Responsive Documents Marked As Trade Secret
Responsive Documents Marked As Trade Secret
Responsive Documents Marked As Trade Secret
lnfDrmatton unlen It ~1pl1y1 vatld 0MB control number. The vi/Id 0MB control numbn for thle lntormltlon coll"tion 11105784l3!11nd 0579-0333. USDA r IIUlltlon 1h an bl del lvef'ICI to any I rtennldlata hlncleror car rlar!or
0579,-0()SIJ
The time required to complete thla tnlormatton collectlon t 111Umattd to 1111,rage .25 hour, per re,pon11, Including the ti ma for m,!IWfng lr11tructionl,
tran1portetlon In commerce, unleH 1occmpantld by I heal th car11flcat111ucuttd and
0579-03!3
"arching llX!ftlna c1a1111o~~hllring n mllntalnln; the data nffded, end complljlng and rwvtewlng th! eolllctton of lnfo~n.
!Hued by I licfnlld \1911rln1rtan (7 u.s.c. 21.~3.9; CFR, $~~,..f'~rrn.
WARNING: Anyone who m1k11 1. TYPI! OF AMMAL SHIPPl!D(atltct one only-)~
f 2. Cl!RTIFICAT!NOMBIER OFFICIAL USE ONLY
1 fllM, flct1Uou1, orfrau.ldulent
UNITED STATES DEPARTMENT OF AGRICULTURE
1ta1emant on 1h11 docum11t1t, or
Cog
Cat
Other_ _ _ _ __
ANIMAL ANO PLANT HEALTH INSPECTION SERVICE
P-1001
It
Nonhuman F'rtmate
Ferret
Rodent
UNITED STATES INTERSTATE AND INTERNATIONAL
fraudulent may be subject to 1
CERTIFICATE Of HEALTH !XAMINATION
4, PAGE
nn of not more than $10,000 or 3, TOTAL NUMBER OF ANIMAL
FOR SMALL ANIMALS
lmprlaonment ol net mont than 5
1 of 1
2
ve1r1 er bothjjS lJ.S.C.1001),
B~ NAM!, ADDRES!I, ANO TELEPHONE NUMBER OF RECIPIENT AT DESTINATION (CONS/ONEI!)
I, NAMI!, ADDRESS, AND TELEPHONE NUMBER OF OWNER ICONSKJNORf
Ac:coidfn 11 to rho Pape!WO(k RldUC!ion~Ai:!of 199e, lin 1g111cy may not ccni!uct~i 1poritior, and 1p11rion 11 nofraqUlrtd to rnpond lo, 1 collec11on of
[8]
Buekahlra corporation
202!! N. Rldga Rd,
Perkalla, PA 18944
a.
BREED-COMMON
OR SCIENTIFIC
NAME
AGE
SEX
COLOR OR
DISTINCTIVE
MARKS OR
MICROCHIP
(1lvssM
macaca fatc1culart1
BROWN
1 YEAR
RABIES VACCINATION
OTHER VACCINATIONS,
D 2 YEARS D 3 YEARS
Vaccination Date
Product
12) AM!583G
Cate
05-14-15
05-13-15
(3)
(4)
(5)
(!)
VETERINARY CERTIFICATION: I oertlfy that the 1nlmala deterlbed In box 7 have bNn txtmlnecl by me 1h11 data, that tilt
Information provldad In box 8 11 true and accurate to the bell of my knowledge, and that the fellowing finding hlvt bNn rrade
rX'' applicable llatemanll).
~
[&]
I certJfy thll the animal() d11Crlb1d lbov, ana on continu1Uan 1hltil(1), ff 1ppllcabla, have bHn lnapactld by me on Ihle d1t1 and
app11r to be rr., af any lnfactlau, or conllgloua dlte11111na to the beat af my knowlldge, expaaunt thlrlta, whleh would endanger the
lnlmal or athlr 111Jma1t or would end111g1r public h1atth.
[8]
To my kllOYAldge, lhe 1nlmll(1) d11crlblld 1bova Ind on conUnulllon 1hN1(1) If appllcllbll, onglnalad from 1n ll'H not qull'llntned
VM 13112
Accradbd(8]Yn
No
If YII, plNH comp1etiliilow
NATIONALACCRl!DrrATIONNUMll!R.
I()
._
07539'1
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(NOV 2010)
DATE
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DATE
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Trade Secret
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1:1
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CERTIFICATE NUMBER
PAGE
RABl[S
BREED-COMMON
COLOR OR
AGE
SEX
Rhesus
Brown
DFKH
"
"
"
"
DFKM
"
"
DFKE
OR SCIFNTIFIC
NAME
"
DFLT
"
"
DFNL
"
DISTINCTIVE MARKS
"
"
"
DFLV
"N
...,,
<A
"
OFPI
"
"
DFPK
"
"
DFTJ
"
DFVA
"
DFXX
"
"
--
"
"
D-H-L
LIVE VIRUS
Product
Date
Product
Date
Type/ Fesult
1-3-2015
"
"
"
"
"
"
"
"
"
"
"
"
"
"
"
"
"
"
"
"
"
"
"
"
"
"
"
"
DFPG
- KILLED VIRUS
Date
"
DFKN
DFKP
of
VACCINATION HISTORY
ANIMAL IDENTIFICATION
RML
903 South 4th Street
Halilton, MT 59840
tn
'-:i
'-'
~
....
."
UNITED STATES INTERSTATE AND INTERNATIONAL CERTIFICArE OF HEALTH EXAMINATION FOR SMALL ANIMALS
(Continuation Sheet)
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CERTIFICATE NUMBER
UNITED STATES INTERSTATE AND INTERNATIONAL CERTIFICATE OF HEALTH EXAMINATION FOR SMALL ANIMALS
Cl!
0,
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(Continuation Sheet)
PAGE
ANIMAL IDENTIFICATION
DF73
OR SCIENTIFIC
u,
RABIES
Rhesus
DFAB
"
"
"
DFBG
COLOR OR
D-H-L
AGE
SEX
Date
Type/ Result
Brown
1-3-2015
"
"
"
"
NAME
DFBD
VACCINATION HISTORY
BREED-COMMON
DFA1
DFAG
RML
903 South 4th Street
Halilton, MT 59840
of
Date
"
"
"
"
"
Product
Date
Product
"
"
"
"
"
"
"
"
"
"
"
"
"
"
"
"
"
"
"
"
DFBT
"
"
DFCC
"
"
DFDO
"
DFDC
"
DFEM
DFEV
"
DFEW
"
"
"
"
"
"
"
"
"
"
"
DFHH
"
"
"
"
DFHJ
"
"
"
"
"
DFHN
DFHT
"
"
"
"
"
"
DFJW
"
"
DFJZ
"
"
DFKB
"
"
DFKD
"
):
"
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DFFD
,.f,lll'
"
"
DFCH
"
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-\
TRADE l1RCRET
No dog.cat. n<>mLmanP<ima0,0<a<klitional~n<h0<cta,,e,olaoim"'<les-by
USDA r egljatlon sh all be cf.et 1wred to any r ntermediate harder or car rtfor
rnfonn.atiofl urie,s 11 ~Sj)Wrys a vaid 0MB control number. The vaid 0MB conlro{ numbers for this 1nform81ion collection are 0579-0:>36 and 0579-0333.
