Příloha x. 11 x xxxxxxxx x. 357/2001 Xx.
XXXX XXXXXXX XXXX
Xxxxx x xxxxxxxx
1. Xxx xxxxxxx xx xxxxxx xxxxxxxxxxx koně xxxxxxx xx xxxxxx xxxxxxxxxxxx xxxx xxxxxxxx.
2. Xxx xxxxx majitele xxxx xxx průkaz xxxx co xxxxxxxx xxxxxx xxxxxxxxx xxxxxxxxxx x uvedením) jména x xxxxxx xxxxxx xxxxxxxx x zaregistrování xxxxx.
3. Pokud xx xxx více xxx xxxxxxx xxxxxxxx, xxxx xx v xxxxxxx xxxxxxxxxxx, xxxx xxx x xxxxxxx xxxxxxx xxxxx x státní xxxxxxxxxxx xxxxx xxxxxxxxx xx koně. Xxxxx xxxx xxxxxxxx xxxxxxx xxxxxxxx xxxxxxxxxxxxx, musí xxxxx xxxxxx xxxxxxxxxxx xxxx.
4. Xxxxxxxx Xxxxxxxxxxx xxxxxxxx federace xxxxxxx xxxxxxxx xxxx Národní xxxxxxxxx xxxxxxxx, xxxx xxx xxxxxxxxxxx této xxxxxxxxx na xxxx xxxxxxx xxxxxxx.
Xxxxxxx xx xxxxxxxxx
1. Xxx xxxxxxxxxxx xxxxxxxx, the nationality xx xxx xxxxx xx xxxx of xxx owner.
2. Xx xxxxxx xx xxxxxxxxx xxx xxxxxxxx xxxx xxxxxxxxxxx xx lodged xxxx xxx issuing xxxxxxxxxxxx, xxxxxxxxxxx xx xxxxxxxx agency, xxxxxx xxx xxxx xxx xxxxxxx xx the xxx xxxxx, xxx xxxxxxxxxxxx xxx xxxxxxxxxx xx xxx xxx xxxxx.
3. If there xx xxxx than xxx owner xx xxx xxxxx xx xxxxx xx x xxxxxxx, then xxx xxxx of xxx xxxxxxxxxx xxxxxxxxxxx for xxx xxxxx xxxx xx xxxxxxx xx xxx passport xxxxxxxx xxxx xxx nationality. Xx the xxxxxx xxx xx xxxxxxxxx xxxxxxxxxxxxx, they xxxx xx xxxxxxxxx xxx xxxxxxxxxxx of xxx xxxxx.
4. Xxxx xxx Xxxxxxxxxx xxxxxxxx xxxxxxxxxxxxxx xxxxxxxx xxx xxxxxxx xx x xxxxx xx x xxxxxxxx xxxxxxxxxx xxxxxxxxxx, xxx xxxxxxx xx xxxxx xxxxxxxxxxxx xxxx xx xxxxxxxx by xxx xxxxxxxx xxxxxxxxxx federation xxxxxxxxx.
Xxxxxxx xx xxxxx xx xxxxxxxxx
1. Xxxx xxx compétitions, xx xxxxxxxxxxx xx cheval xxx xxxxx xxx xxx xxxxxxxxxxxx.
2. Xx xxx xx xxxxxxxxxx xx propriétaire, xx xxxxxxxxx doit etre xxxxxxxxxxxxx déposé xxxxxx xx x´xxxxxxxxxxxx, x´xxxxxxxxxxx xx le xxxxxxx xxxxxxxx x´xxxxx xxxxxxx xxxx le nom xx x´xxxxxxx du xxxxxxx xxxxxxxxxxxx xxxx xx xx xxx xxxxxxxxxxx aprés xxxxxxxxxxxxxxxx.
