Vs 9-5 Report Of Table-egg Producers, Meat-type Chicken And Tur

According to the Paperwork Reduction Act of 1995, no persons are required to re spond to a collection of information unless it displays a valid OMB control num ber. The valid OMB control number for this information collection is 0579-0007 . The time required to complete this
information collection is estimated to average 1.0 hour per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.

FORM APPROVED
OMB NO. 0579-0007,
0579-0305

This report is required by Memo of Understanding. Failure to report can result in publication of inaccurate and/or incomplete information for the NPIP.
STATE

DATE SUBMITTED:

U.S. DEPARTMENT OF AGRICULTURE
ANIMAL AND PLANT HEALTH INSPECTION SERVICE

REPORT OF HATCHERIES, DEALERS AND INDEPENDENT FLOCKS
PARTICIPATING IN THE NPIP

SUBMITTED BY:

IMPORTANT: Read instructions on reverse.
NAMES AND ADDRESSES OF PARTICIPANTS
(List alphabetically by Subpart, and
give complete mailing address of each, including zip code)

VS FORM 9-5
(AUG 2005)

SUBPART
OR
TYPE OF
POULTRY

EGG CAPACITY
OR
TYPE OF DEALE

PRODUCTS CLASSIFIED
"U.S. PULLORUM-TYPHOID CLEAN"

ADDITIONAL
CLASSIFICATIONS
FOR WHICH THESE
PRODUCTS QUALIFY

INSTRUCTIONS
1. Prepare in duplicate copy. The original copy of the complete report should be submitted to the Poultry Improvement Staff, Building 265, BARC - East,
Beltsville, Maryland, 20705, as changes occur in participation. These reports will be used in preparing supplements to publications APHIS 91-41 and 91-42. The
duplicate copy should be retained in the office of the Official State Agency.
2. List participants alphabetically, by Subparts, with the complete mailing address of each participant, including Zip Code.
3. Subpart or Type of Poultry - Indicate Subpart for which participant's products are qualified, as follows:
B
- Egg Type Chickens
- Meat Type Chickens
C
D
- Turkeys
- Waterfowl, Exhibition Poultry, and Game Birds
E
4. For hatcheries - the egg capacity should include both incubating and hatching capacity. For dealers - use this column to indicate the type of products each
dealer offers for sale with the following codes. Leave column blank for Independent Flocks.
E
- Hatching Egg dealer
- Chick dealer
C
E & C - Dealer in both hatching eggs and chicks
- Poult dealer
P
E & P - Dealer in both hatching eggs and poults
5. List the code for the breed or variety (including strain and trade names) of products handled in the column "Products Classified U.S, Pullorum-Typhoid Clean."
The codes which were published in the tables of stock codes in the latest revision of publications APHIS 91-41 should be used. Stocks not included in the tables
should be assigned a code by the reporting Official State Agency and the code explained on a supplementary sheet.
Crosses should be designated by combining the code letters and numbers of the stocks involved, indicating the variety of the male first. For example,b1c2 would
indicate Arbor Acres Rhode Island Red males mated to Colonial Barred Plymouth Rock females.
6. Additional diseases and breeding classifications for the individual products handled should be indicated in the "Additional classification For Which These
Products Qualify" column. For those products that have an additional disease classification as well as a breeding classification, always list the disease
classification first. The following abbreviations should be used for these additional classifications:
MG
MS
App
None

- U.S. M. Gallispeticum Clean
- U.S. M. Synoviae clean
- U.S. Approved
- No classification other than U.S. Pullorum-Typhoid Clean

The following is an example of a report for one hatchery:

VS FORM 9-5 (Reverse)

NAMES AND ADDRESS OF PARTICIPANTS
(List alphabetically by Subpart and
give complete mailing address of each, including zip code)

SUBPART
OR
TYPE OF
POULTRY

EGG CAPACITY
OR TYPE OF
DEALER

Abbotts Quality Hatchery, 221 State Street, Anytown, State 60606

C

100,000

PRODUCTS
ADDITIONAL
CLASSIFIED :U.S.
CLASSIFICATIONS FOR WHICH
PULLORUM-TYPHOID
THESE PRODUCTS QUALIFY
CLEAN"
t9tl,t17t20

MG, MS