Feed Affidavit

LIVESTOCK OWNER'S CERTIFICATE

The undersigned certifies that, to the best of his/her/its knowledge, as of the date of shipment or delivery, none of the livestock shipped to or delivered to Unionville Livestock Market, Unionville, MO, will be, on such date, adulterated within the meaning of the Federal Food, Drug and Cosmetic Act (i.e., none of the cattle or other ruminants will have been fed any feed containing protein derived from mammalian tissues, e.g. meat and bone meal, as that term is defined in 21 CFR 589.2000 and none of the livestock will have any illegal or drug residues). This certificate shall remain in full force and effect until revoked in writing by the undersigned seller and such revocation is delivered to Unionville Livestock Market, Unionville, MO.

PRINT NAME: DATE:
STREET OR PO BOX:
CITY, STATE & ZIP CODE:
PHONE: CELL PHONE:

BY CLICKING HERE, I CERTIFY THAT THE ABOVE INFORMATION IS ACCURATE AND THAT I AGREE TO THE TERMS OF THE FEED AFFIDAVIT RULES AND REGULATIONS.