Application_Form_for_Ear_Tags.pdf

Application to Produce Eartags for the Official Identification of Sheep and Goats

Company name:______________________________________________________________

Address:____________________________________________________________________

Phone number:_______________________________________________________________

Legally responsible person:_____________________________________________________

Contact Person:_______________________________________________________________

We request approval to produce official eartags for sheep and goats in accordance with 9 CFR part 79.

The following are enclosed:

___ A list of the names, stock numbers, ICAR code, etc., used to identify the types of tags for which approval is requested.

___ Specifications and materials used to make each tag type.

___ The company’s quality control plan and evidence of our ability to produce the tag.

___ All data regarding the retention, legibility, durability, and any other factor that may effect tag quality or utility.

___ At least 25 sample tags, including at least 10 tags of each color requested, that are marked as required by Animal Plant Health Inspection Service (APHIS).

___ Additional sample tags when requested by APHIS for evaluation.

___ Articles of incorporation or other documentation establishing ownership of the company, and the authority of the signatory to enter into an agreement on behalf of the company.

___ Two signed copies of the approved tag company agreement.

___ For RFID tags and other tags utilizing “840” AINS the “AIN Tag Manufacturer Application” form if not previously submitted for the device.

NAME:

TITLE:

SIGNATURE:

DATE: