Fillable Seasonal Pass Application for Multiple Livestock (Arizona)

Fill Online, Printable, Fillable, Blank Seasonal Pass Application for Multiple Livestock (Arizona) Form

Use Fill to complete blank online ARIZONA pdf forms for free. Once completed you can sign your fillable form or send for signing. All forms are printable and downloadable.

Seasonal Pass Application for Multiple Livestock (Arizona)

On average this form takes 31 minutes to complete

The Seasonal Pass Application for Multiple Livestock (Arizona) form is 6 pages long and contains:

  • 0 signatures
  • 40 check-boxes
  • 107 other fields

Country of origin: US
File type: PDF

BROWSE ARIZONA FORMS

Related forms
Fill has a huge library of thousands of forms all set up to be filled in easily and signed.
Fill in your chosen form
Sign the form using our drawing tool
Send to someone else to fill in and sign.
find another form
 
www.agriculture.az.gov
Seasonal Pass Application for Multiple Livestock
Arizona Department of Agriculture
Animal Services Division – Self-Inspection
1688 W. Adams St.
Phoenix, AZ 85007
(602) 542-6407 selfinspection@azda.gov Fax (602) 542-4290
$5.00 FEE per exhibitor for up to 10 animals. If more than 10 animals, add $0.50 for each additional animal.
Name: _____________________________________________________________________________________________________
(Last) (First) (Middle Initial)
Email Address: _____________________________________________________ Phone Number: __________________________
Physical Address: ____________________________________________________________________________________________
_____________________________________________________________________________________________
(City) (State) (Zip Code)
Mailing Address: ____________________________________________________________________________________________
_____________________________________________________________________________________________
(City) (State) (Zip Code)
Name of Group: _____________________________________________________________________________________________
(4-H, FFA, etc.)
Group Leader’s Name: _______________________________________________________________________________________
Owner/Lessee Signature: _______________________________________________________________Date:__________________
MUST SIGN or application will not be processed
Parent/Guardian Signature: _____________________________________________________________Date:_________________
If owner/lessee is under 18 years of age, the parent/guardian MUST SIGN or application will not be processed
(By signing, owner/lessee and/or parent/guardian state that the information provided on this application is true to the best of his/her knowledge.)
Douglas A. Ducey
Governor
Mark W. Killian
Director
www.agriculture.az.gov
Seasonal Pass Application for Multiple Animals
1. Type of Livestock: ☐ Cattle ☐ Sheep ☐ Goat ☐ Swine Premise ID: ___________________________________________
(Please check) REQUIRED for sheep, goats, & swine
Breed: _____________________________________________________________________________________________________
Sex: _______________________________________________________________________________________________________
Color: _____________________________________________________________________________________________________
Permanent I.D. (ear tag, brand, tattoo, microchip, ear notch):__________________________________________________________
REQUIRED for sheep, goats, swine, & most out-of-state cattle
Name of Seller (if purchased in Arizona): _________________________________________________________________________
REQUIRED
Arizona Inspection Certificate Number (if purchased in Arizona): ____________________________________________________
REQUIRED – a Livestock Inspection Form or Self-Inspection Certificate Number
Health Certificate Number: ________________________________ Entry Permit Number: _______________________________
REQUIRED if livestock has been brought in from out-of-state and must be in exhibitor’s name
2. Type of Livestock: ☐ Cattle ☐ Sheep ☐ Goat ☐ Swine Premise ID: ____________________________________________
(Please check) REQUIRED for sheep, goats, & swine
Breed: _____________________________________________________________________________________________________
Sex: _______________________________________________________________________________________________________
Color: _____________________________________________________________________________________________________
Permanent I.D. (ear tag, brand, tattoo, microchip, ear notch):__________________________________________________________
REQUIRED for sheep, goats, swine, & most out-of-state cattle
Name of Seller (if purchased in Arizona): _________________________________________________________________________
REQUIRED
Arizona Inspection Certificate Number (if purchased in Arizona): ____________________________________________________
REQUIRED – a Livestock Inspection Form or Self-Inspection Certificate Number
Health Certificate Number: ________________________________ Entry Permit Number: _______________________________
REQUIRED if livestock has been brought in from out-of-state and must be in exhibitor’s name
www.agriculture.az.gov
Seasonal Pass Application for Multiple Animals
