Statement for the applicant to read:
I hereby certify that the meat products specified above have been prepared in an establishment certified for export to Canada and are derived from animals that have been examined and found, by ante-mortem and post-mortem inspection at the time of slaughter, to be free from disease and that the meat products are suitable in every way for human consumption and are otherwise in compliance with requirements at least equal to those in the Canadian Meat Inspection Act and Regulations.
After reading the statement, the applicant must supply the following information:
Day, month and year
Signature of the Official Veterinarian and his printed name