Instruction 1753/MAF on the Registration of Production Establishments for the Export of Plants and Plant Products

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Application for Establishment Registration for Plant Export. - sjmJJ nrnnm.J jir\~e.miuusjnu cc;;:i: n,unnnrnJri c;;:irnn 13/~w~. ;3j5utn 15 l.J:~n 2016/Pursuant to Law on Plant Protection and Plant Quaranti~ ~ ~ -- 13/NA, dated 15th November 2016); ~ n· - Sjrl'lJJ ffin5j jir\mw,r1L1:n,rn;J2im'cJJwri ~,~u ~jssn cc;;:i: ~j . ~,i I ' ( 2986/rn.J, ~j5rnn 28 .UtJU"l 2019/Pursuant to Ministerial •~ Phytosanitary Measure for Expor and reexport No2986/MAF dat 2019. ~,,,_;~~ ,n_ 0 0 ~I - 0. ~~ C, 0 CL.I - 9jl1'lJJ mcrn:u, n:5~nu n,u2um:u:5u~:riiumtJ:nsun,ur.1:;;:iri ~,;;:iun,u~j ssrn:!ri cc;;:i: r.1:~rm:i:Juwri/Pursuant to guidedance on establishment registerion certificate for export plant and plant product c;;:inm/no 1753/rn.J, :;3j5um 25 ~jtn'l 2020 1. ~ cc;;:i: 1J'lJJ~:rJU~59j2 (Full Name of applicant) ......................................... ...... 2. ~ cc;;:i: zR~~iunj'l1J/tJ~~rl~j99n (Name and address of company) .................... - t.isu~tJ:1 uuu,u (Present address, village) .......................................... .............. . - cssrn;;:inm (House No) .............................. m.i~e.J (Unit) .................................... . - C.LJ9j (District) ........................................... CC2~j (Province) .............................. - cOtm;;:i:~u (Telephone No) ......................... sw;;:i (E-mail) ............................... . 3. .i}1riu:~j2§ um:uju~:ri,utau:nsun,ur.1:fa1 ~,~un,ui,jssn iiri cc;;i: r.,:;jri mwuiiri Clj~JJD (Purpose to apply for establishment registerion certificate for export plant and plant product): - ~:ilriwri~~jssn (crops intended for export) .................................................... .. - u:cwri~:t)"l1J~u:nsun,uc.1:;jr1 (Type of Establishment): ................................... . D ~;)1J~n D t5jC5SutadjJJtfl D t5j9tJS"lrne:lu rJJ U"lLir1 D §u~ ........ .. - ~jSSll'cuiJ:CUlr1/export to ....................................................... ............... .............. . 4. u:nsucsn:~"luiirifirncis~:rn112§uui:uj1JC1jl1 /attchedmments for applications: □ ~"lcih~um:UjlJ;J~"lm:firi /trued coppy of extrerprise registration; □ ~,ciJ,~uS:1.Jmriri,ciiunri-;i:mun:~n"l cc;;i: V"l 'c.u /trued coppy of Agriculture and Forestry Business Lisence; □ ~"lCU"l~tJ~jU1Jll"llJC~EJS"lllS1Ju:~,D~rn.ihEJ /coppy of Tax payment certificate:-~►-:::::=:::::::,,,....._ D rj.Dn,uri,cii1Jj"l1J llj;JlltJ n,uc.1:;jriwri cc;;i: CCtJtJCCCJ1Jll°l1J~r1ll"ltJ~rn1~ ~ u:maun,umJJccuur:lJJ nrn..i 18 iucan::~,u~a1nfr1e.J 2 2ajii,ccu1f ! /Standard Operation of Etablishment as PQD form no 18 in An~ guidance; □ ~UJJSU~r1 cc;;i: ~,ciJ,uriu:~"lrl;J28j~Ducsn:~°11J iun;;i::ii~m~§1JJJ"lD1JR~ifQ-"1 - ==:::;.,--- CCU11J, letter of Authorizatio if anoher person represent for applicant. 