The bme ri&<p.lired to comp6&te this info1111-ation collecbon is esUmal&d to 3Va-r&ge .25 hou-s per re$pOOM, lnclud!flg !he ti me for reviewing inslrucbons.
Ocat OOther
15-021
[RI
4. PAGE
1 of3
u.s.c.
RML
~.3 S
7780 NW 53 Street
Miami, FL 33166
4th Street
H!lllloli. MT 59840
4Q6475-9688
239-867-2020
BREED -COMMON
OR SCIENTIFIC
AGE
SEX
COLOR OR
DISTINCTIVE
MARKS OR
NAME
MICROCHIP
o,
RABIES VACCINATION
YEAR 02YEARS
OTHER VACCINATIONS,
TREATMENT, AND/OR TESTS AND RESULTS
3 YEARS
Vaccination Date
Date
Product
~"
J.2)/H<:.
-3
0MB APPROVED
0579--0036
0579-0333
searctmo exi"""" da!a sources. aathefino and maint~....,;...,. the data needed a"ld ...........i....,.,. aod re'wi--:."",., the collecilOf'I of inl'Offilation.
issue<! b a license,d velertnatian
WARNtNG: Anyone who makes
1. TYPE OF ANIMAL SHIPPED (select one onty)
a false, flclruous, or fraucMent
UNITED STATES DEPARTMENT OF AGRICULTURE
0009
statement on thJs document, or
ANIMAL AND PLANT HEALTH INSPECTION SERVICE
us.es such document kno'Moy it
Nonhuman Pnrnate 0Ferret
Rodent
lobe false, fictitiou.s, or
UNITED STATES INTERSTATE ANO INTERNATIONAL
fraudwefll may be .subject to a
CERTIFICATE OF HEALTil EXAMINATION
3. TOTAL NUMBER OF ANIMALS
flfle of not more than S10,000 or
FOR SMALL ANIMALS
imprisonmool of not ITl0(8 than 5
40
ve.m or both (18
1001).
(4) DFOI
(5) DF43
(G} DF57
VETERINARY CERTIFICATION: I certify that the animals described in box 7 have been examined by me lhia date, lhat the
infonnation provided In box 8 is true and accurate to the best of my knowledge, and that dH!I folowmg findings have been made
(xn ap~icable statements).
~ a v e verified the preseoca of the microchip, If a rriaochip is ltsted Kl box 7.
certify 1hal the animci(s) de-scribed above and on oonoouaUoll sheet(s), if appHcabie, have been 'm,pec(ed by me on this dale and
appeer lo be free of any infectious or contagious diseases and to the best of my kn<Wi4edge, expot.ure !hereto, which woofd eodanQttf Ile
anwnal or other rinals Of' woufd endanget pobffc heafth.
~my knowledge, the anfmal(s) descfibed above and on cooliluatioo :sheel(s} rf applk.ab4&, originated from an area noc quarantined
for rabies and has/haw OOI been e ~ to rabtfls.
J Rowell, DVM
Ffolida
Accr<dimll.KIYn
No
H yes, plo ... ~ below
<
APHIS Form 7001
(NOV2010)
mFN
DATE
!DATE
2-10-2015
'
Jo
afa,a)
(Page 1
2)
of
additional information.
NO. 0579-0036
2. PAGE
: 1. INVOICE NO.
IOC150203A
j 1 of 6
RECORD
13. DATE OF D!SPOS!l10N
LJ
D DONATION
XCHANGE OR TRANSfER
SALE
\
I
PO # 4500106353
2131201s
INSTRUCTIONS: Campi
' icable [terns 1 through 13. Original and one copy to accompany animals. When 4. DEALER'S LICENSE NO.
delivery is made Items 14 through 20 must be completed. Original retained by Buyer (Receiver) and copy one
returned to Dealer (Seller or Donor). Copy two to be retained by Dealer (Seller or Donor). Attach Continuation\
SS-R-Ol 44 ANO 58 _8 _0536
Sheet (APHIS FORM 7020A) as needed.
I
14-R0144
i C.
A.
B.
CONTA!NER
TAG NO.,
CRATE
OR PEN
NO.
NO.
AN[MALS
24-B
-
30-B
30-C
24-C
25-A
D.
PREVIOUS
INVOICE
NO.
lNDMDUAL
!DENT.,
TAITOOS, TAG
NOS.
(if any)
AGE-SEX
E.
SPECIES
r.
I
i
I
I
j
100342
-- ------ ----- _Macaca fascicularis -
1
1
101808
Macaca fascicularis
1101936
Macaca fascicularis
110321
Macaca fascicularis
31-8
1104738
Macaca fascicularis
25-8
110708
110886
1-8
31-C
Buyer's Truck
(Condition, etc.)
I
I
F
F
I
I
!
\
i
I
I
!
!I
---
_2_.z:1_
3.07
TB Test: 1/22/2015
3.01
TB Test: 1/19/2015
3.07
TB Test: 1/19/2015
3.08
TB Test: 1/22/2015
Macaca fascicularis
2.75
TB Test: 1/19/2015
Macaca fascicularis
3.07
TB Test: l/22/201S
'
-
- -~--i--
------
I
I
I
II
I
I
II
I
f .
I
IMacaca fascicularis
--
) K
REMARKS
(kgs.)
---l- F -rI
Macaca fascicularis
101350
EST.
WE[GHT
NO.
ADULT
1110268
31-A
--
Macaca fascicularis
1100766
i
!
--
).
:
i
RECEIVER'S USE
I.
IH
G.
NO.
YOUNG
(if applicable}
F.
I
I
Dealer's Truck
(Seller or Donor)
AWB#:
j'
18. BY (Signature)
119. mLE
(Replaces VS FORM 16-20, which is now obsolete, and
APHIS form 7020 (10-80) which may be used.)
120. DATE
TRADE SECRET
(Page 2
of
2)
TRADE SECRET
I
Accord.mg lo.I ha Paperwork Reduction Acl o. 1199.5, an agency may not conduct or sponsor, and a person IS no! requ:r&d. to respond lo . a collecli011. of
mforma!.loft unless it displays a vabd 0MB COfltrol number. The vahd 0MB control numbers for !his infonnatlon collection me 0579-0036 and 0579-0333.
