Annex B: Application to Return Canadian Products Exported

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Name of company:

We hereby request permission to return to Canada the following product from country:

Product Exported:

  • Description:
  • Weight: (lbs/kg)
  • # of packaged units

Request to Return:

  • Description:
  • Weight: (lbs/kg)
  • # of packaged units

Date of export:

From Est. #

CFIA/ACIA 1454 #

Type of packaging:

Type of tamper evident means:

A. Shipment was in transit and did not reach country of destination.

B. Shipment refused on arrival and remained at point of entry under official control of importing country (customs, agriculture)

C. Shipment left point of entry and was refused in receiving establishment. Shipment always remained under official control of importing country.

Date and place of refusal:

Date:

Place/Region:

Reasons for refusal:

Product complies with provisions of the Meat Inspection Act and Regulations: Yes / No

if no describe the intended use.

Shipment will return to Canada by:

  • truck checkbox
  • air checkbox
  • ship checkbox
  • Other checkbox

Point of landing:

Date:

We are attaching the following documents (applicable only for return from countries other than the USA):

  1. CFIA/ACIA 1454 (copy) for case A, B, C.
  2. Letter stating details of the reason for the shipment being returned to Canada as well as proof that the shipment seals are intact (case A).
  3. Form Official Declaration for Exported Canadian Meat Products Returned to Canada (in English or French) be completed by a representative of the government of the importing country (custom, agriculture, health) (cases B and C).

Firm's representative

  • Name:
  • Signature:
  • Date:
  • Tel.:
  • Fax:
Date modified: