Export Certificate Application


Plant Protection and Weed Control Program
1320 Research Park Drive
Manhattan, KS 66502
Telephone: (785) 564-6698 Fax: (785) 564-6779
KDA.PPWC@ks.gov

Instructions

DO NOT USE ABBREVIATIONS

APPLICANT NAME AND ADDRESS:
As the heading states, please list the Name and Address of the Company, individual, corporation etc. who is filling out this form in this section. Applicant will be billed for the certificate.

EXPORTER NAME AND ADDRESS:
In this section, specify the name and address of the exporter. This must be a United States address. 
CAUTION: Never enter more than one exporter's name in these blanks.

CONSIGNEE NAME AND ADDRESS:
In this section, specify the name and address of the consignee. This address must be in the country specified in section 4, DESTINATION COUNTRY. CAUTION: Never enter more than one consignee’s name in these blanks.

DESTINATION COUNTRY:
Fill in the name of the foreign country to which the commodity is being exported. The country entered here must be the same as the country identified in the name and address of the consignee.

LOCATION OF COMMODITY:
Indicate the exact location of the commodity in order for an inspector to check the material if it becomes necessary.

ORIGIN OF COMMODITY:
In this section, indicate the geographical or political subdivision where the product was grown.

INSPECTION DATE:
If known, insert the date on which the commodity was inspected.

QUANTITY AND COMMON NAME OF COMMODITY: 
The information in this section will include the name, quantity, and weight of the product.

BOTANICAL NAME OF COMMODITY:
The scientific name of the commodity being certified is entered in this section. USDA guidelines indicate the exporter is responsible for providing this information. We are generally able to assist exporters in determining the correct scientific name.

NUMBER AND DESCRIPTION OF PACKAGES:
The number and types of shipping containers (boxes, crates, rail cars, etc.) is listed in this section. For bulk product shipments, the weight of the shipment should be used. For other types of shipments, the actual number of bags, boxes, containers, etc., should be used. Information not appropriate for this section include trade names, intended use, sizes, grades, or other commercial terms.

DISTINGUISHING MARKS OR IDENTIFICATION: (rail car numbers, etc.)
The markings applied to the containers listed in the previous section are listed here. Examples would be the actual car numbers of the rail cars involved in the shipment or specific markings on bags, containers, etc.

* All attachments listing car numbers, container numbers, etc. MUST be submitted on the form supplied by the KDA. This is to insure uniformity of the documents when they are presented to the officials of the importing country.

MEANS OF CONVEYANCE:
If known, the name of the railroad, truck line, airline, or ocean vessel may be listed. If the name is not known, then the type of conveyance (air, rail, ocean vessel, truck, etc.) should be provided.

POINT OF ENTRY:
This section is used to indicate the actual point of entry as designated by the exporter. This must be a point in the country specified in Section 4. United States points are not acceptable in this section. Some countries have specified points where all shipments must enter.

DATE THE INSPECTION NEEDS TO BE COMPLETED BY:
Here enter the date by which you would like to receive the Certificate at your office.

EXPRESS DELIVERY INFORMATION:
If the certificate is to be forwarded to you by express delivery fill in the information requested in these three sections. Please provide a telephone number for the express delivery forms.

Application

Applicant Information

Format example: (913) 555-1212

Mail Shipper Copy To (if different from APPLICANT)

Exporter Information (if different from APPLICANT)

Consignee Information (must be in the Destination Country/State)

Other Information

Format example: 12/12/2012
Format example: 12/12/2012
If you wish to have the original certificate returned by express delivery, please complete the following: