VS 4-52 Report of Backtags Applied

According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not 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 0579-0047. The time required to complete this information collection is estimated to average .083 hours 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

OMB Approved 0579-0047 Exp. 00/00/0000

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

REPORT OF BACK TAGS APPLIED

WHERE APPLIED – NAME AND ADDRESS

1. RANCH OR FARM

FOR OFFICE USE ONLY BLOOD TEST RESULTS

2. PUBLIC STOCKYARDS

3. OTHER LIVESTOCK MARKETS

4. SLAUGHTER ESTABLISHMENTS

PREFIX NUMBER

CHECK ONE

TAGS APPLIED BY:

1. OWNER

Dairy

Beef

2. STOCKYARD EMPLOYEE

(Yellow Tag)

(White Tag)

3. BRAND INSPECTOR

4. LIVESTOCK INSPECTOR

TAG NUMBER

DATE TAGS APPLIED

SALES TAG NO.

BRAND AND LOCATION

HERD OWNER’S NAME

ADDRESS

COUNTY

N

S

R

66 26
	27
	28
	29
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	31
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	33
	34
	35
	36
	37
	38
	39
	40
	41
	42
	43
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	46
	47
	48
	49
66 50

VS 4-52 Replaces VS Form 4-52 (July 1974), Which may be used.

APR 2009