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pdfAccording 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.
1. DATE OF DISPOSITION
UNITED STATES DEPARTMENT OF AGRICULTURE
ANIMAL AND PLANT HEALTH INSPECTION SERVICE
OMB Approved 0579-0036
Exp.: XX/XXXX
2. PAGE
1 OF
RECORD OF DISPOSITION OF DOGS AND CATS
This record is required by law (7 U.S.C. 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
SALE
EXCHANGE OR TRANSFER
DONATION
for not more than 1 year, or a fine of not more than $1,000, or both.
INSTRUCTIONS: Complete applicable items 1 through 8. Original and USDA Copy to be retained by seller.
Buyer’s Copy to accompany shipment. It must be retained by Buyer.
3. SELLER OR DONOR (Name and Address)
4. BUYER OR RECEIVER (Name and Address)
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 EACH ANIMAL BEING DELIVERED (See reverse for Breed Abbreviations for Dogs and Cats) * If mixed breed, list 2 dominant breeds
A.
B.
IDENTIFICATION
NUMBER
C.
DOG
CAT
“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
COMPLETE ITEMS A THROUGH G FOR EACH ANIMAL
F.
G.
D.
E.
AGE OR
DATE OF
BIRTH
WEIGHT
BREED OR
TYPE *
DESCRIPTION OF ANIMAL
(Color, Distinctive Marks, Hair, Tail, Tattoos, etc.)
6. DELIVERY BY (check one and complete applicable items 7 and 8)
COMMERCIAL SHIPPER
BUYER’S VEHICLE
7. NAME AND ADDRESS OF COMPANY OR FIRM (Include ZIP Code)
9. RECEIVED BY
APHIS 7006
JUL 2009
SELLER’S VEHICLE
8. NAME AND ADDRESS OF TRUCK DRIVER (Include ZIP Code)
10. SIGNATURE
(Previous edition may be used.)
11. TITLE
12. DATE
BREED ABBREVIATIONS – DOGS (Column F)
Afghan Hound
Airedale Terrier
Akita
American Bull Terrier
Basenji
Basset Hound
Beagle
Bedlington Terrier
Bichon Frise
Black and Tan
Coonhound
Bluetick
Boston Terrier
Boxer
Bullmastiff
Cairn Terrier
Catahoula
Chihuahua
Chinese Crested Dog
Chow-Chow
Cocker Spaniel
Collie
Coonhound (Specify)
Dachshund
Dalmatian
Doberman
Elkhound
English Bulldog
-
AH
AD
AK
AB
BS
BH
BE
BL
BF
BT
-
BK
BO
BX
BM
CT
CU
CA
CD
CC
CK
CL
CH
DH
DL
DB
EH
EB
English Setter
Eskimo Dog
Foxhound
Fox Terrier
French Bulldog
German Shepherd
German Short Haired
Pointer
Golden Retriever
Gordon Setter
Great Dane
Great Pyrenees
Greyhound
Husky
Irish Setter
Jack Russell Terrier
Keeshond
King Charles Spaniel
Komondor
Labrador Retriever
Lhasa Apso
Malamute
Mastiff
Maltese
Miniature Pinscher
Newfoundland
Old English Sheepdog
Pekingese
-
ES
ED
FH
FT
FB
GS
SH
-
GR
GO
GD
GP
GH
HK
IS
JR
KH
KC
KM
LR
LA
MM
MA
MT
MP
NF
OE
PK
Pomeranian
Poodle
Pug
Redbone Coonhound
Rhodesian Ridgeback
Rottweiler
Saint Bernard
Samoyed
Schipperkee
Schnauzer
Scottish Terrier
Shar-pei
Shetland Sheepdog
Shih-tzu
Silky Terrier
Spitz
Springer Spaniel
Staffordshire Bull
Terrier
Walker
Weimaraner
Welsh Corgi
Whippet
Yorkshire Terrier
Other (Specify)
BREED ABBREVIATIONS – CATS (Column F)
Abyssinian
Burmese
Domestic Long Hair
Domestic Short Hair
Himalayan
Maine Coon
APHIS 7006 (REVERSE)
JUL 2009
-
AB
BU
DL
DS
HM
MC
Manx
Persian
Russian Blue
Rex
Siamese
-
MX
PR
RB
RE
SI
-
PM
PO
PU
RB
RR
RW
SB
SM
SK
SN
SC
SP
SS
SI
ST
SZ
SR
SA
-
WK
WI
WC
WH
YT
TYPE (Column F)
Other (Specify)
Hound Crossbreed
Terrier Crossbreed
Shepherd Crossbreed
Spaniel Crossbreed
-
HX
TX
SX
PX
File Type | application/pdf |
File Title | According to the paperwork reduction Act of 1995, no persons are required to |
Author | Government User |
File Modified | 2015-03-31 |
File Created | 2014-02-25 |