Formular c. 14/ Form No 14 ll1>opJl,a.Nk 14Aktualizovano EK dne 12/12/2011 a 16/0112012 - verze z 16. bfezna 2012 / Updated by COM on 12/12/2011 and 16/0112012-

version of 16March 2012/ 06H061leH EK 12/12/2011 U 16/01/2012 - 6epcuH om 16Mapma 2012ORIGINAL / ORIGINAL 1 OPJ1rJfHAH 0 KOPIE 1 COPY / KOIlJ15l 0

1.Popis zasilky 1 Shipment description 1 OnucaHue nocma6KU 1.5.(:islo osvedceni / Certificate No 1 Cepmu¢wwm M 000

1.1. Nazev a adresa odesilatele / Name and address of consignor / Ha36aHUe ***U aopec zpY300mnpa6UmeJlfl: * ** EU ** ****Veterinarni osvCdceni pro ryvoz jednodennich mlad'at kuradomaciho, kruty, kachny, husy, pstrosa a nasadorych vajec

1.2. Nazev a adresa pfijemce / Name and address of consignee / Ha36aHUetechto druhU z EU do Celni unie

U aopec zpY30nOJlY'lameJlfl:Veterinary certificate for day-old chicks, turkey poults,

ducklings, goslings, ostrich chicks and hatching eggs of thesespecies exported from EU to the Customs Union

BemepuHapllwu cepmufjJuKam Ha 3KcnopmupyeMblXU3 E6poneucKozo COlO3a6 TaMOmeHHWU COlO3cymo'lHwe

u.blnllHma, UHOlOlUama, ymHma, ZYCHma, cmpaycHmaU uHKV6au.UOHHwe HUu.a 3mllX 6U006 nmuu.

1.3. Dopravni prostfedky / Means of transport 1 TpaHcnopm: 1.6. Zeme puvodu ptalcl: / Country of origin of birds: 1 CmpaHa(cislo zeleznicniho vag6nu / nakladniho automobilu, kontejneru, cislo letu, npouCXO:JICOeHUJInmUl.fbl:nazev lodi 1 the number of the railway carriage, truck, container, flight-number, name of the ship / NQ 6aZOHa, a6mOMaUlUHbl, KOHmeuHepa, peucCaMOJlema, HG36aHUecyoHa.)

104.Zeme traozitu 1 Country(ies) of transit / CmpaHa(bl) mpaH3uma: 1.7 ClenskY stat v EU vydavajici osvedceni / Certifying MemberState in the EU 1 CmpaHa-'lJleH EC, 6blOaBUlaJl cepmu¢uKam:

1.8. Pfislusny organ v EU / Competent authority in the EU /KOMnemeHmHoe 6eooMcm6o EC:

§IrlTF(CITMWN 1.9. Organizace v EU vydavajici osvedceni 1 Organisation

;11 ill, ~ ltvJ1lli I in the EU issuing the certificate 1 Y'lpe:JICOeHUecmpaHbl-3Kcnopmepa, 6bloaBUlee cepmu¢uKam:

1.10. Misto prekroceni hranice Celni unie 1 Point of crossingthe border of the Customs Union / IlyHKm nepeCe'leHUJIzpaHUl.fbl TaMO:JICeHHOZOCOI03a:

2. Identifikace zbozi 1 Identification of goods 1 HoeHmufjJuKau.uH m06apa:

2.1 Nazev zbozi / Name of the goods / HaUMeHo6aHue m06apa:

2.2 Druh a plemeno drUbeze (nasadoyYch vajec) / Species and breed of poultry (hatching eggs) / Buo, nopooa nmUl.fbl (umry6al.fUOHHblX JlUl.f):

2.3 Kategorie (cista linie, prarodice, rodice, brojleri, nosnice, ostatni) / Category (Pure line/grandparents/parents/broilers/layers/others) /

KamezopUJI ('lucmGfl JlUHUJI,npapooumeJlu, pooumeJlu, 6poiiJIepbl, HecyUlKu, opyzue):

.•.204 Pocet ptakU/vajec: 1 Number of birds/eggs: 1 KOJlU'leCm60 nmUl.fbl/JlUl.f:

2.5 Pocet a druh baleni: 1 Number and type of package: / KOJlU'leCm60 U 6UOyna~o6Ka:

2.6 Oznaceni 1 Identification marks / MapKupo6Ka:

2.7 Prepravni podminky (teplota, vlhkost) / Conditions for transport (temperature, humidity) / YCJl06UJlmpaHcnopmupo6KU (meMnepamypa,

6Jla:JICHOcmb):

2.8. Byla jednodenni kufata ockovana proti Markove chorobe?: ANO ( ) NE ( ) / For day-old chicks vaccination against Marek disease: YES ( )

