HUSS LIVESTOCK MARKET, LLC

KEARNEY, NE

 PRODUCER AFFIDAVIT                                          SALE DATE:_______________________________

 PRODUCER INFORMATION

                Name:__________________________________  Phone #:____________________________

Address:________________________________  Cell #:______________________________

City: _________________State: ______Zip:_______         Premises ID #________________________

Original Ranch of Origin (where born)________________________________________________

Location of Livestock Just Prior to Sale:______________________________________________

 

AGE VERIFICATION

                Date First Calf Born (mm/dd/yy):____________________________________________________

Type of Records Retained for Audit Trail:_____________________________________________
                                                                                                   (ie:  calendar, calving book, computer records)

INDIVIDUAL ID METHOD

                Ranch Brand:_________________________                Location:____________________________

Visual Ear Tags(#, color, etc)_______________________________________________________

EID Tags, Manufacturer’s Name:____________________________________________________

VACCINATIONS GIVEN

                Date                                                        Product

_______________                           __________________________________________________

_______________                           __________________________________________________

_______________                           __________________________________________________

_______________                           __________________________________________________

_______________                           __________________________________________________

_______________                           __________________________________________________

_______________                           __________________________________________________

IMPLANTS GIVEN

_______________                           __________________________________________________

_______________                           __________________________________________________

 

WEANING PERIOD

                Dates Calves Separated from Dams:_________________  _______________  ________________

 PRODUCER ATTESTATION:

                I have raised these calves from birth.  The information provided on this form is true and correct to  the best of my knowledge.  I understand that I may be asked for proof of the accuracy of this information and I will make available any documentation in my possession in the event of a third party audit upon reasonable notice of seven days.

                __________________________________________                ____________________________________

                Signature                                                                              Date

MARKETING REPRESENTATIVE SIGNATURE

                These calves were sold by us on the date noted above.  The producer is in good standing with our  Marketing Agency.

                __________________________________________                ____________________________________