:::1~~:res:!~;;:;~~l~=::.1:~~~:~==~~nm~i;:c~':iit~:~~7:~:~~ra:~:r::1e~ij~~ride;e~=:s~;~1::i~/,~:~:;~;,:~~iew;nginslrucbons, 11:::~:~~~~~;cod;,:,:~r~~r~an~~~si.;~~ft.~t;.~~i;R~;~~~~~;c;'.ap:~e;ledand
OMS APPROVED
.
0579 0036
OS?9--0JJJ
4. PAGE
1 of 3
fr. NAME, ~DRESS, AND TELEPHONE NUMBER OF RECIPIENT AfDESTINATION (CONSIGNEE)
.~
C01
,,
6995 LOr:ig!ey lane
Reno, ,NV 89511
1756?2-2166
(11 1006073
BREED - COMMON
OR SCIENTIFIC
NAME
AGE
Cyno
SEX
COLOR OR
DISTINCTIVE
MARKS OR
MICROCHIP
RABIES VACCINATION
1 YEAR
2 YEARS
Vaccinalion Dale
OTHER VACCINATIONS,
TREATMENT. ANO/OR TESTS ANO RESULTS
3 YEARS
Product
BROWN
Date
8-1-15
B-1-2015
(2 )1011019
(J) 1011039
(4 )1012009
(S)1012015C
5
( )1101005
--~-------------------
VETERINARY CERTIFICATION: I certify Iha! the animals described in bo:,; 7 have been examined by me this date, that U,e
informalion provided in box 8 is true and accurate to the best of my knowledge, and that the following findings have been made
("X" applicable statements).
LJ
LJ
I certify that lhe animal(s) described above and on continuation sheel(s). if applicable, have been inspected by me on this date and
appear to be free of any infectious or contagious diseases and lo the best of my knowledge. exposure thereto. which would endanger lhe
animal or other animals or would endanger public health.
To my knowledge, the ammal(s) descnt>ed above and on continuation sheel(s) if applicable. originated from an area not quarantined
for rabies and has/have not been exoosed to rabies.
Accredited [8]ves
No
If yes, please complete below
iiATIONAL ACCREDITATION NUMBER
;1,,.rr
075369
DATE
~F ISSUING Vir.AR'.'-
, .
\./
DATE
7-29-2015
TRADE SECRET
(Page 1
of
16)
LJ
SALE
EXCHANGE OR TRANSFER
1 of 5
3. DATE OF DISPOSITION
- - 0144
AND SB
CONTAINER
TAG NO.,
CRATE
OR PEN
NO.
NO.
AN!
MALS
PREVIOUS
INVOICE
NO.
(if any)
E.
AGE-SEX
F.
INDIVIDUAL
IDENT.,
SPECIES
TATTOOS, TAG
NOS.
14-R-0144
NO.
YOUNG
(if applicable)
H.
RECEIVER'S USE
I.
G.
K.
J.
NO.
ADULT
38
0904142
Macaca fascicularis
BA
0907196C
Macaca fascicularis
EST.
WEIGHT
REMARKS
(kgs.)
(Condition, etc.)
TB Test: 7/30/2015
'
BB
- 8 - 0536
' C.
PO # 4500116233
8/17/2015
DONATION
B.
2. PAGE
OC1508017
INSTRUCTIONS: Complete applicable Items 1 through 13. Original and one copy to accompany animals. When
delivery is made - Items 14 through 20 must be completed. Original retained by Buyer (Receiver) and copy one
returned to Dealer (Seller or Donor). Copy two to be retained by Dealer (Seller or Donor). Attach Continuation
Sheet (APHIS FORM 7020A) as needed.
A.
1. INVOICE NO.
[ii
0909060
Macaca fascicularis
3.23
TB Test: 7/30/2015
!
9A
0909068
! Macaca fascicularis
3.07
TB Test: 7/30/2015
4B
0912112
Macaca fascicularis
3.49
TB Test: 7/30/2015
6A
1001036
Macaca fascicularis
3.28
TB Test: 7/30/2015
SA
1002124
Macaca fascicularis
SB
1002178
Macaca fascicularis
3.65
TB Test: 8/4/2015
6A
1003136
Macaca fascicularis
3.38
TB Test: 7/30/2015
23A
1004053
Macaca fascicularis
4.72
TB Test: 8/4/2015
---
I"
Buyer's Truck
BILL OF LANDING NO
AWB#:
13. NAME AND ADDRESS OF TRUCK DRIVER
(JAN 90)
74
POOR CONDffiON
TRADE SECRET
(Page 2
of
16)
This record is authorized by law (7 USC 2131-2156). Failure to maintain this record can result in a suspension or
revocation of license and/or imprisonment for not more than 1 year, or a fine of not more than $1,000, or both.
SALE
EXCHANGE OR TRANSFER
2.PAGE
1. INVOICE NO.
00508017
. 2 of 5
!x:j
3. DATE OF DISPOSITION
PO # 4500116233
8/17/2015
4. DEALER'S LICENSE NO.
DONATION
A.
B.
CONTAINER
TAG NO.,
CRATE
OR PEN
NO.
MAlS
D.
C.
NO.
PREVIOUS
INVOICE
NO.
AN!-
E.
AGE-SEX
F.
INDMDUAL
!DENT.,
TATIOOS, TAG
NOS.
(1fany}
SPECIES
(if applicable}
lA
(1005014
H.
G.
EST.
WEIGHT
NO.
ADULT
NO.
YOUNG
(kgs.}
J.
K.
REMARKS
(Condition, etc.}
Macaca fascicularis
1005066
Macaca fascicularis
6B
RECENER'S USE
I.
7A
1006058
Macaca fascicularis
26A
1006073
Macaca fascicularis
78
1006078
Macaca fascicularis
13B
1008016
Macaca fascicularis
lOA
1008080
Macaca fascicularis
lB
1010002
Macaca fascicularis
14A
1010032
Macaca fascicularis
19A
1011004
Macaca fascicularis
22A
1011019
Macaca fascicularis
22B
1011039
Macaca fascicularis
---
36B
1012009
Macaca fascicularis
14B
1012014
Macaca fascicularis
26B
1012015C
Macaca fascicularis
15A
1012070
Macaca fascicularis
34A
1101005
Macaca fascicularis
15B
1101012
Macaca fascicularis
37A
1101033
Macaca fascicularis
'
TRADESECRET
(Page 3
of
16)
1. INVOICE NO.
OC1508017
3. DATE OF DISPOSITION
EXCHANGE OR TRANSFER
PO # 4500116233
DONATION
A.
B.
