Completion of the Cultivated Ginseng Shipping Certificate

Name and Address of the Shipper:

Enter your name and address as the registered grower or dealer. These certificates may only be used by the registered grower or dealer to whom they were issued.

This is your registration number and is entered by the NDDA.

Circle one: Dry weight or Green (Fresh) Weight, This refers to the condition of the roots being shipped.

Number of Pounds (Use Number): Enter the number of pounds being shipped, example: 200 lbs.

Number of Pounds (Use Words): Enter the number of pounds being shipped, example: twenty-five pounds.

State of Origin: Enter the state in which the cultivated ginseng in this shipment was grown, use the

Date of Shipment: Enter the date the shipment leaves your possession.

Year of Harvest: Enter the year or years in which the ginseng in your shipment was harvested.

For International Export: Check Yes or No. If yes, contact the North Dakota Department of Agriculture, as you will need Federal Permits and a federal inspection of your ginseng roots. Selling to a person or company that intends to export the ginseng does not mean that your shipment is for international export. Check the ‘No’ box for all domestic shipments.

Company or Individuals name: Enter the name or company name of the purchaser.

Purchasers Registration Number: Enter the purchasers registration number.

Address: Enter the purchasers address.

Signature of Registered Grower, Dealer, Seller or Shipper: The registered grower’s or dealer’s signature must appear in this box.

Completion of the Confidential Dry Root Shipping Record

Name of Shipper: Enter your name as a registered grower or dealer.

Grower Registration Number: Enter your registration number, this number can be found on your Certificate of Registration.

Date of Sale or Shipment: Enter the date the shipment leaves your possession.

For International Export: Check box Yes or No. If Yes, contact the North Dakota Department of Agriculture, as you will need special Federal Permits and a federal inspection of your ginseng roots. Selling to a company whose final destination is intended for international export does not mean that your shipment is for international export. Check the ‘No’ box for all domestic shipments.

Company or Individuals name: Enter the name or company name of the person to whom you are selling the ginseng.

Purchaser’s Registration Number: Obtain the purchaser their registration number and enter in box.

Address: Enter the address of the person or business to which you sold your cultivated ginseng.

Registration Number of Sources of Ginseng: If you are a grower and your shipment is comprised only of cultivated ginseng you produced, enter only your own registration number. This number can be found on your Certificate of Registration. If your shipment includes ginseng received from other growers or dealers, enter the registration numbers that apply. These numbers will appear on the shipping certificates that must accompany any ginseng that your receive from other growers or dealers.

Weight of cultivated Ginseng sold or Shipped: Enter the weight of each source of ginseng. Indicate dry weight or green weight.

Year of Harvest: Enter the year of harvest for each source of ginseng.

Signature of Seller or Shipper: Your signature is required certifying that the shipment consists of ginseng that was legally obtained from the listed sources.

Date: Enter the date which you completed this form.