TGA use only

This form, whencompleted, willbeclassified as 'For official use only'.
For guidance on how your information willbetreated by the TGA see: Treatment of information provided to the TGA at

Facsimile- Request for approval to export

(Regulation 8 of the Customs (Prohibited Exports) Regulations)

Regulation 8 of Customs (Prohibited Exports) Regulations requires permission to export:

  1. Human body fluids, organs and other tissue:

(a)including a part or constituent of material of that kind, if the internal volume of the immediate container in which the material is packed exceeds 50mL; and

(b)excluding viable material derived from human embryo clones.

  1. A substance derived from human blood.

As a consequence, permission is not required to export pathology and research samples, provided that the volume of each individual container (not the total shipment) is 50mL or less.

Item 2 refers to products such as blood fractions, immunoglobulins, etc, which are manufactured from human blood.

Please use block letters to aid legibility of your facsimile request.

Name of applicant
Applicant’s address
Telephone / Facsimile
Substance(s) to be exported*
Volume of individual container(s) and total shipment
Reason for request**
Overseas recipient & address***
Flight/courier details
Applicant’s name & signature / Date

Fax to: 02 6232 8399Attention: EXPORT OFFICER

*For plasma/fraction products specify the source of plasma and batch number for the plasma source as well as the item number and batch number for the finished product.

For blood/tissue related materials provide information about the donor (including nationality).

**Please specify whether this product will be used for clinical use, for research purposes etc.

***If the product is obtained from an Australian donor (blood/tissue products) or from the Australian donor plasma pool (plasma/fraction products) and is intended to be used on a non-Australian citizen, a formal indemnity statement from the government in the home country of the patient must be provided.

CONFIDENTIALITY NOTE: The information contained in this facsimile is legally privileged and confidential information intended only forthe use of the individual or entity named above. If the receiver of this transmission is not the intended recipient the receiver is hereby notifiedthat any dissemination, distribution or copy of this facsimile is strictly prohibited. If this facsimile is received in error please notify the senderby telephone and return to the sender at the above address. Thank you.

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