7006A Continuation Sheet for Record of Disposition of Dogs and

Animal Welfare

APHIS 7006-A

Animal Welfare (Private Sector)

OMB: 0579-0036

Document [doc]
Download: doc | pdf

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 1 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.

OMB APPROVED

0579-0036

Exp. XX/XXXX

U.S. DEPARTMENTOF AGRICULTURE

ANIMAL AND PLANT HEALTH INSPECTION SERVICE


Continuation sheet for

Record of disposition of dogs and cats


sale Exchange or Transfer Donation

1. Sell’s invoice number

2. Page

3. Date of disposition

4. Dealer’s License number or research facility registration number

5. seller or Donor (Name)

6. Buyer or receiver (Name)

7. identification of the animals being delivered

research

facility use


description of breed, type or mongrel

a.


Tattoo or USDA

Tag Number

b.


Dog

c.


Cat

D. Age

X”

E.


Weight

F.


Distinctive Marks

G.


Breed, Type or Mongrel

h.


Mongrel – describe

(Hair, Tail, Ears, Color, etc.)

i.


Number Assigned by Facility

J.

Young

Adult


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










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









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.


APHIS FORM 7006A Previous Versions are Obsolete

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 Modified2009-06-15
File Created2009-06-15

© 2024 OMB.report | Privacy Policy