Producer Name
*
First Name
Last Name
Producer Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Producer Phone Number
*
Producer Tag Number
*
Unloading Vehicle Truck Tag Number
Age of Cows
*
Sex of Cows
*
Steer
Heifer
Bull
Checkbox
*
Upon submission of this form, you attest that all cows dropped off have met all withdrawal periods for medicines or applications observed prior to drop off dates and that all animals are ambulatory. Check the box to agree.
Yes
No
Name, Address, and Phone Number of Customer #1
*
Please also add if customer got a half, whole, or quarter of a cow. As well as, any identifying marks as to which cow the customer purchased.
Name, Address, and Phone Number of Customer #2
Please also add if customer got a half, whole, or quarter of a cow. As well as, any identifying marks as to which cow the customer purchased.
Name, Address and Phone Number of Customer #3
Please also add if customer got a half, whole, or quarter of a cow. As well as, any identifying marks as to which cow the customer purchased.
Name, Address, and Phone Number of Customer #4
Please also add if customer got a half, whole, or quarter of a cow. As well as, any identifying marks as to which cow the customer purchased.
Name, Address, and Phone Number of Customer #5
Please also add if customer got a half, whole, or quarter of a cow. As well as, any identifying marks as to which cow the customer purchased.
Name, Address, and Phone Number of Customer #6
Please also add if customer got a half, whole, or quarter of a cow. As well as, any identifying marks as to which cow the customer purchased.
Name, Address, and Phone Number of Customer #7
Please also add if customer got a half, whole, or quarter of a cow. As well as, any identifying marks as to which cow the customer purchased.
Name, Address, and Phone Number of Customer #8
Please also add if customer got a half, whole, or quarter of a cow. As well as, any identifying marks as to which cow the customer purchased.
Name, Address, and Phone Number of Customer #9
Please also add if customer got a half, whole, or quarter of a cow. As well as, any identifying marks as to which cow the customer purchased.
Name, Address, and Phone Number of Customer #10
Please also add if customer got a half, whole, or quarter of a cow. As well as, any identifying marks as to which cow the customer purchased.
Name, Address, and Phone Number of Customer #11
Please also add if customer got a half, whole, or quarter of a cow. As well as, any identifying marks as to which cow the customer purchased.
Name, Address, and Phone Number of Customer #12
Please also add if customer got a half, whole, or quarter of a cow. As well as, any identifying marks as to which cow the customer purchased.