Passport No …

I, the undersigned, certify that12 the animal identified above meets the following requirements:

1. (a)

   it has been examined today and shows no clinical sign of disease;

2. (b)

   it is not intended for slaughter under a national programme of contagious or infectious disease eradication;

3. (c)

   • it does not come from the territory or part of the territory of a Member State which is the subject of restrictions for reasons of African horse sickness, or

     it comes from the territory or part of the territory of a Member State which was subject to prohibition for animal health reasons and has undergone, with satisfactory results, the tests provided for in Article 5(5) of Directive 2009/156/EC in the quarantine station of …between … and …13

   • it is not vaccinated against African horse sickness, or,

     it was vaccinated against African horse sickness on …1314;

4. (d)

   it has not come from a holding which was subject to prohibition for animal health reasons nor had contact with equidae from a holding which was subject to prohibition for animal health reasons:

   • during six months in the case of equidae suspected of having contracted dourine, beginning on the date of the last actual or possible contact with a sick animal. However, in the case of a stallion, the prohibition shall apply until the animal is castrated,

   • during six months in the case of glanders or equine encephalomyelitis, beginning on the day on which the equidae suffering from the disease in question are slaughtered,

   • in the case of infectious anaemia, until the date on which, the infected animals having been slaughtered, the remaining animals have shown a negative reaction to two Coggins tests carried out three months apart,

   • during six months from the last case, in the case of vesicular stomatitis,

   • during one month from the last case, in the case of rabies,

   • during 15 days from the last case, in the case of anthrax,

   • if all the animals of species susceptible to the diseases located on the holding have been slaughtered and the premises disinfected during 30 days, beginning on the day on which the animals were destroyed and the premises disinfected, except in the case of anthrax, where the period of prohibition is 15 days;

5. (e)

   to the best of my knowledge, it has not been in contact with equidae suffering from an infectious or contagious disease in the 15 days prior to this declaration;

6. (f)

   at the time of the inspection it was fit to be transported on the intended journey in accordance with the provisions of Regulation (EC) No 1/200515.

   Date	Place	Stamp and signature of the official veterinarian16
   Name in block capitals and capacity.