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

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 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
time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.

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