On the manufacturer’s letterhead with name address and ph, fax email

Mosquito Declaration

Vessel	Voyage

Container number

Suppliers invoice number

The tyres are free of mosquito eggs and larvae, they are dry, and that they have been stored under cover from the time of manufacture until the time of export.

The container number _____________ is fully enclosed with six hard sides.

The brand new tyres are shipped in a 6 hard sided container (DC or HC or GP of HCGP)

The Tyres are free of water and watermarks, live insects, soil and other quarantine risk material

Yours faithfully

Signature

Name of a person

Position in the company

Date when signed

Jeff Shaw

2012-12-28

Indah

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