Faith Livestock Commission Company, Inc

P O Box 397 – Faith, SD  57626

Phone-605-967-2200      Fax-605/967-2203 flc@faithsd.com

 

 

Owner’s Name: _____________________________ Sale Date: _________________

The following procedures have been done on the following livestock by the owner.

 

 

Brand: ________________Location_____________ Number of Head:_____________

 

Scourguard:                YES     NO      Month given_________________________

 

Vibrio lepto:               YES     NO      Month given:  _______________________

 

Prg-guard:                  YES     NO      Month given:________________________

 

Cows were poured      YES     NO      Type of pour on: _____________________

 

 

_______________________bulls were turned in on ___________________________   

 

for _______ days, cows/heifers to start calving on _____________________________.                      

 

 

Details: ________________________________________________________________

 

_______________________________________________________________________ 

 

As an affidavit is deemed by USDA as an official record of Country of Origin, I attest through first-hand knowledge, normal business records, or producer affidavit(s) that all livestock referenced by this document or other communications specific to the transaction and transferred are of United States origin.  Should the origin of my livestock become other than that described above, I agree to notify Faith Livestock when this occurs.

 

This affidavit/declaration shall remain in effect until revoked in writing by the undersigned and is delivered to Faith Livestock.

 

I certify that the information provided on this form is correct.  I agree to indemnify the above named market against any and all claims, losses, cost and expenses including reasonable attorney’s fees that arise out of or relate to this certification.

 

 

 

____________________________    _________    ____________________________

      Signature                              Date                                 Ranch Name