"Request for Veterinary Supplies" - Iowa

Request for Veterinary Supplies is a legal document that was released by the Iowa Department of Agriculture and Land Stewardship - a government authority operating within Iowa.

Form Details:

  • Released on July 31, 2017;
  • The latest edition currently provided by the Iowa Department of Agriculture and Land Stewardship;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of the form by clicking the link below or browse more documents and templates provided by the Iowa Department of Agriculture and Land Stewardship.

ADVERTISEMENT
ADVERTISEMENT

Download "Request for Veterinary Supplies" - Iowa

Download PDF

Fill PDF online

Rate (4.7 / 5) 20 votes
REQUEST FOR VETERINARY SUPPLIES
TO: IOWA DEPARTMENT OF AGRICULTURE & LAND STEWARDSHIP
BUREAU OF ANIMAL INDUSTRY
TH
WALLACE BUILDING, 502 E 9
STREET, DES MOINES, IOWA 50319
515-281-5321 (Office)
REMITTANCE PRIOR TO SHIPMENT – PRICES SUBJECT TO CHANGE WITHOUT NOTICE – ALL SALES FINAL
PLEASE MAKE CHECKS PAYABLE TO THE IOWA DEPARTMENT OF AGRICULTURE & LAND STEWARDSHIP (IDALS)
OFFICIAL HEALTH CERTIFICATES (Code 98)
QUANTITY
@ COST
TOTAL
CERTIFICATE OF VETERINARY INSPECTION (out-of-state)
____ (pkg/100) @$13.00
$ _________
CERTIFICATE OF INSPECTION (intrastate – Form M-1/2 page) ____ (pkg/50) @ $ 6.00
$ _________
DOG AND CAT CERTIFICATES (Form DC)
____ (pkg/50) @ $ 6.00
$__________
NATIVE SWINE FARM TO FARM
____ (pkg/25) @ $ 6.00
$ __________
AFFIDAVIT OF SLAUGHTER
____ (pkg/50) @ $ 6.00
$ __________
IDENTIFICATION TAGS ($65 PER 1,000 OR $6.50 PER 100) (Code 50)
CALFHOOD – ORANGE (VACCINATION)
___ (100/1,000) @$6.50/$65 $ __________
*LARGE SILVER (bright tags)
___ (100/1,000) @$6.50/$65 $ __________
*SMALL SILVER
___(100/2,000) @$3.80/$38 $ __________
* IF YOU ARE AN APPROVED TAGGING SITE:
CONTACT DEE CLAUSEN AT 515/281-8236 TO ORDER TAGS
WHITE VINYL IDENTIFICATION TAGS (FLEX) ($37.50 per 50) (Code 50)
1½ X 1¼, 2 PART, FRONT & BACK
__________
$ __________
TAGGING PLIERS (Code 50)
SMALL ($17.50 per pair)
__________
$ __________
LARGE (for calfhood/bangs/silver bright tags):
($27.50 per pair)
__________
$ __________
VINYL (Flex tags) ($27.50 per pair)
__________
$ __________
TOTAL AMOUNT
$ ___________
****************************************************************************************************************************
Veterinarian/Business________________________________________________________________
Street Address (mailing address, no PO boxes):
_________________________________________________________________________________
City, State, and Zip Code______________________________________________________________
Telephone (required): ____________________________________
****************************************************************************************************************************
IDALS OFFICE USE ONLY
DATE SHIPPED: _______________________
CLERK: __________________
Check Amount: $ ________________
Check #: ________________
Inventoried: Yes _____________
By: ____________
Revised: 7/31/2017
REQUEST FOR VETERINARY SUPPLIES
TO: IOWA DEPARTMENT OF AGRICULTURE & LAND STEWARDSHIP
BUREAU OF ANIMAL INDUSTRY
TH
WALLACE BUILDING, 502 E 9
STREET, DES MOINES, IOWA 50319
515-281-5321 (Office)
REMITTANCE PRIOR TO SHIPMENT – PRICES SUBJECT TO CHANGE WITHOUT NOTICE – ALL SALES FINAL
PLEASE MAKE CHECKS PAYABLE TO THE IOWA DEPARTMENT OF AGRICULTURE & LAND STEWARDSHIP (IDALS)
OFFICIAL HEALTH CERTIFICATES (Code 98)
QUANTITY
@ COST
TOTAL
CERTIFICATE OF VETERINARY INSPECTION (out-of-state)
____ (pkg/100) @$13.00
$ _________
CERTIFICATE OF INSPECTION (intrastate – Form M-1/2 page) ____ (pkg/50) @ $ 6.00
$ _________
DOG AND CAT CERTIFICATES (Form DC)
____ (pkg/50) @ $ 6.00
$__________
NATIVE SWINE FARM TO FARM
____ (pkg/25) @ $ 6.00
$ __________
AFFIDAVIT OF SLAUGHTER
____ (pkg/50) @ $ 6.00
$ __________
IDENTIFICATION TAGS ($65 PER 1,000 OR $6.50 PER 100) (Code 50)
CALFHOOD – ORANGE (VACCINATION)
___ (100/1,000) @$6.50/$65 $ __________
*LARGE SILVER (bright tags)
___ (100/1,000) @$6.50/$65 $ __________
*SMALL SILVER
___(100/2,000) @$3.80/$38 $ __________
* IF YOU ARE AN APPROVED TAGGING SITE:
CONTACT DEE CLAUSEN AT 515/281-8236 TO ORDER TAGS
WHITE VINYL IDENTIFICATION TAGS (FLEX) ($37.50 per 50) (Code 50)
1½ X 1¼, 2 PART, FRONT & BACK
__________
$ __________
TAGGING PLIERS (Code 50)
SMALL ($17.50 per pair)
__________
$ __________
LARGE (for calfhood/bangs/silver bright tags):
($27.50 per pair)
__________
$ __________
VINYL (Flex tags) ($27.50 per pair)
__________
$ __________
TOTAL AMOUNT
$ ___________
****************************************************************************************************************************
Veterinarian/Business________________________________________________________________
Street Address (mailing address, no PO boxes):
_________________________________________________________________________________
City, State, and Zip Code______________________________________________________________
Telephone (required): ____________________________________
****************************************************************************************************************************
IDALS OFFICE USE ONLY
DATE SHIPPED: _______________________
CLERK: __________________
Check Amount: $ ________________
Check #: ________________
Inventoried: Yes _____________
By: ____________
Revised: 7/31/2017