APHIS 7006 Record of Disposition of Dogs and Cats

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 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 and 0579-XXXX

UNITED STATES DEPARTMENT OF AGRICULTURE ANIMAL AND PLANT HEALTH INSPECTION SERVICE Record of disposition of dogs and cats sale Exchange or Transfer Donation

1. Date of disposition

2. Page 1 of

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.

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. Identification Number

complete items a through g for each animal

b. Dog

C. Cat

d. Age or date of birth

E. Weight

F. Breed or Type *

G. description of animal (Color, Distinctive Marks, Hair, Tail, Tattoos, etc.)

“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

6. Delivery by (check one and complete applicable items 7 and 8) commercial shipper buyer’s vehicle seller’s vehicle

7. name and address of company or firm (Include ZIP Code)

8. name and address of truck driver (Include ZIP Code)

9. received by

10. signature

11. title

12. date

APHIS 7006 (Previous edition may be used.)

JUL 2009

Breed abbreviations – dogs (Column F)

Afghan Hound - AH English Setter - ES Pomeranian - PM

Airedale Terrier - AD Eskimo Dog - ED Poodle - PO

Akita - AK Foxhound - FH Pug - PU

American Bull Terrier - AB Fox Terrier - FT Redbone Coonhound - RB

Basenji - BS French Bulldog - FB Rhodesian Ridgeback - RR

Basset Hound - BH German Shepherd - GS Rottweiler - RW

Beagle - BE German Short Haired - SH Saint Bernard - SB

Bedlington Terrier - BL Pointer Samoyed - SM

Bichon Frise - BF Golden Retriever - GR Schipperkee - SK

Black and Tan - BT Gordon Setter - GO Schnauzer - SN

Coonhound Great Dane - GD Scottish Terrier - SC

Bluetick - BK Great Pyrenees - GP Shar-pei - SP

Boston Terrier - BO Greyhound - GH Shetland Sheepdog - SS

Boxer - BX Husky - HK Shih-tzu - SI

Bullmastiff - BM Irish Setter - IS Silky Terrier - ST

Cairn Terrier - CT Jack Russell Terrier - JR Spitz - SZ

Catahoula - CU Keeshond - KH Springer Spaniel - SR

Chihuahua - CA King Charles Spaniel - KC Staffordshire Bull - SA

Chinese Crested Dog - CD Komondor - KM Terrier

Chow-Chow - CC Labrador Retriever - LR Walker - WK

Cocker Spaniel - CK Lhasa Apso - LA Weimaraner - WI

Collie - CL Malamute - MM Welsh Corgi - WC

Coonhound (Specify) - CH Mastiff - MA Whippet - WH

Dachshund - DH Maltese - MT Yorkshire Terrier - YT

Dalmatian - DL Miniature Pinscher - MP Other (Specify)

Doberman - DB Newfoundland - NF

Elkhound - EH Old English Sheepdog - OE

English Bulldog - EB Pekingese - PK

BREED ABBREVIATIONS – CATS (Column F) Abyssinian - AB Manx - MX Other (Specify) Burmese - BU Persian - PR Domestic Long Hair - DL Russian Blue - RB Domestic Short Hair - DS Rex - RE Himalayan - HM Siamese - SI Maine Coon - MC

TYPE (Column F) Hound Crossbreed - HX Terrier Crossbreed - TX Shepherd Crossbreed - SX Spaniel Crossbreed - PX

APHIS 7006 (REVERSE)

JUL 2009