Vs 10-13a Owner/shipper Certificate Fitness To Travel To A Slaught

Commercial Transportation of Equines for Slaughter

VS 10-13A Feb 2018

Business

OMB: 0579-0332

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UNITED STATES DEPARTMENT OF AGRICULTURE
ANIMAL AND PLANT HEALTH INSPECTION SERVICE
VETERINARY SERVICES
TAG
PREFIX

TAG
NO.

OWNER/SHIPPER CERTIFICATE
FITNESS TO TRAVEL TO A SLAUGHTER FACILITY
(CONTINUATION SHEET)(Please type or print in ink)

COLOR DESCRIPTION
Bay

Grey

Black

Pinto

Chestnut

OMB APPROVED
0579-0332
Exp. Date XX/XXXX

Other

TB

QT

BREED/TYPE

SEX

Draft

Stall
ion

Pony

Other

Mare

Geld
-ing

BRANDS
Tattoos,
etc.

REMARKS
Include
precondition

I HEREBY AUTHORIZE THE CFIA TO DISCLOSE THIS DOCUMENT AND THE INFORMATION IN IT AS COMPLETED BY THE CFIA TO THE USDA. FALSIFICATION OF
THIS FORM OR KNOWINGLY USING A FALSIFIED FORM IS A CRIMINAL OFFENSE AND MAY RESULT IN A FINE OF NOT MORE THAN $10,000 OR IMPRISONMENT
FOR NOT MORE THAN 5 YEARS OR BOTH (18 U.S.C. SECTION 1001).
SIGNATURE OF OWNER/SHIPPER (I certify that the information contained in this form is true and correct to the best of my knowledge.)

VS FORM 10-13A
FEB 2018

Page __________of____________


File Typeapplication/pdf
AuthorKhbrown
File Modified2018-02-20
File Created2018-02-20

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