No.

REPUBLIC OF INDONESIA
MINISTRY OF AGRICULTURE
KT - 10 INDONESIAN AGRICULTURAL QUARANTINE AGENCY

PHYTOSANITARY CERTIFICATE Plant Protection Organization of Indonesia

No.: .D...R...A....F..T....D...R....A...F...T........................ to: Plant Protection Organization(s) of.
.V I E T N A M.............................................................
I. DESCRIPTION OF CONSIGNMENT
Name and address of exporter: Declared name and address of consignee:
PT. OLAM INDONESIA LONG BINH BRANCH OF OLAM VIETNAM LIMITED,
SOUTH QUARTER TOWER A, LANTAI 21, UNIT A,G,H
JL.R.A KARTINI KAV. 8 JAKARTA SELATAN, INDONESIA LOT E05, LONG BINH INDUSTRIAL PARK, LONG
BINH WARD BIEN HOA CITY, DONG NAI
PROVINCE, VIETNAM, TAX CODE: 6000346337-009

Declared means of conveyance: Declared point of entry:

MARITIM TRANSPORT BG. SEJAHTERA 3032 11/23B HO CHI MINH, VIETNAM

HS Code: Place of Origin:

- PANJANG, INDONESIA

Distinguishing marks: Number and description of packages, name of produce, Quantity Declared:
OLAM#6600117476 botanical name of plants:
45,545.00 kilograms
WHITE PEPPER
1. 24,775 KGS INDONESIA WHITE PEPPER Total: 45,545.00 kilograms
NET WT: 59.99 KG 20,770 KGS INDONESIA BLACK PEPPER RAW
SUPPLIER : PT.
OLAM INDONESIA
Piper nigrum
ORIGIN : HS CODE : 0904.11.10 & 0904.11.20
INDONESIA Number of Commodities: 1
HARVEST CROP :
DEC 2022

II. ADDITIONAL DECLARATION III. DISINFESTATION AND/OR DISINFECTION TREATMENT

BL NUMBER : EGLV083300000905 Treatment Date
=== NONE === === NONE ===
OLAM#6600117477
BLACK PEPPER RAW Chemical (active ingredient) Concentration
NET WT: 61.09 KG === NONE === === NONE ===
SUPPLIER : PT. OLAM INDONESIA
Duration and Temperature
ORIGIN : INDONESIA === NONE ===
HARVEST CROP : FEB 2023
Additional Information
=== NONE ===
This is to certify that the plants or plant products or other regulated articles described herein:
- have been inspected and/or tested according to appropriate official procedures and
- are considered to be free from the quarantine pests specified by the importing contracting party and
- to conform with the current phytosanitary requirements of the importing contracting party, including those for
regulated non-quarantine pests.

Name of
authorized officer:
Place of issue: BANDAR LAMPUNG

Date of issue: MARCH, 2023

(Signature) (Stamp of Organization)
No financial liability with respect to this certificate shall attach to Plant Quarantine Service of Indonesia or to any of its officers or
representatives.