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

UNITED STATES DEPARTMENT OF AGRICULTURE
ANIMAL AND PLANT HEALTH INSPECTION SERVICE
VETERINARY SERVICES

OMB APPROVED
0579-0047

REPORT OF BACK TAGS APPLIED

WHERE APPLIED – NAME AND ADDRESS

1. RANCH OR FARM
2. PUBLIC STOCKYARDS
3. OTHER LIVESTOCK MARKETS

FOR
OFFICE
USE
ONLY

4. SLAUGHTER ESTABLISHMENTS

Dairy

TAGS APPLIED BY:

1. OWNER

3. BRAND INSPECTOR
4. LIVESTOCK INSPECTOR
DATE
TAGS
APPLIED

SALES
TAG
NO.

BRAND
AND
LOCATION

HERD OWNER’S NAME

ADDRESS

66 26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
66 50
VS 4-52
APR 2009

BLOOD
TEST
RESULTS

2. STOCKYARD EMPLOYEE

Beef

(White Tag)

TAG
NUMBER

CHECK ONE

(Yellow Tag)

PREFIX
NUMBER

REPLACES VS FORM 4-52 (JULY 1974), WHICH MAY BE USED.

COUNTY

N

S

R