PET CLEARANCE FORM

FULL NAME

ADDRESS

PHONE NUMBER

I DECLARE THE CUSTOMS VALUE OF THE ANIMAL DOES NOT EXCEED AUD $1000.00

YES it is not over $1000 AUD value NO the price paid / Value is over $1000 AUD in value

Price paid/ value for customs purposes

Description of the Animal

ARE THE GOODS PROHIBITED OR RESTRICTED IMPORTS OR DO YOU WISH TO REFER THESE GOODS TO CUSTOMS FOR ASSESSMENT OR PROHIBITED OR RESTRICTED STATUS? (Refer to www.customs.gov.au or call Australian Customs on 1300 363 263 for more information OR call/email us on 02 95405599 imports@matthewshort.com.au).

DO YOU WISH TO REFER THESE GOODS TO THE DEPARTMENT OF AGRICULTURE (QUARANTINE). (Do your goods contain animal product, plant product or food stuffs? If so, you MUST DECLARE your goods and refer them to QUARANTINE for processing. (Refer to http://www.agriculture.gov.au/ or call QUARANTINE on 1800 020 504 for more information)

ARE THE GOODS ALCOHOL OR TOBACCO PRODUCTS

Please select one of the below, is the animal

FAMILY PET UNDER 12 MONTHS FAMILY PET OVER 12MONTHS OF AGE NEW PUPPY/KITTEN PURCHASE

AIR WAY BILL NUMBER/ BILL OF LADING NUMBER

DATE OF FLIGHT

PLEASE READ THE FOLLOWING BEFORE SIGNING AND DATING THIS FORM. MATTHEW SHORT & ASSOCIATES and its nominees and/or subagents are appointed by you to act as your registered Self-assessed clearance declaration communicators for the purposes of the Customs Act 1901 as amended, at all places in the Commonwealth and you . A false or misleading statement to the Australian Customs Service and Department of Agriculture is an offence and may involve heavy penalties, including forfeiture, destruction or re-export of any goods concerned at your expense. In line with Customs requirements and The Privacy Act 1988 we must tell you why we are collecting this information, how we will use it and whether you have to give it to us. This information is required to ensure importers comply with Australian Customs, Quarantine, Health, Wildlife and Currency laws. We request this information under the Customs Act 1901, the Quarantine Act 1908, the Wildlife Protection (Regulation of Exports and Imports) Act 1982 and the Financial Transaction Reports Act 1988. Matthew Short & Associates Pty Ltd also needs the information to ensure all SAC declaration requirements are met, including the calculation of the right amount of duties and taxes for alcohol, tobacco and tobacco products imports. I declare that the above particulars are to the best of my knowledge true and correct and that I have understood the questions contained in this form and the answers provided to those questions are true and correct. I remove Matthew Short & Associates Pty Ltd from all liability that may arise from providing false or misleading information and agree to all terms and conditions available on our website www.matthewshort.com.au . This is a legally binding document and may be used as evidence. I CONFIRM THERE IS NO ASBESTOS IN THIS SHIPMENT and confirm the shipment does not contain any illegally logged timber.

BY TICKING THIS BOX YOU ACCEPT THE ABOVE STATEMENT

CREDIT CARD AUTHORITY VISA / MASTERCARD/ AMEX ---------------*Sac Clearance (under $1000) is $135 plus GST, Urgent clearance $150 plus GST ----------------- (FID) Full import clearance (over $1000) is $160 plus GST, {GST and customs CICS fee will be payable also for FID}

DOCUMENTS - LICENCE, AIRWAY BILL/BILL OF LADING or email nikki@matthewshort.com.au MAX 1GB UPLOAD (OR TEXT PHOTO OF DOCUMENT TO 0425225330)