7020A Continuation Sheet for Record of Acquisition, Dispositio

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 numbers for these information collections are 0579-0036 and 0579-0092. The time required to complete this information collection is estimated to average 1.7 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 and 0579-0092

U.S. DEPARTMENTOF AGRICULTURE ANIMAL AND PLANT HEALTH INSPECTION SERVICE Record of Acquisition, disposition or transport of animals (Other Than Dogs and Cats) sale Exchange or Transfer Donation

1. invoice number

2. Page of

3. Date of disposition

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.

4. dealer’s license number

5. seller or Donor (Name)

6. Buyer or receiver (Name)

8. identification of animals being delivered

a. container tag number crate or pen number

b. number animals

C. previous invoice number (if any)

d. individual ident tattoos, tag number (if applicable)

E. species

Age - sex

G. remarks (Condition, etc.)

Receiver’s use

f. number Young

G. Number Adult

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APHIS FORM 7020A

JUN 2009