VS 5-12A Additions - Natural/Purchased Continuation Sheet (Draft)

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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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-XXXX. 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.

OMB APPROVED

0579-XXXX

EXP: XX/XXXX

UNITED STATES DEPARTMENT OF AGRICULTURE

ANIMAL AND PLANT HEALTH INSPECTION SERVICE

VETERINARY SERVICES

Additions - Natural/Purchased

Continuation Sheet

Page


_____ of _____

Owner Name



Date

Official ID

(Flock ID or Serial tag)

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

Remarks


































































































































































VS FORM 5-12A

NOV 2018

File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorHarris, Sheniqua M - APHIS
File Modified0000-00-00
File Created2021-01-15

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