NO ( ) / J(JlJl cymO'lHblX l.fblnJlJlm npo6eoeHa 6aKl.fUHal.fUJlnpomU6 EOJle3HUMapeKa J(A ( ) HET ( )

3.1 Nazev, cislo schvaleniJregistrace, adresa zai'izeni: / Name, approval/registration number, address of the establishment: / HCl3eallUe, HOMepymeep:JICOeHWl!pezucmpa/tuu, aopec npeOnpUJlmWl:

- liheii / hatchery / uH1ry6amop:

- chovne zafizeni / breeding establishment / nJleM3aeoo:

3.2 Spravni jednotka / Administrative-territorial unit! AOMuHucmpamueHo-meppumOpUWlbHafleouHu/ta:

Ja, niie podepsany uredni veterimlrni lekar, potvrzuji, ze: / I, the undersigned State /official veterinarian certify that: / D,Humenoonuca6lUuuCR zocyoapcm6eHHblu/OfjJU~Utl.!lbHblU eemepuHapHblu 6pa'l, yoocmOeepJlIO CJleoYIOU4ee:4.1 (1) Jednodenni mlad'ata kura domaciho, krUty, kachny, husy a pstrosa a nasadova vejce techto druhli ptakii, vyvazena do Celni unie, pochazeji z

hospodarstvi nebo spravnich uzemi vyvazejici zeme, ktera jsou prosta techto nakaz zvifat: / (I) Exported to the Customs Union day-old chicks,turkey poults, ducklings, goslings and ostrich chicks and hatching eggs of these species originates from premises or administrative territoriesof the exporting country free from the following contagious animal diseases: / (1) 3KcnopmupyeMbie e TaMO:JICeHHbIUCOlO3 KJlUHU'leCKU300poebie cymO'lHble /tblnJlJlma, UHOlOuwma, ymJlma, ZYCJlma, cmpayCJlma U UH1ry6a/tUOHHble Jlu/ta npOUCXOOJlm U3 X03JlUCme WlUaOMUHucmpamueHblX meppumopuu cmpaHbl-3Kcnopmepa, ce0600HbiX om CJleoylOUjux 3apa3HbiX 60Jle3HeU :JICUeOmHblX:

(2) bud' / either / IillH:

[4.1.1. avillrni influenzy, jejii hlliseni je povinne, podle Veterin:irniho kodexu pro suchozemska zvifata OlE:- v poslednich 12 mesicich v zemi nebo na spravnim uzemi v souladu s regionalizaci;nebo- v poslednich 3 mesicich pod podrninkou, ze v zemi nebo na spravnim uzemi v souladu s regionalizaci je provaden stamping out, a

pod podminkou, ze byly splneny pfislusne pozadavky OlE (dezinfekce a surveilance s negativnimi v)'sledky);] /[4.1.1. Notifiable avian influenza according to OIE Terrestrial Animal Health Code:

- within the last 12 months in the country or administrative territory according to regionalization;Or- within the last 3 months provided that stamping out is applied in the country or administrative territory according to regionalization

provided the relevant OlE requirements have been fulfilled (disinfection and surveillance with negative results);] /WlU:

[4.1.1 zpunna nmu~, nOOJlemaU4eZo 06J13ameJlbHOU oeKJlapa~uu (e coomeemcmeuu C CaHumapHblM KooeKcoM Ha3eMHbiX :JICUeOmHblXM3E)- e me'leHUe nOCJleOHUX12 MeCJl/tee Ha meppumopuu cmpaHbl WlU aOMuHucmpamueHou meppumopuu e coomeecmeuu

C pezuoHWlu3a/tueu;J1JlU- e me'leHUe nOCJleOHUX3 MeCJl/tee npu npoeeoeHuu «cm3MnUHZ aym» Ha meppumopuu cmpaHbl WlU aOMuHucmpamueHou meppumopuu

6 coomeemcmeuu C peZUOHaJlU3a/tueu npu YCJloeuu C06JllOOeHWl comeemcmeylOUjux mpe60eaHuu M3E (oe3umjJeK/tUJlu 3nU300mU'leCKUU KOHmpOJlb) npu ompu/tameJlbHblX pe3YJlbmamaX 3nU300mU'leCKOZO KOHmpOJlJl,]

(2) nebo: [4.1.1 vysoce patogenni avilirni influenzy Gakje definovana Veterinarnim kodexem pro suchozemska zvrrata OlE) - v poslednich12 mesicich v zemi nebo na spravnim tizemi v souladu s regionalizaci nebo v poslednich 3 mesicich v zemi nebo na spravnimuzemi v souladu s regionalizaci pod podminkou, ze byly splneny pnslusne pozadavky OlE (stamping out, dezinfekcea surveilance) a drubeZ/nasadova vejce byla ziskana z rodicovskych hejn, ktera byla drzena nejmene 21 dnli pfed sberem vajecv zafizeni prostem avi:irni influenzy, jejiz hlaseni je povinne, nejmene v poslednich 12 mesicich nebo v poslednich 3 mesicichpod podrninkou, ze je provaden stamping out, a surveilance byla provedena s negativnimi v)'sledky;]

