Board Notices > Biosecurity Rules for Livestock Agents > Addendum A : Health Declaration for Animals going on Auction

ADDENDUM A

HEALTH DECLARATION FOR ANIMALS GOING ON AUCTION:

ANIMAL OWNER	LIVESTOCK INFO
NAME	BREED
FARM NAME	ID NO.
POST ADDRESS
DISTRICT
TEL
FAX
E-MAIL
STATE VET	PRIVATE VET
NAME	NAME
TOWN	TOWN
PROVINCE	PROVINCE
POSTAL ADDRESS	POSTAL ADDRESS
TEL	TEL
FAX	FAX
E-MAIL	E-MAIL

WE REQUIRE HEALTH INFO TO THE BEST OF YOUR KNOWLEDGE.

To accept animals at the auction pens we need info on the health status of the animals and the farm of origin.

The Vet at the auction facility need correct info and that is why this health attestation is important.

The info can be of your personal work, from the local state vet, private vet, or district animal health technicians.

1.	We need to know if any of the diseases was diagnosed on the farm of origin in the last year. If you do not know please mark "?" otherwise YES or NO.

1.1	Brucellosis (CA)	YES	NO	?
1.2	Tuberculosis (TB)	YES	NO	?
1.3	Paratuberculosis	YES	NO	?
1.4	Infectious Bovine Rhinotracheitis	YES	NO	?
1.5	Leptospirosis	YES	NO	?
1.6	Bluetongue	YES	NO	?
1.7	Trichomonas foetus	YES	NO	?
1.8	Campylobacter foetus	YES	NO	?
1.9	Enzootic bovine Leucosis	YES	NO	?
1.10	Rabies	YES	NO	?
1.11	Lumpy skin disease	YES	NO	?
1.12	Rift Valley fever	YES	NO	?
1.13	Bovine Viral Diarrhea (B.V.D.)	YES	NO	?
1.14	Foot and Mouth disease	YES	NO	?
1.15	Other	YES	NO	?

2.	Was animals vaccinated against the following diseases. If YES, give the date of vaccination.

2.1	Lumpy skin	YES	NO	?	Date: _______________
2.2	Rift valley	YES	NO	?	Date: _______________
2.3	Rabies	YES	NO	?	Date: _______________
2.4	Brucellosis (CA)	YES	NO	?	Date: _______________
2.5	B.V.D.	YES	NO	?	Date: _______________
2.6	Bluetongue	YES	NO	?	Date: _______________
2.7	Foot and Mouth Disease	YES	NO	?	Date: _______________
2.8	I.B.R.	YES	NO	?	Date: _______________
2.9	Other: Black quarter, Bohtax, Anthrax, etc.	YES	NO	?	Date: _______________

3.	Was any samples tested at a lab for:

3.1	Brucellosis (CA)	YES	NO	?	Date: _______________
3.2	Tuberculosis (TB)	YES	NO	?	Date: _______________
3.3	Sheath washes - Trichomonas - Campylobacter	YES YES	NO NO	?	Date: _______________
3.4	B.V.D.	YES	NO	?	Date: _______________
3.5	I.B.R.	YES	NO	?	Date: _______________
3.6	Leukosis	YES	NO	?	Date: _______________
3.7	Other	YES	NO	?	Date: _______________
3.8	If available attach the lab results.

4.	Since when were animals kept on farm of origin _________________________________

5. When last were any new animals introduced on farm of origin______________________

6. Is the farm correctly under quarantine:

If YES, explain

YES

___________________________________________________________________________________

Hereby I, ____________________________________________, as the state vet / herd veterinarian / animal health technician, declare that I examined the above mentioned animals and that the animals were clinically healthy and clinically free from any communicable disease

________________________________________	____________________
STATE VET / PRIVATE VET - SIGNATURE	DATE

Hereby I, ____________________________________________, as the owner / representative of the owner, declare that I examined the above mentioned animals and that the animals were clinically healthy and clinically free from any communicable disease.

________________________________________	____________________
OWNER / REPRESENTATIVE	DATE

For Office use

Hereby I, ____________________________________________, as the auction vet, declare that I examined _____________ animals of the above mentioned owner and that the animals were clinically healthy and clinically free from any communicable disease.

________________________________________	____________________
AUCTION VET / SIGNATURE	DATE

________________________

Date of Auction

Agricultural Produce Agents Act, 1992 (Act No. 12 of 1992)

Board Notices

Biosecurity Rules for Livestock Agents

Addendum A : Health Declaration for Animals going on Auction