7019 Record of Animals on Hand

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.

2. NAME AND ADDRESS OF DEALER

3. BUSINESS YEAR
FROM (Mo., Day, Yr.)

AGE - SEX
CONTAINER
TAG
NUMBER
CRATE OR
PEN
NUMBER

NUMBER
ANIMALS

INDIVIDUAL
IDENTIFICATION
TATTOOS OR
TAG NUMBERS
(if applicable)

SPECIES

A

B

C

D

APHIS Form 7019
AUG 2011

OMB
APPROVED
0579-0036
Exp.:
XX/XXXX

RECORD OF ANIMALS ON HAND
(Other than Dogs and Cats)

UNITED STATES DEPARTMENT OF AGRICULTURE
ANIMAL AND PLANT HEALTH INSPECTION SERVICE
1. USDA LICENSE NUMBER

This record is required by law (7 U.S.C.
2131-2156). Failure to maintain this record
can result in suspension or revocation of
license.

NUMBER
YOUNG

ARRIVAL AT PREMISES

NUMBER
ADULT

E
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

INVOICE
NUMBER

DATE
(Mo., Day, Yr.)

F

G

INSPECTOR’S INITIALS

TO (Mo., Day, Yr.)

4. PAGE
NUMBER

DISPOSITION

FROM
(Name and Address)

DATE SOLD, EXCHANGED, OR
DONATED
DATE DIED

(Give License Number, if Licensee)

INVOICE NUMBER

Mo., Day, Yr.

H

I

J

DATE

(Mo., Day, Yr.)

K