CONTAINER
TAG NO.,
CRATE
OR PEN
NO.
NO.
AN!MALS
D.
C.
PREVIOUS
INVOICE
NO.
(if any)
!NDMDUAL
IDENT.,
TATTOOS, TAG
NOS.
(1f applicable)
llA
1101034
E.
AGE-SEX
SPECIES
F.
G.
NO.
YOUNG
NO.
ADULT
Macaca fascicularis
-
! I.
H.
EST.
WEIGHT
(kgs.)
REMARKS
(Condition, etc.)
1101036
Macaca fascicularis
168
1101092
Macaca fascicularis
1102009
Macaca fascicularis
1104005
Macaca fascicularis
i
27A
-r
RECEIVER'S USE
J.
16A
23B
PAGE
8/17/2015
I'
3 of 5
[JS]
.. ~ I - - - - - - - - -
2A
1103020
Macaca fascicularis
278
1104003
Macaca fascicularis
28A
1104017C
Macaca fascicularis
30A
1105019
28B
1105023
Macaca fascicularis
17A
1105024
Macaca fascicularis
308
1105027
Macaca fascicularis
34B
1105033
Macaca fascicularis
118
1105036
Macaca fascicularis
12A
1105040
Macaca fascicularis
29A
1106003
Macaca fascicularis
378
1106007
Macaca fascicularis
31A
, 1106011
178
1106022
Macaca fascicularis
TRADESECRET
(Pag(a 4
of
16)
1. INVOICE NO.
4 of 5
3. DATE OF DISPOSITION
EXCHANGE OR TRANSFER
PO # 4500116233
8/17/2015
12. PAGE
OC1508017
~ SALE
DONATION
A.
B.
CONTAINER
TAG NO.,
CRATE
ORPEN
NO.
C.
NO.
AN!-
MALS
0.
PREVIOUS
INVOICE
NO.
INDMDUAL
!DENT.,
TATIOOS, TAG 1
NOS.
(if any)
AGE-SEX
E.
SPECIES
(if applicable)
F.
G.
NO.
YOUNG
NO.
ADULT
H.
I.
EST.
WEIGHT
(kgs.)
RECEIVER'S USE
).
K.
REMARKS
(Condition, etc.)
35A
1107003
Macaca fascicularis
4A
1107004
Macaca fascicularis
358
1107017
Macaca fascicularis
26
1107022
Macaca fascicularis
24A
1109001
Macaca fascicularis
318
1109003
Macaca fascicularis
32A
1109021
Macaca fascicularis
18A
1109036
Macaca fascicularis
198
1109049
Macaca fascicularis
128
1110014
Macaca fascicularis
328
1110029
Macaca fascicularis
298
1110053
Macaca fascicularis
-~
----
------1
1111001
Macaca fascicularis
33A
1111017
Macaca fascicularis
338
1111027
Macaca fascicularis
248
1111231
Macaca fascicularis
1112002
Macaca fascicularis
1112008
Macaca fascicularis
1112009
Macaca fascicularis
36A
188
'
13A
20A
'
TRADE SECRET
(Page 5
of
16)
1. INVOICE NO.
2. PAGE
0(1508017
5 of 5
3. DATE OF DISPOSITION
PO # 4500116233
8/17/2015
----
~ SALE
EXCHANGE OR TRANSFER
DONATION
----------
A.
B.
CONTAINER
TAG NO.,
CRATE
OR PEN
NO.
NO.
AN!MALS
C.
PREVIOUS
INVOICE
NO.
(if any)
D.
INDMDUAL
!DENT.,
TATIOOS, TAG
NOS.
(,f applicable)
AGE-SEX
E.
F.
SPECIES
NO.
YOUNG
l H.
I.
RECEIVER'S USE
G.
J.
EST.
WEIGHT
(kgs.)
NO.
ADULT
K.
REMARKS
(Condition, etc.)
25A
1112071
Macaca fascicularis
208
----~---
1201009
Macaca fascicularis
3A
1201040
Macaca fascicularis
21A
1202033(
Macaca fascicularis
258
1203059
Macaca fascicularis
108
1204018
Macaca fascicularis
218
1204055
Macaca fascicularis
TRADE SECRET
(Page 6
of
16)
:::r~~:/:~~~
1n slruclions,
1. TYPE OF ANIMAL SHIPPED (selact one only)
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239-867-2020
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7. ANIMAL IDENTIFICATION
NAME, AND/OR TATIOO NUMBER
DR OTHER IDENTIFICATION
(1>1006073
BREED - COMMON
OR SCIENTIFIC
NAME
AGE
Cyno
SEX
COLOR OR
DISTINCTIVE
MARKS OR
MICROCHIP
RABIES VACCINATION
1 YEAR
02 YEARS D
Vaccination Dale
Product
BROWN
OTHER VACCINATIONS,
TREATMENT, AND/DR TESTS ANO RESULTS
3 YEARS
Dale
8-1-15
8-1-2015
(2 ) 1011019
(J)
1011039
4
{ >1012009
5
( l101201sc
16 )1101005
VETERINARY CERTIFICATION: I certify that the animals described In box 7 have been examined by mo this date, that the
lnformalion provided In box 8 is lrue and accurate lo the best of my knowledge, and that the following findings have been made
("X" applicable slalements).
L.J
LJ
I certify lhal the animal{s) desclibed a.bove and on continuation sheel{s). if applicable, have been inspeded by me on this dale and
appear to be free of any infectious or contagtous diseases and lo the bes! of my knowledge, exposure thereto, which would endanger the
animal or other animals or would endanger publlc health.
Drabies
for
To my kno'Medge. lhe arnmal{s) described above and on contmuation sheel{s) if applicable. onginated from an area not quarantined
and has/have no\ been ex0<1sed to rabies.
AccredltedlX]Yes
No
DATE
DATE
7-29-2015
L/
TRADE SECRET
:,
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TRADESECRET
CERTIFICATE NUMBER
UNITED STATES INTERSTATE AND INTERNATIONAL CERTIFICATE OF HEALTH EXAMINATION FOR SMALL ANIMALS
(Continuation Sheet)
PAGE 2
ANIMAL IDENTIFICATION
COMPLETE USDA TAG, COLLAR
AND/ OR TATIOO NUMBER
1102009
BREED-COMMON
OR SCIENTIFIC
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1104003
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1105019
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8-1-2015
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8-1-2015
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ANIMAL IDENTIFICATION
RABIES
BREED-COMMON
OR SCIENTIFIC
AGE
SEX
NAME
1203059
COLOR OR
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D-HL
Date
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Date
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TREATMENTS
Date
Type/ Result
8-1-2015
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Accord.ing tot he Papel'WOfk Reduct.ion. Act of i995. an agency may not conduct or sponsor, an~ a person is net required to respond. to, a collectton of
mformallon unless 11 displays a valid 0MB control number. The valid 0MB control numbers for this information coltect1on are 0579-0036 and 0579-0333.