3. Type of Livestock: ☐ Cattle ☐ Sheep ☐ Goat ☐ Swine Premise ID: ___________________________________________
(Please check) REQUIRED for sheep, goats, & swine
Breed: _____________________________________________________________________________________________________
Sex: _______________________________________________________________________________________________________
Color: _____________________________________________________________________________________________________
Permanent I.D. (ear tag, brand, tattoo, microchip, ear notch):__________________________________________________________
REQUIRED for sheep, goats, swine, & most out-of-state cattle
Name of Seller (if purchased in Arizona): _________________________________________________________________________
REQUIRED
Arizona Inspection Certificate Number (if purchased in Arizona): ____________________________________________________
REQUIRED – a Livestock Inspection Form or Self-Inspection Certificate Number
Health Certificate Number: ________________________________ Entry Permit Number: _______________________________
REQUIRED if livestock has been brought in from out-of-state and must be in exhibitor’s name
4. Type of Livestock: ☐ Cattle ☐ Sheep ☐ Goat ☐ Swine Premise ID: ____________________________________________
(Please check) REQUIRED for sheep, goats, & swine
Breed: _____________________________________________________________________________________________________
Sex: _______________________________________________________________________________________________________
Color: _____________________________________________________________________________________________________
Permanent I.D. (ear tag, brand, tattoo, microchip, ear notch):__________________________________________________________
REQUIRED for sheep, goats, swine, & most out-of-state cattle
Name of Seller (if purchased in Arizona): _________________________________________________________________________
REQUIRED
Arizona Inspection Certificate Number (if purchased in Arizona): ____________________________________________________
REQUIRED – a Livestock Inspection Form or Self-Inspection Certificate Number
Health Certificate Number: ________________________________ Entry Permit Number: _______________________________
REQUIRED if livestock has been brought in from out-of-state and must be in exhibitor’s name
www.agriculture.az.gov
Seasonal Pass Application for Multiple Animals
5. Type of Livestock: ☐ Cattle ☐ Sheep ☐ Goat ☐ Swine Premise ID: ___________________________________________
(Please check) REQUIRED for sheep, goats, & swine
Breed: _____________________________________________________________________________________________________
Sex: _______________________________________________________________________________________________________
Color: _____________________________________________________________________________________________________
Permanent I.D. (ear tag, brand, tattoo, microchip, ear notch):__________________________________________________________
REQUIRED for sheep, goats, swine, & most out-of-state cattle
Name of Seller (if purchased in Arizona): _________________________________________________________________________
REQUIRED
Arizona Inspection Certificate Number (if purchased in Arizona): ____________________________________________________
REQUIRED – a Livestock Inspection Form or Self-Inspection Certificate Number
Health Certificate Number: ________________________________ Entry Permit Number: _______________________________
REQUIRED if livestock has been brought in from out-of-state and must be in exhibitor’s name
6. Type of Livestock: ☐ Cattle ☐ Sheep ☐ Goat ☐ Swine Premise ID: ____________________________________________
(Please check) REQUIRED for sheep, goats, & swine
Breed: _____________________________________________________________________________________________________
Sex: _______________________________________________________________________________________________________
Color: _____________________________________________________________________________________________________
Permanent I.D. (ear tag, brand, tattoo, microchip, ear notch):__________________________________________________________
REQUIRED for sheep, goats, swine, & most out-of-state cattle
Name of Seller (if purchased in Arizona): _________________________________________________________________________
REQUIRED
Arizona Inspection Certificate Number (if purchased in Arizona): ____________________________________________________
REQUIRED – a Livestock Inspection Form or Self-Inspection Certificate Number
Health Certificate Number: ________________________________ Entry Permit Number: _______________________________
REQUIRED if livestock has been brought in from out-of-state and must be in exhibitor’s name
www.agriculture.az.gov
Seasonal Pass Application for Multiple Animals
7. Type of Livestock: ☐ Cattle ☐ Sheep ☐ Goat ☐ Swine Premise ID: ___________________________________________
(Please check) REQUIRED for sheep, goats, & swine
Breed: _____________________________________________________________________________________________________
Sex: _______________________________________________________________________________________________________
