EmailMe Form - WPLA Consignor/Livestock Owner's Certificate

The undersigned consignor/livestock owner:

(1.) BONE MEAL: Certifies that to the best of his/her knowledge, none of the livestock are adulterated within the meaning of the Federal Food, Drug & Cosmetic Act (e.g. none of them has been fed any feed derived from mammalian tissues as prohibited by 21 C.F.R. 589.2000 nor are they contaminated with foreign materials nor do they have illegal levels of drug residues);
(2.) DRUG RESIDUE: Certifies that neither the undersigned nor the person(s) from whom the consignor purchased the livestock are on the USDA/FSIS actives list of repeat violators as having had more than one residue violation in the past 12 months or if they are on the USDA/FSIS list that the consignor has identified the animals being sold that come from the person whose name appears on the USDA/FSIS list;
(3.) COUNTRY OF ORIGIN: 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 USA origin and should the origin of the livestock become other than that described above, the undersigned will notify the buyer/agent when this occurs;
(4.) Delivers livestock to be sold at public auction in accordance with this markets usual customs and practices.

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

Name

First Last

Date

MM / DD / YYYY

Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Phone

### - ### - ####

Cell Phone

### - ### - ####

Email

BY CLICKING HERE, I CERTIFY THAT THE ABOVE INFORMATION IS ACCURATE AND THAT I AGREE TO THE TERMS OF THE Consignor/Livestock Owner's Certificate RULES AND REGULATIONS.

The undersigned consignor/livestock owner:

(1.) BONE MEAL: Certifies that to the best of his/her knowledge, none of the livestock are adulterated within the meaning of the Federal Food, Drug & Cosmetic Act (e.g. none of them has been fed any feed derived from mammalian tissues as prohibited by 21 C.F.R. 589.2000 nor are they contaminated with foreign materials nor do they have illegal levels of drug residues);
(2.) DRUG RESIDUE: Certifies that neither the undersigned nor the person(s) from whom the consignor purchased the livestock are on the USDA/FSIS actives list of repeat violators as having had more than one residue violation in the past 12 months or if they are on the USDA/FSIS list that the consignor has identified the animals being sold that come from the person whose name appears on the USDA/FSIS list;
(3.) COUNTRY OF ORIGIN: 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 USA origin and should the origin of the livestock become other than that described above, the undersigned will notify the buyer/agent when this occurs;
(4.) Delivers livestock to be sold at public auction in accordance with this markets usual customs and practices.

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

I agree