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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 numbers for this information collection are 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.
OMB APPROVED 0579-0036
Exp.: XX/XXXX
UNITED STATES DEPARTMENT OF AGRICULTURE
ANIMAL AND PLANT HEALTH INSPECTION SERVICE
RECORD OF ACQUISITION OF DOGS AND CATS ON HAND
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 for not more than 1 year, or a
fine of not more than $1,000, or both.
1. RECORD FOR (“X”)
USDA LICENSE OR
REGISTRATION NUMBER
Dealer
Holding Facility (Submit copy to Dealer)
Other
Exhibitor (Dogs and Cats only)
2. NAME AND ADDRESS OF LICENSEE, REGISTRANT, OR HOLDING
FACILITY
IDENTIFICATION OF EACH ANIMAL BEING DELIVERED (See reverse for Breed Abbreviations)
A.
TATTOO OR
USDA TAG NUMBR
B.
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
D.
E.
AGE OR
DATE OF
BIRTH
WT.
F.
G.
BREED OR
TYPE *
(If mixed breed,
list 2 dominant
breeds)
LAST INSPECTION (Date)
APHIS 7005
JUL 2009
INSPECTOR USE
ONLY
TOTAL NUMBER ANIMALS ENTERED
SINCE LAST INSPECTION
TO (Mo., Day, Yr.)
ACQUIRED FROM
H.
DESCRIPTION OF ANIMAL
(Color, Distinctive Marks, Hair, Tail,
Tattoos, etc.)
3. BUSINESS YEAR
FROM (Mo., Day, Yr.)
I.
J.
NAME AND ADDRESS,
USDA LICENSE OR REGISTRATION NUMBER,
OR DRIVER’S LICENSE NUMBER AND STATE,
VEHICLE LICENSE NUMBER AND STATE
DATE
ACQUIRED
COUNT TOTAL NUMBER
ANIMALS ACTUALLY ON
PREMISES
Previous edition may be used. Replaces VS 18-5 which may be used.
DIFFERENCE (+ OR -)
4. PAGE
NUMBER
DISPOSITION
K.
Date
Removed or
Sold
Date
Died or
Euthanized
(Specify)
DATE
INITIALS
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)
-
AH
AD
AK
AB
BS
BH
BE
BL
BF
BT
-
BK
BO
BX
BM
CT
CU
CA
CD
CC
CK
CL
CH
Dachshund
Dalmatian
Doberman
Elkhound
English Bulldog
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
-
DH
DL
DB
EH
EB
ES
ED
FH
FT
FB
GS
SH
-
GR
GO
GD
GP
GH
HK
IS
JR
KH
KC
Komondor
Labrador Retriever
Lhasa Apso
Malamute
Mastiff
Maltese
Miniature Pinscher
Newfoundland
Old English Sheepdog
Pekingese
Pomeranian
Poodle
Pug
Redbond Coonhound
Rhodesian Ridgeback
Rottweiler
Saint Bernard
Samoyed
Schipperkee
Schnauzer
Scottish Terrier
Shar-pei
Shetland Sheepdog
BREED ABBREVIATIONS – CATS (Column F)
Abyssinian
Burmese
Domestic Long Hair
Domestic Short Hair
Himalayan
Maine Coon
APHIS 7005 (REVERSE)
JUL 2009
-
AB
BU
DL
DS
HM
MC
Manx
Persian
Russian Blue
Rex
Siamese
Other (Specify)
-
MX
PR
RB
RE
SI
-
KM
LR
LA
MM
MA
MT
MP
NF
OE
PK
PM
PO
PU
RB
RR
RW
SB
SM
SK
SN
SC
SP
SS
Shih-tzu
Silky Terrier
Spitz
Springer Spaniel
Staffordshire Bull
Terrier
Walker
Weimaraner
Welsh Corgi
Whippet
Yorkshire Terrier
Other (Specify)
-
SI
ST
SZ
SR
SA
-
WK
WI
WC
WH
YT
TYPE (Column F)
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 |