(2) or: [4.1.1 Highly pathogenic avian influenza (as defined in the OlE Terrestrial Animal Health Code) - during the last 12 monthsin the country or administrative territory according to regionalization or during the last 3 months in the country or administrativeterritory according to regionalization provided the relevant OlE requirements have been fulfilled (stamping out, disinfectionand surveillance) and poultry/hatching eggs were derived from parent flocks which had been kept for at least 21 days priorthe collection of eggs in an establishment free from notifiable avian influenza for the last 12 months or for the last 3 monthsprovided that stamping out is applied and surveillance has been carried out with negative results;]

(2) WlU :[4.1.1 eblCOKonamozeHHOZO zpunna nmu~ (e coomeemcmeuu C CaHumapHblM KooeKcoM HCl3eMHbIX:JICUeOmHblXM3E) - e me'leHUenOCJleOHUX12 MeCJl/tee Ha meppumopuu cmpaHbl WlU aOMuHucmpamueHou meppumopuu e coomeemcmeuu C pezuoHWlU3a/tueU WlUe me'leHUe nOCJleOHUX3 MeCJl/tee Ha meppumopuu cmpaHbl WlU aOMuHucmpamueHou meppumopuu e coomeemcmeuuc pezuoHWlU3a/tueu npu YCJloeuu C06JllOOeHUJlcoomeemcmeylOUjux mpe60eaHuu M3E (<<cm3MnuHz aym», Oe3UHpeK/fWl,3nU300mU'leCKUU KOHmpOJlb)u nmu/ta!uH1<y6a/tuoHHble Jlu/ta 6blJlU nOJlY'leHbl om pOOUmeJlbCKUXcmao, Komopble COOep:JICWlUCbe me'leHUe nOCJleOHeZO21 OHfl 00 c60pa Jlu/t e X03JlUCmee c60600HOM om zpunna nmu/t nooJle:JICaUjezo 06Jl3ameJlbHOU oeKJlapa/tuue me'leflUe nOCJleOHUX12 MeCJl/tee WlU e me'leHUe nOCJleOHUX3 MeCJl/tee npu npoeeoeHuu «cm3MnUHZ aym» npu ompu/tameJlbHblXpe3YJlbmamaX 3nU300mU'leCKOZO KOHmpOJlJl};

1 Spnivni uzemi, zony a casove terrniny mohou b)'t vzajemnou dohodou upraveny na zaklade Memoranda Evropske unie a Celni unie 0

cleneni na zony a regionalizaci nebo Memoranda Evropske unie a Ruske federace 0 cleneni na zony a regionalizaci. / Administrativeterritories, zones and time periods may be modified with a mutual agreement on the basis of the European Union and Customs UnionMemorandum on zoning and regionalization or the European Union and Russian Federation Memorandum on zoning and regionalization,as applicable. / AihiUflucmpamu6Hbie meppumopuu, 30Hbl U CpOKU Awzym 6blmb U3AleHeHbl no 63aUAlHOAlY C02JlaCUTOcmopOH fla OCH06e

MeAlopafloYAla E6poneucKozo COT03a U TaMO:JICeHHOZO COT03a no peZUOHaJlU3QI./UU U 30Hup06aHUTO WlU, coomeemC6eHHO, HQ OCH06e

MeAlOpaHoyMa E6poneiicKozo COT03a U POCCUUCKOU <Peoepal./uu no pezuOHaJlU3al./UU U 30HupoeaflUTO .

2 Nehodici se skrtnete. / Cross out as appropriate. / He Hy:JICHoe ebl'lepK/iYmb

4.1.2. Newcastleske choroby Uakje definovana Veterinamim kodexem pro suchozemska zvifata OlE):- v poslednich 12 mesicich v zerni nebo na spravnim uzerni v souladu s regionalizaci,nebo- v poslednich 3 mesicich pod podminkou, ze v zemi nebo na spravnim uzemi v souladu s regionalizaci je provaden stamping out, a

pod podminkou, ze byly splneny pfislusne pozadavky OlE (dezinfekce a surveilance) s negativnirni yYsledky; /Newcastle disease (as defined in the OIE Terrestrial Animal Health Code):- within the last 12 months in the country or administrative territory according to regionalization,Or- within the last 3 months provided that stamping out is applied in the country or administrative territory according to regionalization

provided the relevant OIE requirements have been fulfilled (disinfection and surveillance) with negative results; /EOfle3HU HblOKaCfla (6 coom6emcm6UU C CaHUmapHblM KooeKCOM Ha3eMllblX :J/CU60mHblXM3E):- 6 me'leHUe nocfleoHux 12 MeCJllle6 Ha meppumopuu cmpaHbl UJlUaOMuHucmpamu6Hou meppumopuu 6 coom6ecm6UU