2,r.J::c~,Mbuuj, ~.I.JU cc;i:: csn::~,u~u:nsuJJ,11 cc.uui)nr\sj cc;i: ~srieisjmJJ rl;J~j / I certify that the information and document provided on this application is true and correct). 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'lufl)ll1Jn"11Jn~nn, ~::t1"11JuitJ::naun"11Jt.1::Sn :o,;iun,1JS)aan t:in et;::):: r.1::Snn::iJ1Jt:in (Establishment Inspection Certificate for export Plant and Plant Products) - SjmJJ nrim.m.Jdirioe.JmlJt!SjlllJ cc~:: munnri11r:in ( ~::Ut.JUt.Jt}j) c~rna 13/~r.J~. ;JjOlJUl 15 r..i::~n 2016\Pursuant to Law on Plant Protection and Plant Quarantine No 13/NA, dated 15 th November 2016); - SjmJJ ~nn;b d,riocJJJ'1Cll.'1:mlJ~2,11, 'wfJn ii,;:iu ~j99fl cc;;i:: ~j99fl~ c;;irnn 2986/ntJ, . ;JjOlJUl 28 .Ut)lJ'l 2019\ Pursuant to Ministerial Decision on Phytosanitary Measure for Expor and reexport No2986/MAF dated 28 June 2019. _ sjmJJ 'lue1,ssj2§11U1::U:J1J ~=t1i11rRtJ::nsum11r.1::;im5,;iun,u~jssnfJri c'· ~~~ I Pursuant to application for establishment registration for plant export c 2::ccrrujtjnr:Jj ssn'lurJjllumun;::,rin,~::t1iutJ::nsun,ur.1::;iri ~,;Ju ~ WCl 'loiccri\Provincial Agriculture Section inspect and certify establishment fo 1. ~tJlli1lJ qi m11~nrbrhcil11nri-;i::m11 (Name of operator): ~ j) 2. ~u;;l~n /company name_ _ _ _ _ _ __ _ _ _ _ __ _ _ __ _ __ 3. ~c~i2sjnri-;i::m11 (Name of business owner): _ _ __ _ _ __ _ _ __ __ 4. tJ::tl..lClnri-;i::mlJ (Type of Establishment): _ _ _ _ ~j99n ttJ /export to_ _ __ 5. lR~jnri-;i::mlJ (Address of Establishment): u,u Nillag - - - - - -- - - - - C.USj District, _ _ _ _ _ CC2;:)j / Province _ _ _ __ cutU1 /Tel·-- -- - 5rnosuussn'lutfjtllJ (Date of issue) :.................................................. . 5rnosuDmJnsie.J (Date of expiry) :............................................................. mrnru,e::tttru~tJnt'/j Head of Agriculture Sector csn:~m.J~srnn,u: 3 2sjtiicm:1h c;Jrnn 1753/rn.J, :5j5uui 25 ~jtm 2020 tnJiucmn (Notice): - r;,tlt'crisutufijtllJ L'1Sjriicilufkr;i:m1JmJ.mius:::umri trn~sriiisjnunrnru,u C;J::: ;J:::UjUmlJ ~rijo~sj 2sj ~tJtJ ;Jio cc;i::: c~sub?tJ:::cuim.hd~,·- ~ (Certified establishment shall comply with related laws and regu obliged to comply with impo11 requirements). rniJ.Jcs,tui)jtiuiltrn~~rn.:ht~, rj,~tri;J:::c.Dri ~:i)n~n~isU5JJ, qj t*cuiuii,c~rnmuuiijccl.ij qj f)n:5jluiriuiijsim cc;\occrin;i:::Dc[h qj Sj ~utJ ;iio (this Certificate cannot be used by other persons who are no.~~J~·J~:-.