Declaration of Sampler | Kent Agri-Lab

FOR APHIS / EXPORT
Origin*
Kind of Seed*
Scientific Name*
Variety*
Lot NO.*
Size of Lot Being Exported*
Crop Certificate NO.
Sampling Equipment Used*
NO. of Samples Taken*
Sample Seed & Treatment*
Sample Taken At*
Conditioned / Packaged By*
Declaration*
- I hereby declare that I have sampled the above lot according to recognized standard sampling procedures and this sample truly represents the seed lot.
Name of Sampler*
First Last
Grader / Sampler License NO.*
Date*
MM slash DD slash YYYY