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McGill University 845 Sherbrooke Street West Montreal, Quebec, Canada H3A 2T5 Declaration for Import of Biological Products Complete this form and fax it back to: (514) 398-1885 Date: ________________________ To: Canadian Food Inspection Agency – Government of Canada Please find below the information needed to facilitate passage through customs. Name and Address of Exporter: Name and Address of Importer: Name: ________________________________ Name: __________________________________ ________________________________ __________________________________ ________________________________ __________________________________ Street: ________________________________ Street: __________________________________ ________________________________ __________________________________ City: ________________________________ Prov./State: City: _________________________ __________________________________ Prov./State:________________________________ Country: _______________________________ Country: _________________________________ Zip/Postal Code: _________________________ Zip/Postal Code: ___________________________ Country of Origin: ___________________________ Scientific Name and Common Name of the product: ________________________________________________ ____________________________________________________________________________________________ Description of the product: _____________________________________________________________________ ____________________________________________________________________________________________ Check one box Infectious: ! Non-infectious: ! Check one box Hazardous: ! Non-hazardous: ! Check one box Animal origin: ! Non-animal origin: ! Check one box Used in vitro: ! Used in vivo: ! Final Use of the product:_______________________________________________________________________ ____________________________________________________________________________________________ Signature Print name Date ** This declaration does not replace at anytime an import permit and/or an official veterinary certificate **
