REQUEST FOR EXPORT SANITARY CERTIFICATE Email request to or fax to: 360-902-2087. If you have questions please contact us at 360-902-1876. Contact Name: Contact Number: Email: Date Submitted: Number of Originals Requested: ($75 per Original) Country Shipping To: Type of Certificate Requested: (Examples on website. See ) Public Health & Sanitary Certificate – Example 1 Sanitary Certificate – Example 2 Certificate of Sanitation and Free Sale – Example 3 Certificate of Sanitation – Example 4 Certificate of Free Sale (Dietary & Nutritional Supplements) – Example 5 Additional Notes or Specific Requests: Product Information to Appear on Certificate (attach additional information if necessary): Processsing Plant Name: Physical Address: City, State, Zip Billing address same as certificate mailing address. Mail Certificate To*: Billing Address: *Note: FedEx will not deliver to a PO Box. Federal Express billing number: FOR OFFICE USE ONLY: Date Received: License # Inspector: Last Inspection Date: L UL Score: Account 90 Days Overdue Invoice # 4101
REQUEST FOR EXPORT SANITARY CERTIFICATE Email request to or fax to: 360-902-2087. If you have questions please contact us at 360-902-1876. Contact Name: Contact Number: Email: Date Submitted: Number of Originals Requested: ($75 per Original) Country Shipping To: Type of Certificate Requested: (Examples on website. See ) Public Health & Sanitary Certificate – Example 1 Sanitary Certificate – Example 2 Certificate of Sanitation and Free Sale – Example 3 Certificate of Sanitation – Example 4 Certificate of Free Sale (Dietary & Nutritional Supplements) – Example 5 Additional Notes or Specific Requests: Product Information to Appear on Certificate (attach additional information if necessary): Processsing Plant Name: Physical Address: City, State, Zip Billing address same as certificate mailing address. Mail Certificate To*: Billing Address: *Note: FedEx will not deliver to a PO Box. Federal Express billing number: FOR OFFICE USE ONLY: Date Received: License # Inspector: Last Inspection Date: L UL Score: Account 90 Days Overdue Invoice # 4101
2089e-requestforexportsanitarycertificate.docx