Pedigree  International LC -  Animal Application
Mail to: Pedigree International  - 3326 South First Road -  Humansville, MO 65674
PLEASE  PRINT
   CURRENT OWNER

NAME _______________________________________________ PI Breeder's # ______      PHONE#___________________________

    ADDRESS_______________________ CITY________________ STATE  ___    ZIP__________

  SIGNATURE OF CURRENT OWNER:_______________________________________________________________________DATE_________
  As applicant, I certify that all information contained in this application and furnished herewith is true and correct

ANIMAL INFORMATION

   HERD BOOK (breed)____________________________ % of Purity_____________ SEX: (circle one) __Doe__ Buck__ Wether

Name of this animal _______________________________________________________________________________

Ear Tag Number (optional)_____________ Ear Tag Color ______________________ DATE of BIRTH (M/D/Y)_________-_________-__________

SIRE PI Registration Number______________________________________ Sire Name_____________________________________________

DAM PI Registration Number _____________________________________ Dam Name ____________________________________________

Dam's Breed if Dam is not registered _________________________________ Tattoo: Right Ear________________ Left Ear ______________

Micro Chip (if used) ___________________________________________________ Litter Size (Circle One) 1 __ 2___3___4______________

Circle One: Horned __ Natural Polled __ Disbudded ________________ Type of Breeding: Natural ___ AI ___ ET Recip #_______________

Seller's Scrapie PREMISE TAG number ( herd ID PLUS individual animal ID number) _________________________________________

COLOR DESCRIPTION (if applicable)_______________________________________________________________________________________

 

 BREEDER INFORMATION (Owner of dam at time of conception)

NAME______________________________________________ PI Breeder's #_____________        PHONE____________

ADDRESS__________________________CITY______________STATE  ____  ZIP___


 CERTIFICATE OF TRANSFER

BUYERS  NAME __________________________________________________ PI Breeder's #______

 ADDRESS____________________________CITY_____________STATE____   ZIP_________ PHONE_____________________________  

 SELLER'S NAME________________________________ PI Breeder's #__________

 ADDRESS__________________________CITY_____________STATE____   ZIP___

DATE OF SALE_________________   SELLER SIGNATURE________________________________________________________________

- This Form   May  Be  Duplicated -
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