Declaration of Origin, form

Form
LB 5
Sign
and fax/email this form to the point of entry:
Kununurra: fax f (08) 9166 4067 or (08) 9168 3190 (a/h);
InterstateLivestockKununurra@agric.wa.gov.au
Kalgoorlie: fax (08) 9093 4839 or (08)(
9091 9854 (a/h).
InterstateLivestockKalgoorlie@agric.wa.gov.au
A signed copyy MUST accompany the stock.
Declaration
of Origin
Equines, ruminants and camelids
from the Liver Fluke Test Exempt Area of Australia
Biosecurity and Agriculture Management Act 2007 and Regulations 2013
This declaration provides
evidence for f the exemption of the
describedd livestock from pre-entry testing
and/or pre-entry treatment for liver fluke on movement into
Western Australia A on the basis that the stock
have been born and grazed solely in
the Liver Fluke Test Exempt Area of Australia and is to
be attached to
the
form Health Certificate for Movement of Stock to Western Australia (LB 1). A border treatment will still
apply if required.
Animal species
Number
Sex
Age
Description
(include official name/s
of registered animal/s)
PIC*
* PIC= property identification code of property of origin
I,
of o
Town
State/
Territory
Postcode:
Telephone: (
)
Email:
being
the owner of the livestock described above, declare that these stock were born and have
grazed solely
within
the area defined below as the Liver Fluke Test Exempt Area of Australia.
Livestock Biosecurity Form LB
5
current as at 1 May
2013
Page 1 of 2

Form LB 5
Declared at this day of 20
Signature of person making the declaration
Signature of witness
(Witness must be a registered Commonwealth elector)
Name of witness (block letters)
Address:
Town:
State/
Territory: Postcode:
Telephone: ( )
Definition:
The Liver Fluke Test Exempt Area of Australia means:
(i) The Northern Territory and
(ii) Queensland, north and west of the line of the road which runs from Hungerford to Thargomindah to Quilpie to
Adavale to Blackall to Jericho to Alpha to Clermont to Mount Douglas on the Gregory Development Road, to
Bowen via Collinsville on the Bowen Development Road and
(iii)
South Australia, north of Highway 32 from the New South Wales border to Peterborough, Highway 83 from
Peterborough to Carrieton, and north of the boundaries of the Counties of Dalhousie and Frome from Carrieton to
Port Augusta, and those areas of the Eyre Peninsular north of County Flinders.
Livestock Biosecurity Form LB 5
current as at 1 May 2013
Page 2 of 2