LS-83 Statement of Certification

REPRODUCE LOCALLY. Include form number and edition date on all reproductions.
FORM APPROVED - OMB NO. 0581-0198
UNITED STATES DEPARTMENT OF AGRICULTURE
AGRICULTURAL MARKETING SERVICE

Producer

Please mark an "X" in appropriate block:

Seedstock Producer
STATEMENT OF CERTIFICATION

Feeder

(Lamb Promotion, Research, and Information Order)

First Handler

The U.S. Department of Agriculture (USDA) prohibits discrimination in all its programs and activities on the basis of race, color, national origin, age, disability, and where applicable, sex, marital status, familial
status, parental status, religion, sexual orientation, genetic information, political beliefs, reprisal, or because all or part of an individual's income is derived from any public assistance program (not all prohibited
bases apply to all programs.) Persons with disabilities who require alternative means for communication of program information (Braille, large print, audiotape, etc.) should contact USDA's TARGET Center at (202)
720-2600 (voice and TDD). To file a complaint of discrimination, write to USDA, Director, Office of Civil Rights,1400 Independence Avenue, S.W.,Washington,D.C.20250-9410, or call (800) 795-3272 (voice) or
(202) 720-6382 (TDD). USDA is an equal opportunity provider and employer.

NAME AND ADDRESS OF ORGANIZATION OR ASSOCIATION

EFFECTIVE DATE

CERTIFICATION NUMBER

Upon due consideration of the organization's or association's application and of other available data, as
applicable, it is hereby determined that the organization or association indicated above is certified under the
Lamb Promotion, Research, and Information Order.
Accordingly, such organization or association is eligible to represent lamb producers, seedstock producers,
feeders, or first handlers, and to participate in the making of nominations of lamb producers, seedstock
producers, feeders, or first handlers to serve as members of the Lamb Promotion, Research, and Information
Board as provided for in the Order.

SIGNATURE OF DEPUTY ADMINISTRATOR, LIVESTOCK AND SEED PROGRAM

LS-83 (09-07) (Destroy previous edition date 07-03).

DATE