The lime req1Jired to complete this rnfC>mlatioo collection is estimated to average .25 hours per response, including the ti me for reviewing 1nstruct10C1S.
searching existrng data s~_rce:,!~tle:~ ancf: maintaining the data needed, and completing and reviewing the collection of information.
0MB APPROVED
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0579-0333
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lmmokalee. FL 34142
239-867-2020
rRe119JN
89511
. J'.75682-2166
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<1logo4142
BREED - COMMON
OR SCIENTIFIC
NAME
AGE
Cyno
COLOR OR
DISTINCTIVE
MARKS OR
MICROCHIP
SEX
RABIES VACCINATION
1 YEAR
2 YEARS
Vaccination Date
OTHER VACCINATIONS,
TREATMENT, AND/OR TESTS AND RESULTS
3 YEARS
Product
Date
Brown
8-2-2015
Brown
8-2-2015
<2lo907196C
(3) 0909060
4
( )0909068
5
( >0912112
6
( )1001036
Cyno
VETERINARY CERTIFICATION: I certify that the animals described in box 7 have been examined by me this date, that the
information provided in box 8 is true and accurate to the best of my knowledge, and that the following findings have been made
("X" applicable statements).
L.J
D
certify
the
on continuation
applicable,
me
appear to be free of any infectious or contagious diseases and to the best of my knowledge, exposure thereto, which would endanger the
1
thal
sheet(s). if
To my knowledge, the an1mal{s) described above and on continuation sheet(s) if applicable, originated from an area not quarantined
for rabies and has/have not been exposed lo rabies.
13172 Florida
Accredited [XIYes
No
APHIS Form
(NOV 2010)
DATE
sz:WtlS~2G{~7Rl~r1{'!lit~ I !IJ.
7001
This certificate is valid for 30 days after issuance
DATE
i
7-30-2015
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PAGE
ANIMAL IDENTIFICATION
OR SCIENTIFIC
Cyno
1003136
"
1005066
1006058
"
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"
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RABIES
AGE
SEX
NAME
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1005014
"
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Date
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Product
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Date
"
1103020
'
8-2-2015
1010032
COLOR OR
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Date
1010002
1011004
0
....,
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.
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1008080
VACCINATION HISTORY
BREED-COMMON
"
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"
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"
"
"
"
.
.
.
"
"
"
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TB test negative Lot# 443X
"
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Brown
8-2-2015
TRADE SECRET
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0
of 3
C01
6995 Longley Lane
Reno, NV 89511
s
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(Continuation Sheet)
PAGE
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VACCINATION HISTORY
ANIMAL IDENTIFICATION
BREED-COMMON
OR SCIENTIFIC
NAME
AGE
Cyno
1107022
.
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1110014
SEX
"
Type/ Result
8-2-2015
"
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1204018
Cyno
D-H-L
Brown
"
RABIES
L, KILLED VIRUS U LIVE VIRUS
Date
1112008
COLOR OR
DISTINCTIVE MARKS
Date
"
1112002
---
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8-2-2015
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informatkm untess it displays a valld 0MB control number. The valid 0MB control numbers for ttus mformalon coHecbon are 0579-0036 and 0579~0333.
The timG required to complete this information colktction Is estimated to average .25 h _ours per resp~mse. irn:ludin~ the l_i me for reviewing instructions.
searchina existrnq data sources, aathenno and ma1ntamrno the data needed. and comcletina and revl8Wlno the coUecUon of mfonnation.
TRADESECRET
I
USDA r e~ulalton sh all be del tvered lo an~ 1 nlermed1ate handler or car ner for
!ransportat~ in commer~e. ~nless accompanied by a heal th certificate executed and
issued by a hcensed vetennanan l7 U.S.C. 21.43.9 CFR Subchacter A, Part 2).
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BREED - COMMON
OR SCIENTIFIC
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AGE
SEX
COLOR OR
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MARKS OR
MICROCHIP
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BROWN
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1
( >1002178
>1105033
(5>1111027
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1 YEAR D 2 YEARS
Vaccination Date
OTHER VACCINATIONS,
TREATMENT, AND/OR TESTS AND RESULTS
3 YEARS
Product
(2) 1004053
(3) 1101033
RABIES VACCINATION
Date
8-7-15
8-7-2015
"
.
A
VETERINARY CERTIFICATION: I certify that the animals described in box 7 have been examined by me this date, that the
information provided in box 8 is true and accurate to the best of my knowledge. and that the following findings have been made
("X" applicable statements).
c:i
I certify that the animal(s) described above and on continuation sheet(s), if applicable, have been inspected by me on this date and
appear to be free of any infectious or contagious diseases and to the best of my knowledge, exposure thereto, which would endanger the
animal or other animals or would endanger public health.
D
To my knowledge, the animal(s) described above and on continuation sheet(s} if applica~e, originated from an area not quarantined
for rabies and has/have not been exoosed to rabies.
ENDORSEMENT FOR INTERNATIONAL EXPORT (IF NEEDED)
13172 Florida
Accredlted(&]Yes
No
If yes, ~lease complete below
. ---
(NOV2010)
--- .
DATE
s1~;5su~t}G V~TERl~N
/,,y J
DATE
8-4-2015
TRADESECRET
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information unless it displays a vahd 0MB control number. The valid OMS control numbecs for this Information co41ect1on are 0579-0036 and 0579-0333.
The lime required lo complete this 1nfom,at1on col~ct1on ls estimated to average .25 hours per response. including the ll me for rev1ew1ng instructions,
searchinc:i ex1st1ng data sources, oathenna and mamta1111na the data needed, and comolet1na and reviewina the collection of mformation.
TRADESECRET
No dog, cal. nonhuman pmna!e. or add1Uonal kinds or classes of animals des;gna!ed by
USDA r egulahon sh all be del
ivered to
any
0579-0036
0579-0333
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'
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4. PAGE
,.
7. ANIMAL IDENTIFICATION
NAME, AND/OR TATTOO NUMBER
OR OTHER IDENTIFICATION
BREED - COMMON
OR SCIENTIFIC
AGE
SEX
NAME
COLOR OR
DISTINCTIVE
MARKS OR
MICROCHIP
RABIES VACCINATION
0
1 YEAR
2 YEARS
OTHER VACCINATIONS,
TREATMENT, AND/OR TESTS AND RESULTS
3 YEARS
Product
Vaccination Dale
Date
(t) 1202033C
Cyno
Brown
8-10-2015
(2 ) 1204055
Cyno
Brown
8-10-2015
(3)
(4)
(5)
(6)
VETERINARY CERTIFICATION: I certify that the animals described in box 7 have been examined by me this date, that the
information provided in box 8 is true and accurate to the best of my knowledge. and that the following findings have been made
("X" applicable statements).
t:11
have verified the presence of the m;crochip. ;fa microchip is listed in box 7.