3. X´xx y a xxxx x´xx xxxxxxxxxxxx xx xx xx xxxxxx xxxxxxxxxx x xxx xxxxxxx, xx xxx de xx xxxxxxxx xxxxxxxxxxx xxxx xx xxxxxx xxxx xxxx xxxxxxx xxxx xx xxxxxxxxx xxxxx xxx xx xxxxxxxxxxx. Xx les xxxxxxxxxxxxx xxxx xx xxxxxxxxxxxx xxxxxxxxxxx, xxx doivent xxxxxxxx xx xxxxxxxxxxx xx xxxxxx.
4. Lorsque xx Xxxxxxxxxx équestre xxxxxxxxxxxxxx xxxxxxxx xx xxxxxxxx x´xx xxxxxx xxx xxx Fédération xxxxxxxx nationale, xxx xxxxxxx de ces xxxxxxxxxxxx doivent etre xxxxxxxxxxx par xx Xxxxxxxxxx xxxxxxxx xxxxxxxxx xxxxxxxxxx.
_________________________________________________________________________________________
Xxxxx xxxxxxxxxx Xxxxx xxxxxxxx Xxxxxx xxxxxxxx Xxxxxx xxxxxxxxxxx Podpis xxxxxxxx Xxxxxxx xxxxxxxxx
xxxxxxxxx xxxxxxxxxx Name of xxxxx Xxxxxxx xx xxxxx xxxxxxxx Xxxxxxxxx xx owner xxxxxxxxxx x podpis
Date xx xxxxxxxxxxxx, Xxx xx Xxxxxxx xx Nationality xx xxxxx Signature xx Xxxxxxxxxxxx,
xx xxx xxxxxxxxxxxx, propriétaire xxxxxxxxxx Xxxxxxxxxxx xx xxxxxxxxxxxx xxxxxxxxxxx xx
xxxxxxxxxxx, xx Xxxxxxxxxxx xx xxxxxxxx xxxxxx stamp
official xxxxxx xxxxxxxxxxxx and xxxxxxxxx
Xxxx x´xxxxxxxxxxxxxx Cachet de x´xxxxxx-,
xxx l´organisation, sation, xxxxxxxxxxx
x´xxxxxxxxxxx xx xx xx xxxxxxx officiel
service xxxxxxxx xx signature
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
Pouze xxxxxxx xxxx
Xxxxxx o xxxxxxxx
Xxxxx xxxxxxxx xxxx xxxx xxx čitelně x xxxxxx xxxxxxx x xxxx xxxxxxx xxxxxxx a xxxxxxxxx xxxxxx, xxxxxxxx a xxxxxxxx veterinárního xxxxxx.
Xxxxxx xxxxxxxx xxxx
Xxxxxxxxxxx xxxxxx
Xxxxxxx xx every xxxxxxxxxxx xxxxx xxx xxxxx xxxxxxxxx must be xxxxxxx xxxxxxx and xx detail, xxx xxxxxxxxx with xxx xxxx xxx xxxxxxxxx xx xxxxxxxxxxxx.
Xxxxxx xxxxxx xxxxxxxxx
Xxxxxxxxxxxxxx des xxxxxxxxxxxx
Xxxxx xxxxxxxxxxx xxxxx par xx cheval xxxx xxxx xxxxxx xxxx xx xxxxx xx-xxxxxxx xx xxxxx xxxxxxx xx précise xxxx xx xxx et xx xxxxxxxxx xx xxxxxxxxxxx.
________________________________________________________________________________________
Xxxxx Xxxxx Země Xxxxxxx Xxxxx, podpis x razítko
Date Xxxxx Xxxxxxx Xxxxxxx xxxxxxxxxxxxx xxxxxx
Xxxx Xxxx Xxxxxx Xxxx, xxxxxxxxx xxx xxxxx xx
_________________________ xxxxxxxxxxxx
Xxxxx Xxxxx série Nom, xxxxxxxxx xx xxxxxx xx
Xxxx Batch xxxxxx xxxxxxxxxxx
Xxx Xxxxxx du xxx
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
Xxxxxxxx xxxxxxxxxx xxxx xxxxxxxxx x xxxxx xxxxxxx
Xxxxxxxx xxxxxxxxxx xxxx xx xxxxxxxxx xxxxxxxxxxxx xxx xxxxxxxxx, xxxxxxxxx xx xxxxxxxxxxxxx prohlídkách. Xxxxxxxxx xxxx strany xxxxxxx, xx xxxxx xxxxxxxxxxxx koně xx x xxxxxxx s xxxxxxxxx xxxxxxxxxxx xxxxxxxx xx xxxxxxxxx xxxxxx.
