Affidavit Of Ownership Form (One Animal/pen Of Three Per Form)

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BACA COUNTY TAG #_________
AFFIDAVIT OF OWNERSHIP
(One animal/pen of three per form)
Exhibitor: ______________________________ Club: _______________________________________
Address: _______________________________ County: _____________________________________
_______________________________
ANIMAL
: Check one: _____ Beef
Circle One:
Steer or Heifer
_____Swine
Barrow or Gilt
_____Sheep
Wether or Ewe
_____Goat
Wether or Doe
_____Chicken
Rooster or Chicken
_____Rabbit
Buck or Doe
Breed/Animal Description_______________________________________________________________
Baca County Ear Tag# _________Tattoo____________ Right Ear Notch________Left Ear Notch__________
Brand__________________
other_____________
Date of Birth____________________________
Purchased or Raised (Circle One)
PURCHASED ANIMALS
:
SELLER: __________________________________ Phone Number: ______________________________
Address: _________________________________ Email Address: _______________________________
_________________________________
Based on the documentation in my possession this animal described above was born in
__________________________ and raised in _______________________________.
Signed:___________________________, Seller
Date:_________________________
RAISED ANIMALS
:
I, ______________________________, raised this animal described above. Based on the
documentation in my possession this animal was born in_______________________ and raised in
____________(Town) ___________ (County) . This animal is marked (brand, ear notch etc.) under
the name of ______________________________.(exhibitors name or parents/guardians name)
Signed:_________________________, Exhibitor
Date:________________________
Parent or guardian_________________________
Date:________________________

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