Form FDACS-09206 "Application for Negative Eia Test Verification Card" - Florida

What Is Form FDACS-09206?

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

Form Details:

  • Released on October 1, 2005;
  • The latest edition provided by the Florida Department of Agriculture and Consumer Services;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;

Download a fillable version of Form FDACS-09206 by clicking the link below or browse more documents and templates provided by the Florida Department of Agriculture and Consumer Services.

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Download Form FDACS-09206 "Application for Negative Eia Test Verification Card" - Florida

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Florida Department of Agriculture and Consumer Services
Remit $5.00 for each negative EIA
Division of Animal Industry
card applying for Online at:
www.doacs.state.fl.us/ai/
www.FDACS.gov/ai
Bureau of Animal Disease Control
- or -
Check or Money Order Payable to
APPLICATION FOR
FDACS and remit to:
Equine Programs Office
NEGATIVE EIA TEST VERIFICATION CARD
NICOLE "NIKKI" FRIED
407 South Calhoun St. Room 329
Tallahassee, Florida 32399-0800
COMMISSIONER
585.145, 585.671, F. S.; Section 5C-4.0016, F.A.C.
www.EquinePrograms@FDACS.gov/ai
.
Note: All documents and attachments submitted with this request are subject to public review pursuant to Chapter 119, F.S
OWNER/AGENT
DATE
MAILING ADDRESS
COUNTY
CITY, STATE, ZIP CODE
DAYTIME TELEPHONE NUMBER
SIGNATURE OF APPLICANT
In accordance with the rules of the State of Florida, Section 5C-18, Florida Administrative Code, I hereby request Equine
Movement Card(s) on the following Equine Infectious Anemia Laboratory Test:
NAME OF HORSE
Corresponding EIA LABORATORY ACCESSION NUMBER
DOCUMENTS TO ACCOMPANY FEE:
Org. Code: 42 09 02 01 000
OE: A2
a completed application
Object Code: 001247 Fee: $5.00
original(s) or legible photocopy(ies) of
Equine Infectious Anemia Laboratory Test
(VS Form 10-11) or color copy of electronic
EIA test with digital images.
Digital image of L side, R side and front of
horse(s) on CD
FDACS-09206 Rev. 10/05
Florida Department of Agriculture and Consumer Services
Remit $5.00 for each negative EIA
Division of Animal Industry
card applying for Online at:
www.doacs.state.fl.us/ai/
www.FDACS.gov/ai
Bureau of Animal Disease Control
- or -
Check or Money Order Payable to
APPLICATION FOR
FDACS and remit to:
Equine Programs Office
NEGATIVE EIA TEST VERIFICATION CARD
NICOLE "NIKKI" FRIED
407 South Calhoun St. Room 329
Tallahassee, Florida 32399-0800
COMMISSIONER
585.145, 585.671, F. S.; Section 5C-4.0016, F.A.C.
www.EquinePrograms@FDACS.gov/ai
.
Note: All documents and attachments submitted with this request are subject to public review pursuant to Chapter 119, F.S
OWNER/AGENT
DATE
MAILING ADDRESS
COUNTY
CITY, STATE, ZIP CODE
DAYTIME TELEPHONE NUMBER
SIGNATURE OF APPLICANT
In accordance with the rules of the State of Florida, Section 5C-18, Florida Administrative Code, I hereby request Equine
Movement Card(s) on the following Equine Infectious Anemia Laboratory Test:
NAME OF HORSE
Corresponding EIA LABORATORY ACCESSION NUMBER
DOCUMENTS TO ACCOMPANY FEE:
Org. Code: 42 09 02 01 000
OE: A2
a completed application
Object Code: 001247 Fee: $5.00
original(s) or legible photocopy(ies) of
Equine Infectious Anemia Laboratory Test
(VS Form 10-11) or color copy of electronic
EIA test with digital images.
Digital image of L side, R side and front of
horse(s) on CD
FDACS-09206 Rev. 10/05