VS 5-12A Additions - Natural/Purchased Continuation Sheet

Scrapie in Sheep and Goats; Flock Certification, Interstate Movement, and Indemnity Revisions

VS 5-12A (NOV 2018)

Private Sector

OMB: 0579-0469

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The valid OMB control numbers for this information collection are 0579-0101 and 0579-0469. The time required to complete this information collection is estimated to average 1 hour per response, including the
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OWNER NAME

Official ID
(Flock ID or Serial tag)

VS FORM 5-12A
NOV 2018

ADDITIONS - NATURAL/PURCHASED
CONTINUATION SHEET

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

Other ID 1
(Serial tag, farm tag,
registry tattoo, etc.)

Sex
(M, F, N)

Breed or
Face Color (Sheep) or
Type (Goats)

Birth Date or
Estimated Age

Date Acquired/
Purchased

OMB APPROVED
0579-0101, 0579-0469

PAGE

_____ OF _____
DATE

Remarks


File Typeapplication/pdf
File Modified0000-00-00
File Created0000-00-00

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