I certify that the animal(s) described above and on continuation sheet(s), if applicable, have been inspected by me on this date and
appear lo be free of any infectious or contagious diseases and to the best of my knowledge, exposure thereto, which would endanger the
animal or other animals or would endanger public health.
0
To my knowledge, the an1mal(s}described above and on continuation sheet(s) if applicable, originated from an area not quarantined
13172 Florida
AccredltedOOYes
No
DATE
S'cJiliSSUINGVETERIN~
~Y.(NOV 2010)
0k!
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According tot he Paperwo.-1< Reduction Act of 1995. an agency may not conduct or sponsor. and a person is not required to respond to, a collechon of
information unless it displays a valid 0MB control number. The valid OMS conlrol numbers for this infonnation collection are 0579-0036 and 0579-0333,
The ti".le requi~ed to complete this informallon c~lle~tion is estimated to average .25 hours per response, including the ti me for reviewing instructions,
searching existina data sources, oatherina and ma1n!atrnna the data needed. and comoletina and reviewino the coHection or informat1on.
USDA r egulation sh all be del 1vered to any i ntermediate handler or car rier for
transportation in commerce, unless accompanied by a heal th certificate executed and
issued bv a licensed veterinarian (7 U.S.C. 21.43.9; CFR SubchaDter A, Part 2t
0Dog
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0MB APPROVED
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":.. '6. NAME; ADDRESS, AND TELEPHONE NUMBER OF RECIPIENT AT DESTINATION (CONSIGNEE)
5. NAME, ADDRESS, AND TELEPHONE NUMBER OF OWNER (CONSIGNOR)
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BREED - COMMON
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AGE
SEX
COLOR OR
DISTINCTIVE
MARKS OR
MICROCHIP
Cyno
Brown
(l)1104005
~
(3)
(4)
(5)
(6)
------ ------
--- -----
-----
RABIES VACCINATION
1 YEAR
2 YEARS
OTHER VACCINATIONS,
TREATMENT, ANO/OR TESTS ANO RESULTS
3 YEARS
Vaccination Date
Date
8-7-2015
--r---
----- ------
VETERINARY CERTIFICATION: I certify that the animals described in box 7 have been examined by me this date, that the
information provided in box 8 is 1rue and accurate to the best of my knowledge, and that the following findings have been made
("X" applicable statements).
l:::11
I certify lhat the animal(s) described above and on continuation sheel(s). if applicable, have been inspected by me on this date and
appear to be free of any infectious or contagious diseases and to the best of my knowledge, exposure thereto, which would endanger the
animat or other animals or would endanger public health.
To my knowledge. the animal(s) described above and on continuation sheet(s) if applicable, originated from an area not quarantined
Accredlted(g]Yes
No
If yes, please complete below
NAi"ioNAL ;.-ccReoii'Ai"ioN-NiiMBE_R _
075369
NOTE: lnternatio~f shtnments mav renuire certification bv an accredite
DATE
DATE
S~S.AN~VETERG/IA~~ I
r(NOV2010)
an.
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8-4-2015
TRADE SECRET
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This record 1s authorized by law (7 USC 2131~2156). Failure to maintain this record can result in a suspension or
revucal!on of iitense acd/or :mpnsonmenl for nol more u,an l y2ar 1 or a fine of not more than $1,000, or both.
EXCHANGE OR TRANSFER
2. PAGE
l. INVOICE NO.
OR150611B
1 of 2
3. DATE OF D!SPOSlTION
PO# NOl-FDA
6/11/2015
DONATION
INS fRUCTIONS. Complete applicable Items 1 through 13. Ong1nal and one copy to accompany animals. When: 4.
de!!very is made~ Items 14 through 20 must be completed. On91nal 1etamed by Buyer (Receiver) and copy one;
returned to Deaier (Seller or Donor). Copy two to be retained by Dealer (Seiter or Donor). Attach Cont1nuat1on:
Sheet (APHIS FORM 7020A) as need~:d.
N01 - FDA/CSER
10903 New Hampshire Avenue
Silver Spring, MD 20993 USA
A.
CON
, r
NO.
PREVIOUS
l'lDIVIDUAL
TAlNEf~
ANJ-
INVOICE
TAG NO.,
CRATE
MALS
!DENT.,
TATIOOS, TAG
NOS.
(1(appl1cab/e}
NO.
(1( any}
OR PEN
I.
E.
D.
l '-
SPECIES
RECE!VER'S USE
EST.
WEIGHT
RUAARKS
(~gs.)
(Conditt0n, etc.)
NO
'
17-A
+----------------------.. . . . -------- -- , - - - - - - -
3.65 ' TB Test: 5/26/2015
Macaca rnulatta
04R
16-A
!OSE
Macaca mulatta
176
I 06E
Macaca mulatta
2.46
TB Test: 5/26/2015
18-A
i 06!
Macaca mulatta
3.60
TB Test: 5/26/2015
3. 70
TB Test: 5/26/2015
-------- -------------------
,061(
18-B
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21-1\
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TB Test: 5i26/2015
19-B
.09X
3.90
TB Test: 5/26/2015
16-B
j OBJ
Macaca mulatta
3.62
TB Test: 5/26/2015
21-B
Macaca mulatta
3. 74 : TB Test: 5/26/2015
20-1\
) Macaca mulat.ta
r-J
Buyer's Truck
AWB#
- - - - - -~-
-----
-------
----------
------------------------------
NUMBER DEAD
119. l!TLE
J 8. BY (Signature)
- (RCP!dli~i VS FGRP.116-20,
whk:h 15
ALIVE _____________ .
20. DATE
TRADE SECRET
oI JO { a~ed
f8l6Z - m 1uaumaoa
(o,:
Jo
,: a6ea)
f111s record is authorized by law (7 USC 21312156). Failure to maintain this record can result in a suspen5!on or
revocation of hcense and/or irnpnsonment for not more than l year, or a fme of not rnore than $1,000, or ooth.
NO. 0579-0036
3. DATE OF DISPOSITION
PO II N01-FDA
6/11/2015
SALE
EXCHANGE OR TRANSFER
DONATION
,c
8.
CONTAIN[R
TAG NO.,
CRATE
OR P[N
NO
NO.
D.
IND[VIO!JAL
IDENT
TATTOOS .. TAG i
PREV[CUS
INJOICE
NO.
(1fany)
ANIMALS
! I.
