Notification of Import Inspection of Dog - maff.go.jp

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೎⸥᭽ᑼ╙䋱ภ

⁅›∛੍㒐ᴺ෸䈶ኅ⇓વᨴ∛੍㒐ᴺ䈮ၮ䈨䈒›䈱ャ౉䈮㑐䈜䉎ዯ಴ᦠ 㪥㪦㪫㪠㪝㪠㪚㪘㪫㪠㪦㪥㩷㪝㪦㪩㩷㪠㪤㪧㪦㪩㪫㩷㪦㪝㩷㪛㪦㪞㪪 㪬㪥㪛㪜㪩㩷㪫㪟㪜㩷㪩㪘㪙㪠㪜㪪㩷㪧㪩㪜㪭㪜㪥㪫㪠㪦㪥㩷㪣㪘㪮㩷㪘㪥㪛㩷㪫㪟㪜㩷㪛㪦㪤㪜㪪㪫㪠㪚㩷㪘㪥㪠㪤㪘㪣㩷㪠㪥㪝㪜㪚㪫㪠㪦㪬㪪㩷㪛㪠㪪㪜㪘㪪㪜㪪㩷㪚㪦㪥㪫㪩㪦㪣㩷㪣㪘㪮

ᐕ䇭䇭䇭䇭᦬䇭䇭䇭䇭ᣣ

ዯ಴⠪૑ᚲ᳁ฬ෸䈶ㅪ⛊వ

Year䇭䇭Month䇭 Day

Name and address of applicant ᳁ฬ䇭Name 䋺 䋨

䋩䇭䇭䇭ශ

૑ᚲ䇭Address 䋺 㔚⹤⇟ภ Telephone 䋺 FAX 䋺 E-mail 䋺

േ‛ᬌ∉ᚲ㐳䇭Ლ To the chief of Animal Quarantine Service

䇭േ‛䉕ャ౉䈚䈢䈇䈱䈪䇮ਅ⸥䈱䈫䈍䉍ዯ಴䉕䈇䈢䈚䉁䈜䇯 䇭䇭I hereby notify for the importation of the undermentioned animal(s). േ‛䈱⒳㘃 Species of animal(s)

㗡ᢙ Quantity

↢ᐕ᦬ᣣ䋨ᐕ㦂 䋩 Date of birth (Age)

ᕈ೎ Sex

઀಴࿖ฬ Country of export

ャ౉䈱႐ᚲ Scheduled place of arrival

៞タ੍ቯ࿾෸䈶៞タ੍ቯᐕ᦬ᣣ Scheduled date and place of embarkation ャ౉䈱ᤨᦼ䋨೔⌕੍ቯᐕ᦬ᣣ䋩 Scheduled date of arrival (year/month/day)

៞タ੍ቯ⦁⥾ 䋨⥶ⓨᯏ䋩 ฬ Name of scheduled vessel (or flight No.)

⩄ㅍੱ૑ᚲ᳁ฬ Name and address of consignor ⩄ฃੱ૑ᚲ᳁ฬ Name and address of consignee

⸥౉ᵈᗧ㪑䇭 㪈㪅᳁ฬ䉕⥄⟑䈜䉎႐ว䈮䈍䈇䈩䈲䇮᛼ශ䉕⋭⇛䈜䉎䈖䈫䈏䈪䈐䉎䇯 2.ᰴ㗁䈱䈠䈱ઁෳ⠨䈫䈭䉎䈼䈐੐㗄ᰣ䈮䈲䇮↪ㅜ䇮઀ะ࿾䇮઀಴࿾䋨㘺㙃ᣉ⸳ฬ⒓෸䈶૑ᚲ䋩䇮䈠䈱ઁャ౉ᬌᩏ਄ෳ⠨䈫䈭䉎䈼䈐੐㗄䉕⸥タ䈜䉎䈖䈫䇯 In the last column of next page, please note the information such as the use of the animal(s), the destination, name and address of the facility in which the animal(s) is/are kept, etc. 䇭

䈠䈱ઁෳ⠨䈫䈭䉎䈼䈐੐㗄 (Other useful information) ฬ⒓ Name of animal(s) ୘૕⼂೎ᣇᴺ䋨䊙䉟䉪䊨䉼䉾䊒╬䋩 Means for identification (e.g.microchip) ᮡ⼂ᐕ᦬ᣣ Date of identification(year/month/day)

୘૕⼂೎⇟ภ/䊙䊷䉪 Identification number/Mark ᮡ⼂ㇱ૏ Location of identification

㩷䊙䉟䉪䊨䉼䉾䊒䋨䊥䊷䉻䊷䋩䈱⒳㘃 Type of microchip (reader)

ຠ⒳ Breed

Ძ⦡ Color

↪ㅜ Use

ャㅍᒻᘒ䋨⽻‛෶䈲៤Ꮺຠ䋩 cargo or hand luggage

૕㐳 Length

䇭 䌣䌭

૕㜞 Height



૕㊀ Weight

䌣䌭

䌫䌧䇭

઀಴࿾䋨㘺㙃ᣉ⸳ฬ⒓෸䈶૑ᚲ䋩 Name and address of the facility in which the animal(s) is/are kept ઀ะ࿾䋨ฬ⒓෸䈶૑ᚲ䋩 Name and address of destination ㆊ෰䋱ᐕએౝ䈱⸰໧࿖෸䈶䈠䈱ᐕ᦬ᣣ Countries visited in the past 12 months and the date of visits ⁅›∛੍㒐ធ⒳ Rabies vaccination

ធ⒳ᐕ᦬ᣣ Date of vaccination (year/month/day)

᦭ലᦼ㒢 Date of expiry (year/month/day)

੍㒐ᶧ䈱⒳㘃 Kind of vaccine

੍㒐ᶧ䈱⵾ຠฬ෸䈶⵾ㅧળ␠ Name of product and manufacturer

ណⴊ೨ Before blood sampling

ណⴊᓟ㩷Booster(if any)

⁅›∛᛫૕ᬌᩏ

㩷ណⴊᣣ

᛫૕ଔ Antibody titer

Rabies serological test Date of blood sampling (year/month/day)

IU/ml

ᬌᩏᯏ㑐ฬ෸䈶૑ᚲ Name and address of the designated laboratory 䈠䈱ઁ䈱੍㒐ធ⒳ Other vaccination

஻⠨ Remarks



ធ⒳ᐕ᦬ᣣ Date of vaccination (year/month/day)

᦭ലᦼ㒢 Date of expiry (year/month/day)

੍㒐ᶧ䈱⒳㘃 Kind of vaccine

੍㒐ᶧ䈱⵾ຠฬ෸䈶⵾ㅧળ␠ Name of product and manufacturer