Xxxxxxxxxxxxxx xx the xxxxx xxxxxxxxx xx this xxxxxxxxx
Xxx xxxxxxxx xx xxx xxxxx xxxx xx checked xxxx xxxx xxxx xx xxxxxxxx by rules xxx xxxxxxxxxxx xxx xxxxxxxxx that it xxxxxxxx with xxx xxxxxxxxxxx given xx xxx diagram xxxx xx xxx xxxxxxxx.
Xxxxxxxxx x´xxxxxxxx xx xxxxxx xxxxxx xxxx ce xxxxxxxxx
X´xxxxxxxx xx xxxxxx xxxx xxxx xxxxxxxxx xxxxxx xxxx xxx xxx xxxx xx xxxxxxxxxx x´xxxxxxx : xxxxxx cette xxxx xxxxxxxx que xx xxxxxxxxxxx du cheval xxxxxxxx xxx conforme x xxxxx xx xx paga xx xxxxxxxxxxx.
________________________________________________________________________________________
Xxxxx xxxxxxxx (xxxx, Xxxxx, podpis a xxxxxx xxxxx xxxxxxxxx xxxxxxxxx
Xxxxx Obec x xxxx xxxxxxxxx xxxx.) Xxxxxxxxx, xxxx (xxxxxxx) xxx xxxxxx xx xxxxxxxx
Xxxx Xxxx xxx Xxxxxxx xx xxxxxxx (xxxxx, health verifying xxx xxxxxxxxxxxxxx
xxxxxxx xxxxxxxxxxx, xxx.) Xxxxxxxxx, xxx xx xxxxxxxxx xx xxxxxxx xx xx
Xxxxx xx xxxx Motif xx xxxxxxxx (xxxxxxxx, xxxxxxxx xxxxx xxxxxxx x´xxxxxxxx
xxxxxxxxxx sanitaire, etc.)
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
Jiné xxxxxx než xxxxxxxxx xxxx
Xxxxxx xxxxxxxx
Xxxxx xxxxxxxx xxxx xxxx xxx xxxxxxx x přesně xxxxxxx x xxxx xxxxxxx tabulce a xxxxxxxxx xxxxxx, xxxxxxxx x podpisem veterinárního xxxxxx.
Xxxxxxxx other than xxxxxx influenza
Vaccination xxxxxx
Xxxxxxx xx xxxxx xxxxxxxxxxx xxxxx xxx horse xxxxxxxxx xxxx xx xxxxxxx xxxxxxx xxx xx xxxxxx, and xxxxxxxxx with xxx xxxx and xxxxxxxxx xx veterinarian.
Maladies xxxxxx xxx xx xxxxxx xxxxxx
Xxxxxxxxxxxxxx xxx vaccinations
Toute xxxxxxxxxxx xxxxx xxx xx cheval xxxx xxxx xxxxxx dans xx cadre xx-xxxxxxx xx facon xxxxxxx xx xxxxxxx xxxx xx xxx xx xx xxxxxxxxx du xxxxxxxxxxx.
_________________________________________________________________________________________
Xxxxxxx/Xxxxxxx/Xxxxxx Jméno, xxxxxx x xxxxxxx xxxxxxxxxxxxx
Xxxxx Xxxxx Země lékaře
Date Xxxxx Country _________________________________ Xxxx, signature xxx xxxxx xx
Xxxx Pays Xxxxx Xxxxx xxxxx Xxxxxx(x) xxxxxxxxxxxx
Xxxx Batch xxxxxx Xxxxxxx(x) Xxx, xxxxxxxxx et xxxxxx xx xxxxxxxxxxx
Xxx Xxxxxx xx xxx Xxxxxxx(x)
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
Xxxxxxxxx xxxxxxxxx xxxxxxxxx autorizovanou xxxxxxxxxx
Xxxxxxxx xxxxx xxxxxxxxx, xxxxxxxxxxx na xxxxxxxx xxxxx xxxxxxxxxxx nebo xxxxxxxxxx xxxxxxxxxx xxxxxx xxxxxxxxxxx xxxxxxx země, xxxx xxx jasně x podrobně zapsány xxxxxxxxxxx, xxxxx reprezentuje xxxxxxxx požadující vyšetření.
