PRC Application Form for Trans-genetic Product Transit Transfer Permit

Name:

The undersigned hereby states that the details and statements in this form are correct and truthful, and we strictly observe the relevant provisions on inspection of entry and exit animal and plant.

Signature and seal:

Date of Application:

Contact:

E-mail：

 

Fax:

Tel.:

Postal Code:

Address:

Name:

Strain:

Research and development provider:

Place of origin:

Purpose:

Export country:

Quantity:

Packing mode:

Place of despatch:

Entry port:

Entry date:

Exit port:

Exit date:

Transport route and mode:

Receptor biology

Chinese name:

Scientific name:

Place of origin:

Target gene

Name:

来源：

Source:

Biological function:

Approval authority in the country of origin:

Approved purpose in the country of origin:

Time of approval in the country of origin:

Whether the rejection is recorded:

Product identification:

 

 

Signature and seal

Date: