Arizona Department of Agriculture (ADA)
Licensing and Registration Section
1688 West Adams, Phoenix, Arizona 85007
Phone: (602) 542-0347
Fax: (602) 542-0466
Brand Release
This is to certify that of
does hereby relinquish all rights, title and interest in the brand, No. for
use on the of cattle and the of horses, effective on
as recorded with the Arizona Department of Agriculture and previously leased from
of
This document must be notarized.
Signature of Lessee(s) Signature of Owner(s)
State of Arizona
County of
This instrument was acknowledged before me, by , this day of
, 20
My commission expires
For ADA/ESD Use Only
Brand #
Check #
Check Date
Check Amount
rev 01/02
Month Day Year
Notary Public, Justice of the Peace, Livestock Officer
Street or PO # Town State Zip
Street or PO # Town State Zip
