According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0579-0234. The time required to complete this information collection activity is estimated to average 2 hours per response. This time includes time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. |
Approved OMB Control Number 0579-0234 |
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U.S. DEPARTMENT OF AGRICULTURE ANIMAL AND PLANT HEALTH INSPECTION SERVICE
ANIMALS IMPORTED FOR IMMEDIATE SLAUGHTER |
1. PORT OF ENTRY |
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Port Veterinarian – Complete items 1 through 12. Distribute copies as indicated below. Veterinarian at Destination – Return Part 3 to Port Veterinarian after completion of items 18 through 22. |
2. ENTRY DATE |
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The animals identified below were imported in accordance with Department regulations for shipment to an establishment under your supervision. These animals must be slaughtered as soon as possible after arrival at destination but not later than two weeks from the “Entry Date” shown below. Slaughter of these animals must be reported by forwarding a copy of this completed form to the port veterinarian shown in item 12 below. |
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3. TO: (Veterinarian at destination, include Zip Code)
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←Mail original to (Use window envelope) |
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4. NUMBER |
5. SPECIES OF ANIMALS |
6. TRUCK (Trailer) LICENSE NUMBER |
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7. RAILROAD CAR NUMBER |
8. SEAL NUMBERS |
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9. NAME AND ADDRESS OF CONSIGNOR (Zip Code)
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10. NAME AND ADDRESS OF CONSIGNEE (Zip Code) |
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11. SIGNATURE OF PORT VETERINARIAN |
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12. PORT VETERINARIAN (Include Zip Code)
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←Return one completed copy to (Use window envelope) |
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REPORT OF SLAUGHTER |
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This is to certify that, except as noted below, all animals identified above were received and held in pens until slaughter was completed, so as to prevent contact with animals not scheduled for immediate slaughter. |
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13. DATE SLAUGHTERED |
14. REMARKS |
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15. NAME AND ADDRESS OF ESTABLISHMENT (Zip Code) |
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16. SIGNATURE OF ESTABLISHMENT OFFICIAL |
17. TITLE |
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ENDORSEMENT AND POST MORTEM REPORT |
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18. TAG NUMBER
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19. DESCRIPTION OF ANIMAL |
20. TUBERCULOSIS LESIONS |
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Insofar as can be determined the above certification with respect to slaughter is true and accurate. Except as noted above, post mortem examination of these animals did not show lesions suggestive of tuberculosis. |
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21. SIGNATURE OF VETERINARIAN AT DESTINATION |
22. DATE SIGNED |
VS FORM 17-33 (FEB 2008) Previous edition may be used.
File Type | application/msword |
File Title | According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it di |
Author | Government User |
Last Modified By | Government User |
File Modified | 2008-02-12 |
File Created | 2008-02-12 |