Laboratory xxxxxx test
The result xx every xxxx xxxxxxx xxx xxx x transmissible xxxxxxx xx x veterinarian xx x xxxxxxxxxx xxxxxxxxxx xx xxx xxxxxxxxxx xxxxxxxxxx xxxxxxx xx xxx xxxxxxx xxxx be xxxxxxx xxxxxxx xxx xx xxxxxx xx trh xxxxxxxxxxxx xxxxxx xx xxxxxx xx xxx xxxxxxxxx xxxxxxxxxx xxx xxxx.
Xxxxxxxxx xxxxxxxxxx xxxxxxxxx xxx xxx xxxxxxxxxxxx
Xx xxxxxxxx xx tout xxxxxxxx xxxxxxxx xxx xx xxxxxxxxxxx xxxx xxx xxxxxxx xxxxxxxxxxxxx xx xxx un xxxxxxxxxxx xxxxx par xx service xxxxxxxxxxx xxxxxxxxxxxxxx du xxxx xxxx xxxx noté xxxxxxxxxx xx xx xxxxxxx xxx xx xxxxxxxxxxx qui xxxxxxxxxx x´xxxxxxxx xxxxxxxxx le xxxxxxxx.
_________________________________________________________________________________________
Xxxxxxxxxx xxxxxx Xxxx xxxxxxxxx Xxxxxxxx xxxxxxxxx Xxxxx protokolu Xxxxxxxxxxxx xxxxxx- Jméno, podpis x
Xxxxx Xxxxxxxxxxxxx Xxxx xx test Xxxxxx xx xxxx Xxxxxx xxxxxx xxx, která xxxxxxxxxxx xxxxxxx veterinárního
Date xxxxxxx xxxxxx xxx Xxxxxx xx Xxxxxxxx xx Xxxxxx xx xxxxxx xxxxxx
Xxxxxxxx x´xxxxxx x´xxxxxx xxxxxxxxx Xxxxxxxx xxxxxxxxxx xx Name, xxxxxxxxx
xxxxxxxxxxxxxx xxxxx xxxxxx xx xxxx and xxxxx of
concernées Xxxxxxxxxxx xxxxxxxx xxxxxxxxxxxx
x´xxxxxxx xx Xxx, xxxxxxxxx xx
xxxxxxxxxxx xxxxxx xx
xxxxxxxxxxx
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
Xxxxxxxx xxxxx xxxx
1) Xxxxxxxxxxxxx číslo xxxx
Xxxxxxxxxxxxxx Xx
Xx d´identification
2) Xxxxx
Xxxx
Xxx
3) Xxxxxxx
Xxx
Xxxx
4) Xxxxx
Xxxxxx
Xxxx
5) Xxxxxxx
Xxxxx
Xxxx
6) Xxxx
Xxxx
Xxxx
7x) Matka 7x) Xxxx xxxxx
Xxx xx
Xxxx par
8) Datum xxxxxxxx
Xxxx of xxxxxxx
Xxxx xx xxxxxxxxx
9) Místo xxxxxxxx
Xxxxx xxxxx bred
Lieu x´xxxxxxx
10) Xxxxxxxx(x)
Xxxxxxx(x)
Xxxxxxxx(x)
11) Xxxxxxxxx xxx
xxxxxxxxx xx
xxxxxx xx
- Xxxxx xxxxxxxxxxx orgánu
Name xx the xxxxxxxxx xxxxxxxxx
Xxx xx x´xxxxxxxx xxxxxxxxx
- Adresa
Address
Adresse
- Xxxxxxx
Xxxxxxxxx Xx
Xxxxxxxx phone
- Xxx
Xxx xxxxxx
X de xxxxxxxxx
- Xxxxxx
(xxxxxxx xxxxxxx xxxxx x funkce xxxxxxxxxxx)
Xxxxxxxxx
(Xxxx xx xxxxxxx letters xxx capacity of xxxxxxxxx)
Xxxxxxxxx
(xxx xx xxxxxxx xxxxxxxxx et qualité xx xxxxxxxxxx)
- Xxxxxxx
Xxxxx
Xxxxxx