Color: _____________________________________________________________________________________________________
Permanent I.D. (ear tag, brand, tattoo, microchip, ear notch):__________________________________________________________
REQUIRED for sheep, goats, swine, & most out-of-state cattle
Name of Seller (if purchased in Arizona): _________________________________________________________________________
REQUIRED
Arizona Inspection Certificate Number (if purchased in Arizona): ____________________________________________________
REQUIRED – a Livestock Inspection Form or Self-Inspection Certificate Number
Health Certificate Number: ________________________________ Entry Permit Number: _______________________________
REQUIRED if livestock has been brought in from out-of-state and must be in exhibitor’s name
8. Type of Livestock: ☐ Cattle ☐ Sheep ☐ Goat ☐ Swine Premise ID: ____________________________________________
(Please check) REQUIRED for sheep, goats, & swine
Breed: _____________________________________________________________________________________________________
Sex: _______________________________________________________________________________________________________
Color: _____________________________________________________________________________________________________
Permanent I.D. (ear tag, brand, tattoo, microchip, ear notch):__________________________________________________________
REQUIRED for sheep, goats, swine, & most out-of-state cattle
Name of Seller (if purchased in Arizona): _________________________________________________________________________
REQUIRED
Arizona Inspection Certificate Number (if purchased in Arizona): ____________________________________________________
REQUIRED – a Livestock Inspection Form or Self-Inspection Certificate Number
Health Certificate Number: ________________________________ Entry Permit Number: _______________________________
REQUIRED if livestock has been brought in from out-of-state and must be in exhibitor’s name
www.agriculture.az.gov
Seasonal Pass Application for Multiple Animals
9. Type of Livestock: ☐ Cattle ☐ Sheep ☐ Goat ☐ Swine Premise ID: ___________________________________________
(Please check) REQUIRED for sheep, goats, & swine
Breed: _____________________________________________________________________________________________________
Sex: _______________________________________________________________________________________________________
Color: _____________________________________________________________________________________________________
Permanent I.D. (ear tag, brand, tattoo, microchip, ear notch):__________________________________________________________
REQUIRED for sheep, goats, swine, & most out-of-state cattle
Name of Seller (if purchased in Arizona): _________________________________________________________________________
REQUIRED
Arizona Inspection Certificate Number (if purchased in Arizona): ____________________________________________________
REQUIRED – a Livestock Inspection Form or Self-Inspection Certificate Number
Health Certificate Number: ________________________________ Entry Permit Number: _______________________________
REQUIRED if livestock has been brought in from out-of-state and must be in exhibitor’s name
10. Type of Livestock: ☐ Cattle ☐ Sheep ☐ Goat ☐ Swine Premise ID: ____________________________________________
(Please check) REQUIRED for sheep, goats, & swine
Breed: _____________________________________________________________________________________________________
Sex: _______________________________________________________________________________________________________
Color: _____________________________________________________________________________________________________
Permanent I.D. (ear tag, brand, tattoo, microchip, ear notch):__________________________________________________________
REQUIRED for sheep, goats, swine, & most out-of-state cattle
Name of Seller (if purchased in Arizona): _________________________________________________________________________
REQUIRED
Arizona Inspection Certificate Number (if purchased in Arizona): ____________________________________________________
REQUIRED – a Livestock Inspection Form or Self-Inspection Certificate Number
Health Certificate Number: ________________________________ Entry Permit Number: _______________________________
REQUIRED if livestock has been brought in from out-of-state and must be in exhibitor’s name
Download
Save PDF to desktop
Email
Email completed PDF
Send for Signing
Email for others to sign
Print
Print document
Choose a Field
Click on a field and
select the person that should complete it
Want to add a signature?
You can add a signature field
and assign it to someone else
to sign
Choose a Field
Click on a field and
select the person that should complete it

Seasonal Pass Application for Multiple Livestock (Arizona)

This document is locked as it has been sent for signing.

You have successfully completed this document.

Other parties need to complete fields in the document. You will recieve an email notification when the document has been completed by all parties.

This document has been signed by all parties.

Completed 20 July 2020

Message

View Audit Log
Print With Audit Log
Duplicate Document