C peZUOHaflU3allUeu;JfflU- 6 me'leHUe nOCfleOllUX 3 MeCJllle6 npu npo6eoeHuu «cm3MnUHZ aym» Ha meppumopuu cmpaHbl UflU aOMuHucmpamU61l0U meppumopuu

6 coom6emcm6UU C peZUOllaflU3allUeu npu YCfl06UU co6flIOOeHUJl com6emcm6YlOUjUX mpe606aHUU M3E (oe3UHpeKlIUJ!U 3nU300mU'leCKUU KOllmpOflb) npu ompuliameflbllblX pe3Yflbmamax 3nU300mU'leCKOZO KOHmpOJlJl;

4.1.3. Salmonel6zy a mykoplazm6zy - v souladu s doporucenimi Kodexu OlE; / Salmonellosis and mycoplasmosis - according to the OlE Coderecommendations; / CaflbMOlleJlJliha U MUKOnfla3M03a - 6 coom6emcm6UU C peKOMeHOallUJlMU KooeKca M3E;

4.1.4 [infekcni bronchitidy dnlbeZe3], [infekcni bursitidy dnlbeze3], [infekcni laryngotracheitidy dnlbeze3

] a [virove hepatitidy kachilae] -nepfitomnost nakazy v rodicovskem hejnu v poslednich 2 mesicich. / [Avian infectious bronchitis\ [Gumboro disease\ [infectiouslaryngotracheitis3

] and [duck viral hepatitis3] - absence of the disease in the parent flock during the last 2 months. / [uHpeKlIuoHHoMy

6poHxumy Kyp 3), [60fle3HU raM60po3], [UllpeKlIUOll1l0MY flapUHzompaxeumy 3] U [6UpyC1l0My zenamumy YmJIm 3] - omcymcm6ue 60fle3HU6 pOOUmeJlbCKOM cmaoe 6 me'leHUe nOCfleoHux 2 MeCJllle6.

Podpis uredniho veterinamiho lekafe / Signature of the State /official veterinarian / Iloonucb zocyoapcm6eH1l0Z0 /O(jJUlIUaflbHOZO 6emepUllapHOZO6pa'la

Podpis a razitko musi by!: v barYe odlisne od barvy vytistenych udaju osvedceni. / Signature and stamp must be in a different colourto that in the printed certificate. / Iloonucb U ne'lamb OOfl:J/CHblOmflU'lambCJl 1I6emOJllom 6flaHKa.

3Nehodici se skrtnete. Osvedceni ma b}1 vydano na ziklade inforrnaci dovazejici zeme CD Komisi ED 0 nezbytnosti vydat osvedceni

pod Ie Kodexu OIE, vydimi z roku 2011, Navod k pouziti ,,A. Obecne poznamky", bod 3, tj. , ze..dovazejici zemeJspravni uzemi provadiucinny program surveilance, jehoz rysledky svedci bud' 0 nepntornnosti nikazy nebo 0 provadeni eradikace. Dovazejici zeme CDposkytne Evropske komisi vsechny pnslusne informace. I Cross out as appropriate. To be certified based on information from the CDimporting country to the EU Commission on the necessity to certify according to the OIE Code, Edition 2011, Users Guide "A. Generalremarks", point 3, i.e. that the importing country/administrative territory carries out an effective surveillance programme, eitherdemonstrating freedom or following which an eradication programme is conducted. The CD importing country submits all relevantinformation to the European Commission. I He HyJICHoe 6bl'<epKHymb. llooRe:JICUm cepmurjJuKal{UU Ha OCH06aHUU uHrjJopMal{UU am

cmpaHbl-uMnopmepa TC, npeoocma6JlJleMoii KOMUCCUU EC omHOCUmeRbHO Heo6xooUMocmu cepmurjJuKal{UU, C02JlaCHO PyKo6oocm6Y

nORb306ameR5l KooeKca M3E, 6 peOaKl{uU 2011 2., «A. 06U/ue 3aMe'laHWl>i, nyHKm 3, m.e. 'lmo 6 cmpaue laOMUHucmpamU6Hoii

meppumopuu 6eOemCH.3rjJrjJeKmU6HQR npOzpaAlMa 3nU300mU'leCKOZO KOHmpOJlJl, no umOZaM Komopoii OeJ\WHcmpupyemcR Ru60 c606ooa

am 60Re3HU, Ru60 np0600umCR npozpaMMa UCKOpeUeHUH..Cmpaua-w.1nopmep TC npeOOCma6JlJlem coom6emcm6YIOU/YIO UHrjJopMal{UIO

E6poneiicKoii KOMUCCUU.