Form CF.ACC.47 "Deceased Animal Disposition Form" - Alabama

What Is Form CF.ACC.47?

This is a legal form that was released by the Alabama Department of Agriculture and Industries - a government authority operating within Alabama. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

Released on November 1, 2010;
The latest edition provided by the Alabama Department of Agriculture and Industries;
Easy to use and ready to print;
Quick to customize;
Compatible with most PDF-viewing applications;
Fill out the form in our online filing application.

Download a fillable version of Form CF.ACC.47 by clicking the link below or browse more documents and templates provided by the Alabama Department of Agriculture and Industries.

Download Form CF.ACC.47 "Deceased Animal Disposition Form" - Alabama

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Deceased Animal Disposition Form

Auburn Case # (Lab Use Only)

Mammal

UPS/FedEx

Thompson Bishop Sparks State Diagnostic Laboratory

___

Cattle/ Bovine BO

PO Box 2209

Courier Address:

____Goat/ Caprine CP

Auburn, Alabama 36831‐2209

890 Simms Road

____Horse/ Equine EQ

Phone 334‐844‐4987 / Fax 334‐844‐7206

Auburn, AL 36830

____Sheep/ Ovine OV

Vet License/Account #

Submitter

Date (Lab Use)

____Pig /Porcine PO

____Dog/ Canine CA

____Cat/ Feline FE

____Deer/ Cervid CV

Address

___Mammal, Other MO

Charge N/C Paid:

Avian

____Chicken/ AC

Mail UPS FedEx Bus

City/State Zip

____Turkey AT

Veterinarian Owner Other

___Quail AQ

____Raptor AR

County (animal origin)

Phone

Fax

Assignments

____Psittacine AP

____Avian, Other AO

(Lab Use)

Veterinarian/ Researcher (if applicable) Phone #

Specimen

Disposal

_____Carcass

Address / Organization

_____Tissue

Requests (Lab Use)

Animal Name / ID

 Continued on back

Clinic Case # Owner Name

 Add'l info attached

Breed

Animals submitted for final disposition must be completely

identified. This form must be completed and signed.

Sex

1. One animal per form or attach multiple animal listing form.

2. Remove all collars, medical bandages, personal material from or

Cause of death

with the body, such as blankets or toys.

3. Fully identify the animal, including any clinical case number.

Color/ Markings

I, the undersigned,

 certify that I am the owner (or duly authorized agent for the

owner) of the animal described to the right and that I request

final disposition of the body of the animal

 certify that to the best of my knowledge, the animal has not

bitten any person or animal during the last ten (10) days, and has

not been exposed to rabies; and

 I understand that animal remains WILL NOT be returned

 I request certification of final disposition ($10 additional fee)

Owner/ Authorized Agent Signature

Date

____

Weight

I certify that the animal described above was disposed of by:

alkaline hydrolysis

______ incinerator

______ renderer

______ other

Date of Disposition

Attendant

CF.ACC.47 Deceased Animal Form KLF November 2010 Page 1 of 1

Deceased Animal Disposition Form

Auburn Case # (Lab Use Only)

Mammal

UPS/FedEx

Thompson Bishop Sparks State Diagnostic Laboratory

___

Cattle/ Bovine BO

PO Box 2209

Courier Address:

____Goat/ Caprine CP

Auburn, Alabama 36831‐2209

890 Simms Road

____Horse/ Equine EQ

Phone 334‐844‐4987 / Fax 334‐844‐7206

Auburn, AL 36830

____Sheep/ Ovine OV

Vet License/Account #

Submitter

Date (Lab Use)

____Pig /Porcine PO

____Dog/ Canine CA

____Cat/ Feline FE

____Deer/ Cervid CV

Address

___Mammal, Other MO

Charge N/C Paid:

Avian

____Chicken/ AC

Mail UPS FedEx Bus

City/State Zip

____Turkey AT

Veterinarian Owner Other

___Quail AQ

____Raptor AR

County (animal origin)

Phone

Fax

Assignments

____Psittacine AP

____Avian, Other AO

(Lab Use)

Veterinarian/ Researcher (if applicable) Phone #

Specimen

Disposal

_____Carcass

Address / Organization

_____Tissue

Requests (Lab Use)

Animal Name / ID

 Continued on back

Clinic Case # Owner Name

 Add'l info attached

Breed

Animals submitted for final disposition must be completely

identified. This form must be completed and signed.

Sex

1. One animal per form or attach multiple animal listing form.

2. Remove all collars, medical bandages, personal material from or

Cause of death

with the body, such as blankets or toys.

3. Fully identify the animal, including any clinical case number.

Color/ Markings

I, the undersigned,

 certify that I am the owner (or duly authorized agent for the

owner) of the animal described to the right and that I request

final disposition of the body of the animal

 certify that to the best of my knowledge, the animal has not

bitten any person or animal during the last ten (10) days, and has

not been exposed to rabies; and

 I understand that animal remains WILL NOT be returned

 I request certification of final disposition ($10 additional fee)

Owner/ Authorized Agent Signature

Date

____

Weight

I certify that the animal described above was disposed of by:

alkaline hydrolysis

______ incinerator

______ renderer

______ other

Date of Disposition

Attendant

CF.ACC.47 Deceased Animal Form KLF November 2010 Page 1 of 1

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Form CF.ACC.47 "Deceased Animal Disposition Form" - Alabama

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