12) Xxxxxxxx popis
Grafický xxxxx
13) Xxxxx xxx xxxxxx
Xxxxxxxxxxx xxxxx xxxx xxx xx
Xxxxxxxxxxx xxxxxx xxxx xx mére xxx
x) Xxxxx
Xxxx
Xxxx
x) Xxxx xxxxxx xxxxxxxxx
Xxxxxxx L
Ant. X
x) Xxxxx xxxxxx končetina
Foreleg X
Xxx. X
x) Xxxx xxxxx xxxxxxxxx
Xxxxxxx L
Post X
x) Pravá zadní xxxxxxxxx
Xxxxxxx X
Xxxx X
x) Xxxx
Xxxx
Xxxxx
x) Xxxxxxx
Xxxxxxxx
Xxxxxxx
x) Dne
On
Le
14) Xxxxxx a xxxxxxx xxxxxxxxxxx xxxxxx (xxxxxxx xxxxxxx xxxxx xxxxxxxxxxx)
Xxxxxxxxx xxx xxxxx xx xxx xxxxxxxxx authority (xxxx xx signatory xx xxxxxxx xxxxxxx)
Xxxxxxxxx xx xxxxxx du xxxxxxxx xxxxxxxxxx (xxx xx xxxxxxxxxx en xxxxxxx capitales)
Potvrzení xxxxxxxxxxxxx xxxxxx o zdravotním xxxxx x xxxxxxxx xxxxxxx v chovu
Veterinary xxxxxxxxxxxxx for xxxxxxxxxx xxxxxxxxx/Xxxxxxxxxx xxxxxxxxx xxxx xx transport xxxxxxxx
_________________________________________________________________________________________
Xxxxx Xxxxxxxx xxxxxxxxxx Nákazová xxxxxxx Xxxx xxxxxxxxx, xxxx xxxxxx Jméno, xxxxxx x razítko
vyšetření xxxx x xxxxx x xxxxx xxxxxx xxxxxxxxxxxxx xxxxxx
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
_________________________________________________________________________________________
Xxxxxxxxx xxxxxxxxxxx xxxxxx xxxxxxxxxxx xxxxxx x xxxxxxxx situaci x xxxxxx
Xxxxxxxxxx xxxxxxxxxxxxx xxx intrastate xxxxxxxxx/Xxxxxxxxxx xxxxxxxxx pour xx xxxxxxxxx xxxxxxxx
________________________________________________________________________________________
Xxxxx Nákazová xxxxxxx Doba platnosti, xxxx Jméno, podpis x xxxxxxx Xxxxx xxx nalepení xxxxx
x xxxxxx a xxxxx xxxxxx veterinárního lékaře
příslušného xxxxxx
xxxxxxxxxxx správy
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
Datum Xxxxx X xxxxxx průkazu xxxx xx přiloženo Xxxxxxx x xxxxxx xxxxxxxxxxxxx lékaře
Date Place xxxxxxxxxx xxxxxxxxxxx osvědčení xxxxx: Name, xxxxxxxxx xxx xxxxx xx xxxxxxxxxxxx
Xxxx To this xxxxxxxx is attached xxxxxxxxxx Xxx, xxxxxxxxx xx xxxxxx xx xxxxxxxxxxx
xxxxxxxxxx certificate Xx
Xx xxxxxxxx xxx accompagné xxx xxxxxxxxxx
xxxxxxxxx xxxxxxxx Xx
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________