The sampling form could contain the following items. Additional information may be added according to local circumstances.
| Date and time of sampling | |
| Name and signature of sampling officer/sampling office | |
| Reason for sampling | |
| Identification of sample | By name and/or trademark and/or registration number |
| Number and size of final samples | |
| Type of consignment (bulk, packed, etc.) | |
| Number and type of packages in the consignment | |
| Quantity of the consignment and units (e.g. 5 tonnes). | |
| SAMANCTA sampling procedure used or details of other procedures used | If requested, information about sampling tools used should be included.
If the declarant does not agree with the sampling procedures, the reasons must be recorded. |
| Storage and transportation conditions | |
| Safety precautions (if available, provide a copy of the SDS) | |
| Declarant details (name, address, registration number, etc.) | |
| References of declaration or other documents specifying the goods | Declared codes (HS, etc.) and commercial name |
| Seals, marks and sample registration numbers applied to the samples | (chain of evidence) |
| Legal matters; name and signature of the declarant, if present. | To indicate agreement with the sampling action. As an example following declaration are required:
I accept (confirm):
- That I am entitled to take action on behalf of legal entity during customs or tax inspections.
- That I have been informed about sampling procedure before samples were drawn (or any sampling action was taken).
- That the sampling method used was correct.
- That (specify here quantity of samples) samples were drawn from the declared consignment.
- That the samples were proportionate to the consignment as a whole.
- That the samples are representative of the consignment as a whole.
- That the facts in sampling form and related records (photographic evidence) are correct.
- That I have received the sample, which I require, for case of appeal against results of customs laboratory.
- That I am aware that I can claim to get the sample for case of appeal against results of customs laboratory and customs cannot deny it.
- That I request / do not require the return of any unused portions of the samples after analysis.
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