H.
RECElVER'S USE
F.
SPECIES
EST
WEIGHT
NO.
ADULT
NO.
YOUNG
NOS.
l
(if app/1cabfe) 1
REM,\RKS
(Condition, etc.)
(kgs.)
. 01-L
3.35
OGR
Macaca mulatta
3.54
D9FA
Macaca mulatta
---~--~~--
19-A
E.
10-3
'
Test: 5/26/2015
Macaca mu!atta
3. 98 . TB Test: 5/26/2015
; Macaca mulatta
12-8
11-A
14-A
DF38
-- l
------
-;oF:i~i---r~ia~aca-rn~latta
.1.
----l------ ----~-...________.__
j Macaca mulatta
M
i.
.
3 89~est: 5/26/2015
:
; DF3P
15-A
11-B
DFf8
Macaca mJ\atta
DFTZ
Macaca mulat.ta
10-A
DFVS
Macaca rnulatta
13-A
DfVC
Macaca mulatta
3.91 TB Test:
~lilG!Cil ~1ulatta-
15-B
'
-----~~-~---~---~-------1----~---------- --
14-8
- ,r---~-------
l-----[
____4.15---. - --5/26/2015
---- ---- !
M
c------c-------
TB Test:
13-B
f. - r ----
, DFVF
: _______ :oFzE-----~caZa~~i;iatta
5/26/2015
TB Test: 5/26/2015
TRADE SECRET
APHIS FORM 7020A
(JAN 90)
J.O
;,; afrea)
____________ _____
,
Ii
[ZJ
,,,_
OMS APPROVED
, _ ~~~
05 9 00 0
0578-0333
15-042
Roden;
t
~
PAGE
1 of 2
N01-FDA CBER
10903 New Hampsirne Avenue
_Silve1Spring. MD 20993
,., L 240ct!02-7372
--
7. ANIMAL IDENTIFICATION
------
I
i
11104R
I
I
Rilesus
----~
- "
i
(5) 06K
------
I
BREcED - COMMON
OR SCll::NTIFIC
NAME
r==
'51 o7N
'I
Oc,1
- 5. NAME. AD~D_R_E~S-S-,_A_N_D~T~E--L=E=PH-.O~N=E_N_U_M=B_E_R_o=F~o-w=N~E-R-(-cc"'"o-N~S""IG-c'N-O~R)
_______ ___
TRADE SECRE1
I
!'-.o
Ooo
cat. nonh1.1rnan
or arJU:t,onal k1r1us or classes. cf animal& des1~naled by
r egulat1on sh
tie d~l ivererJ tu
any 1 n!PT:ea1ate handler c.r car ner for
trr1n-;pomit1on
1n
comr.1erse
un1ess
accompanied b)' a he~I U1 ce Nr-::~le e.recu\':'d and 1
1
j issued by c !1censt:d vi?lenn2n.::in 17 IJ SC 21 43 9. Cf- R Subcteop1f~r /'... Parl 2)
Accord ng 10 the Paperv.00\ Reduction A~t of ;995 an age:Gf may nci r:<~nd uc.\ Gt sponsor, and a p_crson 1s no! reqv1rc0 lo re.:-~~ond :a a c.0n;,.:i1on~(?f
,nformal1on unl1?ss 1! d1~cra,1s a valtd UMb control nurrber I h!.' va!. d 0MB con!ro! numbers for 011::, imormailon collect1on nm 0.5r9-0D3c and O!::r 9-03.,'.,J
Tt1c t rne re~fLnred iO complete t 11:s I nforn:at1on coll~ct10n Is ('5\1m~!.=:d Io average .::'.5 hour:; per respOn$e I nclud1ng tt1e 11 rne for i~v 1ew1:.g 1n siruct1cfis.
sea-rh11a exist "'Q data sources Jotl-,:r ro .:.md m21nta1:11r.o 't"e data nee,jed 2.11J c:, 11ole! nq and ev,e.vtr1a the co\lect10'1 o 1ntormahon
--~-- -
UNITEDS1~1LSDEPARTMFtHOFAGRICULTURE
ANIMAL ANO PLANT H:.A.LTH tNSPECT!ON SERVICE
SEX
AGE
1
----
I
I
I
:
I
t--
I -r
-~~~~~.!~~~on Uate
2 YEARS
I I
,_.,__
________ __J_
II
Date
Product Ty~~ndl_o_r_R_e_su_l_ts_ _ _ __
5-29-15
T..
---
3 YEARS
OTHER VACCIN~~-NS,
I
I
---
Product
BROWN
'
1 YEAR
~-
l'(A81ES VACCINATION
i
1
COLOR OR
D1STINC1IVE
M.t,RKS OR
MICROCHIP
------1----
---+--
------
------- - - - ' - - - - - ' - - - - - - - - - - - - - - - - - - VETERINARY CERTIFICATION I cert1ly 1ha11he animals descnbed !11 box 7 hove been examined by me this date that the
information provided in box 8 ;s true and accurnte tc t11e best of my knowledge. and that the following fmdings have been made
( X" applicable statetnents).
D
D
I certify U1at the amrna!\S) ctescnbed above and on continuation sheet(SJ. 1f applicable. have been inspected by me on thts date and
appear to be frP.e of any 1nfecl!ous or contagious diseases and to the best of my knowledge, exposure thereto which would endanger the
an11nal or oiher arnmal!:, or \-.,ouli.i endanger pulJ!11.: f1eal\h.
D
fo,
sheetts) if applicable.
rl
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I Accredited[Z]Yes
No
If yes, please complete below
lI
------\
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ongmated
I DATE
-I
J
1 his certificate is valid for 30 days\e_ft&r issuance
ve!e1maria1
075369
1
DATE
15-26-2015
I
r'rY'
:""-'
lKl-Wt ~tL1u:l
TRADE SECRET
CERTIF!CAlT NUMBER
UNITED STATES JNTERSTi\TE ,i:i.rm INTERNATIONAL CERTIFICATE OF HEALTH EXAMINATlm~ FOR SMALL ANIMALS
1 ')
(Contmuat1on St1~eL)
PAGE
of
N01-FDA.CBER
10903 New Hampshire Aven~e
I Silver Spring MD 20993
AGE
VACCINATION HISTORY
SEX
NAM[
R,~BIES
Tl
CDIOR OR
_ DiSTlNll!Vf.:. IV1Af;KS
KlLLE D VIRUS
R~esus
Product
D-H-L
UVL V!RUS
Date
Type/ Result
Brown
5-29-015
Brown
Date
09X
~+--
~ C' Lf
Date
Product
OBJ
OBK
OEX
OFL.