--· older. If there is a violation of this use, the law and regulations shall be applied). csrn:~,u~m.Jtihe.J: 4 2sjt1iccu:1h c;;inui 1753/ntJ, ;ij51Jui 25 ~jm, 2020 ~,m,;;i::1.1::;iri t.J::~imtJ::tn tJ::~i~1.1;;i,.) ii1.1fit.1iu cen::;;iiri tJ::~imtJ::tn cen::t.1,u 5rnn::1.1::t1i"e1.1 n:~;Jjn:fai, cc;i: thtu (Ministry of Agriculture and Forestry) n.utJnWj (Department of Agriculture) c;;inui (No): ............../ntJc.J(DOA) ~UUl::U~lJ d..f C") ..S ., J,,. - n .., - ~::t1"11Jl/lu::neun"lut.1::;in .a"l;JU n"l1.1~)00nr..1n cc;i:: t.1::;im1::t..11Jt..1n (Establishment Registration for export Plant and Plant Products) - Sjm.U l1Clm.J'leJ;)')r];)e.Jni1JOSjnlJ cc;i: n,unnnuliri(~:uuDrn.Jj) c;:inui 13/~r.J~, 5j5lJ ui 15 r.J:~n 2016\Pursuant to Law on Plant Protection and Plant Quarantine No 13/NA, dated 15 th November 2016); - Sjm.u ~fln5:i ;:iir\;JeJJJiriri:mrn;Jeirn tJJr:iri ~,;Su~jssn cc;;i: ~jssnfl c;;inui 2986/ntJ, . 5j51Jui 28 JJr}lJi 2019\Ministerial Decision on Phytosanitary Measure for Expor and reexport No2986/MAF dated 28 June 2019; - Sjm.u 1uflje'.lun,un;Jrin, ~:t1i1JlRtJ:nsun,ur.,::5riih;Jun,u~:issn £lo cc;;i: r.,::5o ri:wtJliri c;:irnn ........... tJt.!2/Establishment Inspection Certificate for g Plant Products No................IPAS I ·?"> I n.ut.Jnw:i ssn1utn:UjlJ:;;:!:t1i1JtJ:nsum1JCJ:;JC1 ii,;Su mu~:issnilo cc;;i: CJ ~ Department of Agriculture certify establishment for export t · ' ~ 1. ~t.Jfle1tl in mtJ~ClC1jC1iciJrn1ri~:mlJ (Name of operator): - -- -~~~,...,,,--~4/ 2. ~u;Ji,o /company name _ _ _ _ _ _ _ _ __ __ _ _ _ _ _ _ _ __ 3. ~c~i2s:ino-;i:m1J (Name of business owner):._ _ __ _ _ __ _ __ _ __ 4. tJ:cr.Jt1nt1~:mlJ (Type of Establishment): ---~:issnctJ/export to_ __ _ 5. tRr'bnri~:mlJ (Address of Establishment): thlJ/Villag,_ _ _C.USj District, - - - CC2;Jj/ Province _ _ _ _ _ _ cOtm/Tel_ __ __ 51Jcns1JtJssn1um:ujtJ (Date of issue): ....................................................... 5rnfisuum]osie.J1UU1:Uj1J (Date of expiry): .................................................. c;;in;;i:mri1utn:uj1J (Code of Registration): 0000/F,P,S/00/00.00/00 tfa:imhn.utJnE:lj Director General truiucmn (Notice): - quhrisu'lufljVlJ '1SjCSiL';!L~ci,cilunrr~::n'llJLm~sm"isj mJJnri tltnj02Sj 2Sj ~tJtJ~io CC~: '1SjtJ::fiurimrn3su'C2nirn.iicfi; (Regis shall comply with related laws and regulations of Lao PDR and obli import requirements); - miJ.Jcs,'luiiJll1Jil'lm~§uti,'l~. r\i~Lri;i::c.Dri -;i::iin~n~isusJ.J, rhoctisu, ;JJ5'cu, Du Ltru @'l~ccmuE"i,c~mrn,e.m1iJccrJ:i @iin;JJtmnm,:isim cc;Soccrin;i::ilciJ, @oi:JnmJJ;i::u:5unrnru,e.i 2Sj ~tJtJ ;iio. (Registration cannot be used by other persons who are not the certificate holder. If there is a violation of this use, the law and regulations shall be applied).