Export approval only as input for TRACES COI

From 19 October 2017 the import transaction certificates (COI) can be final approved and printed in TRACES platform only after
verification of information in CUSI.
Sending signed stamped import TC after this date is not allowed for the EU organic program.

CERTIFICATE OF INSPECTION
FOR IMPORT OF PRODUCTS FROM ORGANIC PRODUCTION INTO THE EUROPEAN UNION
1. Issuing control body or authority (name, address and code) 2. Council Regulation (EC) No. 834/2007,
Control Union Certifications B.V.
Meeuwenlaan 4-6 -Article 33(2) or
8011 BZ ZWOLLE
-Article 33(3)
NETHERLANDS
CB code: ID-BIO-149

3. Serial number of the certificate of inspection 4. (Exporter name and address)

PRJ 0854775/ XXXXXXX PT. Mata Gunung Altazor
Tifa Building, Floor 10. Jl. Kuningan Barat No.26
12710 Jakarta Selatan
DKI Jakarta
INDONESIA

5. Producer or processor of the product (name and address) 6. Control body or control authority (name, address and code)
EJC Production Facility II Control Union Certifications B.V.
Ruko Bukit Cinere Indah Jl. Cinere Raya Block OA No. 20 Meeuwenlaan 4-6

d
16514 Depok 8011 BZ ZWOLLE
Jawa Barat NETHERLANDS
INDONESIA CB code: ID-BIO-149

7. Country of origin 8. Country of export

se
INDONESIA INDONESIA

9. Country of clearance/Point of entry 10. Country of destination

Zurich Airport SWITZERLAND

Zurich
SWITZERLAND

11. Importer (name, address and EORI number)

F & B Affairs AG
Goldbrunnenstrasse 139
ri 12. First consignee in the Union (name and address)
F & B Affairs AG
Goldbrunnenstrasse 139
ho
8055 Goldbrunnenstrasse 8055 Goldbrunnenstrasse
Zurich SWITZERLAND Zurich SWITZERLAND

EORI number:

13. Description of products

ut

CN code Trade name Number of packages Lot number Net weight

09024000 (Black Tea Twisted) Plastic 29576 3.000

09024000 09022000 (Green Tea Twisted) Plastic 29630 2.880

na

09024000 09022000 2101209210 (Medium Oolong Tea Rolled) Plastic 29574 5.760

09024000 09022000 2101209210 09021000 (White Tea Twisted) Plastic 29578 2.520

14. Container number 15. Seal number: 16. Total gross weight: 30.950 kgs

17. Means of transport before point of entry into the Union

Mode :
U

Identification :

International transport document :

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 18. Declaration of control authority or control body issuing the certificate referred to in box 1.
This is to certify that this certificate has been issued on the basis of the checks required under Article 13(4) of Regulation (EC) No 1235/2008 and that the products designated above
have been obtained in accordance with rules of production and inspection of the organic production method which are considered equivalent in accordance with the provisions of
Regulation (EEC) No. 834/2007.

Date: , Zwolle Stamp of the issuing authority or body

Name and signature of authorised person

COPY

19. Customs warehousing Inward processing

Name and address of the operator:

Control body or control authority (name, address and code):

d
Customs Declaration Reference Number for customs warehousing or inward processing:

se
20. Verification of the consignment and endorsement by the relevant Member States competent authority.

Authority and Member State:

Date:

Name and signature of authorised person

ri Stamp
ho
21. Declaration of the first consignee.

This is to certify that the reception of the goods has been carried out in accordance with the provisions of Article 34 of Regulation (EC) No. 889/2008.

Name of the company Date:

Name and signature of authorised person

ut
na
U

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