Form 7006 Record of Disposition of Dogs and Cats

Animal Welfare

APHIS 7006

Animal Welfare (Private Sector)

OMB: 0579-0036

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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 0579-0036. The time required to complete this information collection is estimated to average 2 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

0579-0036

Exp. XX/XXXX

U.S. DEPARTMENTOF AGRICULTURE

ANIMAL AND PLANT HEALTH INSPECTION SERVICE


Record of disposition of dogs and cats


sale Exchange or Transfer Donation

1. Date of disposition

2. Page





1 of

This record is required by law (7 USC 2131-2156). (9 CFR, Subchapter A, Parts 1, 2 and 3). Failure to maintain this record can result in a suspension or revocation of license and/or imprisonment for not more than 1 y ear, or a fine of not more than $1,000, or both.

Instruction: Complete applicable items 1 through 8. Original and USDA Copy to the retained by seller.

Buy’s copy to accompany shipment. It must be retained by Buyer.

3. seller or Donor (Name and Address)

4. Buyer or receiver (Name)

3A. Dealer’s License number or research facility registration number

(Seller)

4A. usda License number or research facility registration number

(If any)

5. identification of the animals being delivered (See reverse for Bread Abbreviations for Dogs and Cats) * If mixed breed, list dominant breeds

a.


Identification

Number

complete items a through g for each animal

b.


Dog

C.


Cat

d.


Age or date of birth

E.



Weight

F.



Breed or Type *

G.


description of animal

(Color, Distinctive Marks, Hair, Tail, Tattoos, Etc.)


X”

M OR F


M

F

M

F






M

F

M

F






M

F

M

F






M

F

M

F






M

F

M

F






M

F

M

F






M

F

M

F






M

F

M

F






M

F

M

F






M

F

M

F






M

F

M

F






M

F

M

F






M

F

M

F






M

F

M

F





6. Delivery by (check one and complete applicable items 7 and 8)


commercial shipper buyer’s vehicle seller’s vehicle

7. name and address of company or firm (Include ZIP Code)

8. name and address of truck driver (Include ZIP Code)

9. received by

10. signature

11. title

12. date


APHIS FORM 7006 Previous Versions are Obsolete

JUN 2009


original – seller’s Record usda copy – to be retained by seller buyer’s copy – To accompany shipment and be retained by buyer


Breed abbreviations – dogs (Col. F)


Afghan Hound

AH

English Bulldog

eb

Pekingese

pk

Airedale Terrier

AD

English Setter

ES

Pomeranian

PM

Akita

ak

Eskimo Dog

ed

Poodle

po

American Bull Terrier

ab

Foxhound

fh

Pug

pu

Basenji

bs

Fox Terrier

ft

Redbone Coonhound

rb

Basset Hound

bh

French Bulldog

FB

Rhodesian Ridgeback

rr

Beagle

be

German Shepherd

gs

Rottweiler

rw

Belington Terrier

bl

German Short Haired pointer

sh

Saint Bernard

sb

Bichon Frise

bf

Golden Retriever

gr

Samoyed

sm

Black and Tan Coonhound

BT

Gordon Setter

go

Schipperke

sk

Bluetick

bk

Great Dane

GD

Schnauzer

sn

Boston Terrier

BO

Great Pyrenees

gp

Scottish Terrier

sc

Boxer

bx

Greyhound

gh

Shar-Pei

SP

Bullmastiff

bm

Husky

hk

Shetland Sheepdog

SS

Cairn Terrier

ct

Irish Setter

is

Shih-Tzu

si

Catahoula

cu

Jack Russell Terrier

jr

Silky Terrier

st

Chihuahua

ca

Keeshond

kh

Spitz

sz

Chinese Crested Dog

CD

King Charles Spaniel

kc

Springer Spaniel

sr

Chow-Chow

CC

Komondor

km

Staffordshire Bull Terrier

SA

Cocker Spaniel

ck

Labrador Retriever

lr

Walker

wk

Collie

cl

Lhasa Apso

la

Weimaraner

wk

Coonhound (Specify)

ch

Malamute

ma

Welsh Corgi

wc

Dachshund

dh

Miniature Pinscher

mp

Whippet

wh

Dalmatian

DL

Newfoundland

nf

Yorkshire Terrier

yh

Doberman

db

Old English Sheepdog

oe

Other (Specify)


Elkhound

eh






Breed abbreviations – cats (Col. F)



type – dogs (Col. F)


Abyssinian

ab

Manx

mx

Hound Crossbreed

hx

Burmese

bu

Persian

pr

Terrier Crossbreed

tx

Domestic Long Hair

dl

Rex

re

Shepherd Crossbreed

sx

Domestic Short Hair

ds

Russian Blue

rb

Spaniel Crossbreed

PX

Himalayan

hm

Siamese

si



Maine Coon

mc

Other (Specify)



































APHIS FORM 7006 (Reverse)

JUN 2009

File Typeapplication/msword
File TitleAccording to the paperwork reduction Act of 1995, no persons are required to
AuthorGovernment User
Last Modified ByGovernment User
File Modified2009-06-18
File Created2009-06-15

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