Appendix I-B population harvest declaration form

This webpage is intended for informational purposes only.

All sections of this appendix must be completed unless otherwise directed in applicable licence conditions or by the Department

Part A.

Part B. Details of drug/chemical treatment while fish in this lot held at the licence facility details of last drug/chemical treatment:

1. Name of Drug and Prescription No. (if any)


2. Date Treatment Commenced

3. Date Treatment Ended

4. Treatment Information (withdrawal time prescribed, how applied to animals (in-feed or bath), amount per Kg of feed, etc.)



Treatment file and details are available at rearing site:

5. Name of Prescribing Veterinarian


Name of Person Responsible for Administering the Treatment

Signature of Person Responsible for the information of this declaration



This form may be used by a licence holder or their agent to satisfy the information requirements specified in licence condition 1.4 concerning shipping of fish/seafood to a market venue or processing plant. This form must accompany the fish/seafood and must be retained by the market or processing licensee for a period of one year. Please note that this form must be submitted even if there has been no drug treatment of the animals in the shipment.