Faith Livestock Commission Company
P O Box 397 – Faith, SD 57626 email@example.com
Owner’s Name: _____________________________ Sale Date: _________________
The following procedures have been done on the following livestock by the owner.
Spring Shots: ______________________________________________
Month Given: ____ ______________________________________________
Fall Shots: _______________________________________________
Month Given: ____ _______________________________________________
Type of pour on: _____________________ Type of Castration: ____________
Spring Implants: _____________________ Fall Implants: ________________
Birth Period: _______________________ through _______________________
Calves are home raised YES NO If NO, Length of ownership ______days
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