Form FDACS-09158 "Permit for Interstate Movement From Usda Approved Livestock Facility" - Florida

Form FDACS-09158 is a Florida Department of Agriculture and Consumer Services form also known as the "Permit For Interstate Movement From Usda Approved Livestock Facility". The latest edition of the form was released in April 1, 2018 and is available for digital filing.

Download a fillable PDF version of the Form FDACS-09158 down below or find it on Florida Department of Agriculture and Consumer Services Forms website.

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Download Form FDACS-09158 "Permit for Interstate Movement From Usda Approved Livestock Facility" - Florida

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Florida Department of Agriculture and Consumer Services
Contact:
Division of Animal Industry
Cattle Programs Office
Bureau of Animal Disease Control
2232 NE Jacksonville Road
Ocala, Florida 34470
(850) 410-0900 Phone
PERMIT FOR INTERSTATE MOVEMENT FROM USDA
(352) 620-7212 Fax
ADAM H. PUTNAM
APPROVED LIVESTOCK FACILITY
COMMISSIONER
CattleForms@FreshFromFlorida.com
Section 585.145 (2), F.S., Rule 5C-3.004, F.A.C.
FreshFromFlorida.com/AI
and in context of cooperative agreement with USDA, Alabama, Georgia and Mississippi
To be completed by Market for cattle moving to Alabama, Georgia and Mississippi
Note: All documents and attachments submitted with this request are subject to public review pursuant to Chapter 119, F.S.
Market of Origin
Purchaser
Phone
Destination State
Destination Name
Phone
Sale Date
Destination Address
All beef cattle over 18 months and all dairy animals must be listed individually and Official Identification (tag) numbers must be provided on this form or an alternative
document provided by the market. Alternative documents such as Sales Invoice or another official form (VS 4-54, etc.) shall be attached and must correlate the Backtag
information to Official Identification. Include Invoice Number or Serial Number of attached documents in Comments column. Animals moving directly to Approved
Slaughter Facility are exempt from Official Identification requirement. Beef cattle under 18 months are permitted to travel using this form as a group without Official
Identification.
Premises Identification Number (PIN)
Official Individual
Backtag or
Number
Invoice Number
Source Herd
Description
if no PIN, Source Herd Address
Identification
Sale Lot #
of Animals
Name
& Comments
(Breed, age, sex)
Market Representative Name (Printed)
Market Representative Signature
Date
Form must be complete fully and legibly.
Form must be submitted to Cattle Programs Office at address above within 7 days of sale.
One copy to accompany shipment; One Copy to be retained by market; One copy or electronic transmission to Florida State
Distribution:
Veterinarian within 7 days of sale date.
FDACS-09158 Rev. 04/18
Florida Department of Agriculture and Consumer Services
Contact:
Division of Animal Industry
Cattle Programs Office
Bureau of Animal Disease Control
2232 NE Jacksonville Road
Ocala, Florida 34470
(850) 410-0900 Phone
PERMIT FOR INTERSTATE MOVEMENT FROM USDA
(352) 620-7212 Fax
ADAM H. PUTNAM
APPROVED LIVESTOCK FACILITY
COMMISSIONER
CattleForms@FreshFromFlorida.com
Section 585.145 (2), F.S., Rule 5C-3.004, F.A.C.
FreshFromFlorida.com/AI
and in context of cooperative agreement with USDA, Alabama, Georgia and Mississippi
To be completed by Market for cattle moving to Alabama, Georgia and Mississippi
Note: All documents and attachments submitted with this request are subject to public review pursuant to Chapter 119, F.S.
Market of Origin
Purchaser
Phone
Destination State
Destination Name
Phone
Sale Date
Destination Address
All beef cattle over 18 months and all dairy animals must be listed individually and Official Identification (tag) numbers must be provided on this form or an alternative
document provided by the market. Alternative documents such as Sales Invoice or another official form (VS 4-54, etc.) shall be attached and must correlate the Backtag
information to Official Identification. Include Invoice Number or Serial Number of attached documents in Comments column. Animals moving directly to Approved
Slaughter Facility are exempt from Official Identification requirement. Beef cattle under 18 months are permitted to travel using this form as a group without Official
Identification.
Premises Identification Number (PIN)
Official Individual
Backtag or
Number
Invoice Number
Source Herd
Description
if no PIN, Source Herd Address
Identification
Sale Lot #
of Animals
Name
& Comments
(Breed, age, sex)
Market Representative Name (Printed)
Market Representative Signature
Date
Form must be complete fully and legibly.
Form must be submitted to Cattle Programs Office at address above within 7 days of sale.
One copy to accompany shipment; One Copy to be retained by market; One copy or electronic transmission to Florida State
Distribution:
Veterinarian within 7 days of sale date.
FDACS-09158 Rev. 04/18
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