Growing Crop Certificate
This certificate specifies the variety, class, area, and the certification number of every lot certified as seed potato on the farm unit. This is a single document to grant certification on all crops meeting the class standard for each applicant.

CFIA 1319 - Bacterial Ring Rot Specimen Report
The inspector includes this form with a sample to be tested for Bacterial Ring Rot. The inspector completes the top and the bottom portion of this form.

CFIA 1370 - Seed Potato Tags: Foundation
Used to attach to containers of seed potatoes to identify class, variety and lot.

CFIA 2100 - Seed Potato Shipment Report
A summary of the cargo exported by ship. A report is to be filled out for each vessel at dockside.

CFIA 2111 - Seed Potato Tags: Certified
Used to attach to containers of seed potatoes to identify class, variety and lot.

CFIA 2113 - Seed Potato Tags: Elite
Used to attach to containers of seed potatoes to identify class, variety and lot.

CFIA 2343 - Record of Bulk Movement
A permit authorizing the sale and transport of seed potatoes in bulk. This form is used to permit movement of graded stock in bulk.

CFIA 2415 - Disinfection Report
The grower may have had material contaminated with the Bacterial Ring Rot pathogen or produced potatoes without field inspection in the previous crop year. The Bacterial Ring Rot Disinfection Report is used to document the cleaning and disinfection activities.

CFIA 2546 - Revocation of Certification
Used when an inspector revokes the crop certificate of a lot from a farm unit, or all crop certificates of a farm unit.

CFIA 3076 - Seed Potato Tuber Inspection Report
Used by the inspector at time of harvest to assess the tuber conditions of the potato crop. Estimated production and estimated grade out figures are also to be included.

CFIA 3256 - Notice of Detention
Used to hold plants and seed potatoes when shipments are not in compliance with the Plant Protection Act, Seeds Act and Seed Regulations Part II.

CFIA 3257 - Notice of Release from Detention
A notice issued when corrective action has been implemented which satisfies the Plant Protection Act, Seeds Act and Seeds Regulations Part II.

CFIA 4351 - Nuclear Stock Certificate
Used to document the movement of Nuclear Stock Class seed potatoes of a registered variety from one farm unit to another within Canada. Also used for the movement of registered varieties to another country.

CFIA 4378 - Certification of Authorization
Permits the movement of seed potatoes of a non-registered variety for which a crop certificate has been issued, between farm units in Canada.

CFIA 4383 - Permit for Bulk Movement of Seed Potatoes for Packaging and Resale
A permit authorizing the movement of seed potatoes that are sold in bulk for the purpose of packaging and resale and are not required to be graded by the grower. The packager must do the grading prior to packaging and resale.

CFIA 4743 - Phytosanitary Certificate
A certificate completed by a Program Officer, or designate, to certify that the plant quarantine import requirements of the importing country have been met.

CFIA 5161PEI - Plant Health Submission Form
The inspector includes this form with samples for Disease Testing. The LSTS is currently under review and changes or updates will follow.

CFIA 5292 - Inspection Report Form for Aseptic Laboratory Facilities Initiating and Multiplying Nuclear Stock Class Seed Potatoes
This form is to be used for recording inspections carried out at aseptic facilities initiating or multiplying nuclear stock.

CFIA 5293 - Inspection Report Form for the Production of Nuclear Stock Class Seed Potatoes in a Protected Environment
This form is to be used for recording pre-planting (part A) and growing crop (part B) inspections carried out in protected environment facilities.
Note: the Inspectors Field Notes (CFIA 1298) should also be completed for each variety.

CFIA 5294 - Notification of Non-compliance of Nuclear Stock Class Seed Potato Production Facility and Requirement for Corrective Action
This form is to be used for reporting non-compliance and corrective action in both aseptic and protected environment facilities.

CFIA 5295 - Application Form for Issuance of Nuclear Stock Tags and Certificates for the Transfer of Nuclear Stock Class Seed Potatoes
This form is intended to create uniform service delivery across different regions.

CFIA 5298 - Seed Potato Tags: Nuclear
Used to attach to containers of seed potatoes to identify class, variety and lot.

North American - Certified Seed Potato Health Certificate
The certificate required for re-certification of seed lots entering the USA

CFIA 5847 - Permit Relating to Packing of Seed Potatoes
A permit authorizing the packing of seed potatoes in containers less than 20 kilograms.

CFIA 5848 - Permit Relating to Repacking of Seed Potatoes
A permit authorizing the repacking of seed potatoes.

CFIA 5849 - Permit Relating to the Cutting of Seed Potatoes
A permit authorizing the cutting of seed potatoes.

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