OGR
D9FA
DF2Z
DF38
DF3N
DF3P
DF4C
DFT8
DFTZ
DFV5
DFVC
DFVF
DFZW
Rh0.sus
<,...
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!JJ
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5
:,
'-'
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/1
///
~I /
1 J. .
(Page 5
of
10)
. l. !~NOICE r,10.
OR150iil 1A
l-~~
I of 2
. 3 C::A TE OF D JS?OSJT,m,1
PO !: .'10 l !i,F
G/ t 1/2015
DONATION
EXCHANGE OR TRANSFER
7. PAGE
4. DEALER'S UCU/SE NO
~101- lRf'/NIAID
8200 Research Plaza
Fredrorick, MD 21702 USA
~10
TAiNER
T!...G NO,,
AN!-
PREVIOUS
:1'lVOICC
Mil.LS
NO
CRA!E
E.
l'IDl\JlDIJ,'.L
EST
_ IDE~].__ ~,
: ,A,TTO(..J'.),
~ws.
(J iiny,
CR PEN
NO
WE;c;1--ff
SPEC1ES
"tJ
HE~AR:<S
(:..~1r.drtion, et,..-.)
(\";:s.)
(iiapplicable) :
4-;l.
OSM
1 Macaca
rnulatta
3.99
TB Test:
s12r,;201s
5-A
;A6V091
Maoca rnulatta
7.83
TB ,est: 6/ l/2015
2-A
'DF79
Macaca rn,1latta
5.00
TB Test: 6/1/2015
2B
: DFBGA
Macaca rnulatta
4 96
TB Test: 6/1/2015
3-;.\
DFCX
Macaca rnulatta
l.92
TB Te;t: 6/1/2015
u.
; DFEZ
, Macaca rnuialta
4.95
TBTcst:6/1/2015
l B
DFHK
Macaca r1ulatta
3-B
DFLD
; Macaca mulattJ
5.33
Macaca mulatta
Macaca mulatta
7.05
;076
S-6
PH 1015
TB Test: 6/1/2015
TB Test: 6/1/2015
- Dealer's Truck
(Seller or Doner)
';\'NB#:
11 l iJ Havecforcl Road
12
-----
"
-----
o'Fs;11ete~-i1nd
20. DATE
.. TRADE SECIIBT
(Page 6
of
10)
nor
Se.!:"~ rev<:~rse
'or
add1t1ona I ,nf,,,,.,,.,,,,nn
c;:ir- 0:;uH.1n
ni11rr~ than
L PAGE
1. [NVO[CE NO.
OR 150611A
2 of 2
, 3. DATE OF DISPOSITION
PO /.' NOJ-(f'.F
6/11/2015
4. DEALCR'S ucrnsE NO
SALE
:y_
EXCHANGE OR TRANSFER
DONATION
~101
8 DUJTIFIC.AT!ON OF AMMJ\l.S f3FIIIG DELlVERED
;\(X SU
'I.
fi'l[Jf',JIDU/:'.i_
Ic>EiH.,
n:rroos. -r "c
SP~c:IES
').
NGS.
OH f'l:::N
clO
6-A
..-'\OULT
(1f app/1catl;;.})
PH 1C65
Mac:ica mulatt,3
PH 1071
Mac2ca rnulatta
r-
TRADE SECRET
w/71'--i'
mav be used
-;;;
"3C:
"'s.
'al
Tlt\DESECRET
AccorJ1:1g !O th~ Pi::!perNGti.. ReducliDn ~\cl of ~S~15. ar:
:nay 11ot condLc! Cir spo-'1sor and a p E>i'son is !1!>! r eq~J11ed to respon::l lC a collec!1on vf
1nrorrr:a11on unless II r11sp!ays a va!in 0MB cor.trG! numbf:.'r
vaiir.i OMS Cl.!Pl1ol numt)ers ror !his :nrorma11on collect1on are 05/S,.Q036 ;,md 0.579~0::n:;.
The t1 me requiri?.d to complete this 1nforr:1at1on coflec!io111 s est1 mated to 3'J erGge .25 hours per response. 1ndud1ng the t1 me f.Jr rev!ewu1g 1nstrt..ctions
::-"'rl'(ht'l J e:,,,,,;tinq J 111 '-OU( cs cJa'l~.::ri I l 311d ~ } h e rl;;t;1 nee )P. 1J 1 J -u !'..J!L'II ~ a 1 J e1;1ow1,q l'1,2 r0Jk,,t1Qn I r r fv 11 J!10P
-----"
5. NAME, ADDRESS, AND TELEPHONE NUMBER OF OWNER (CONSIGNOR)
I'
D
rvl , ..
D
D
!~
I 3. TOTAL NUMBER OF.ANIMALSg
Ferret
OMS APPROVED
0579-0036
oi~,1\1-0:~:n
--------
Nonhuman Pr,rnate
Redel t
! 4. PAGE
I 1 of 2
_ L _ _ _ ___
...
Frederick.MD 21702
239-867-2020
301631-7279
1
7. ANIMAL IDENTIFICATION
,-
'
'
'
l 1J
OSM
\Me' '
CYNO
,!
--
--r- . ------
------
oFBGA.
(SJ DFCX
161 DFEZ
__ ---
1
......- - - - , - -
__
t:
MARKS OR
MICROCHIP
II
11 _____
3! DF79
{41
BREED-COMMON
OR SCIFN ... ll'lf"
"N
12 1 A6V091
<
'
----
II
RABIES VACCINATION
1 YEAR
2 YEARS
------:.i-----------------+,---~------------------Vaccmat:on Date
Product
l___g~te -- l~-Product Type andior. Results
BRO\IVN
i s-2s~2c15
----
~I
M
--- -
I - ----
--
-r-l --t---------
-----..,,f-----I
t-~---I 5-4-7015
--- . -
L: !-r,-,-L ---
OTHER VACCINATIONS
TREATMENT AND/Of{ l'ESTS M,D RESUL ,S
3 YE,\RS
r-----i-------
i
j
~~--
_ _ , ___
i VETERINARY CERTIFICATl()rJ l certify tr,at the animals desuibecl ,n box 7 have been exa11111,ed
information provided in box 8 1s true and accurate to :he b~st of rr;y knowledge and that the foliaw1ng findings !:ave been made
(x" applicable sta~ements).
rr!
fl,;CfOClllD
1S !iSt.:O!(l 1n l)OX J.
.. --
t certify that !he anm1al(s) described above ar:d on cont1nuai1cH1 sheetfs) 1f applicable. have bei:n inspected l1y rne on !his date and
api:1ar to be free of any 1nfecL:ous or con!ag1011s d1se3se-;;; and to lhe bes.! ,Jf n1y knowlt:tlqe exposure thereto. wtJ1cl1 1101.1/ij endanger Jl"',e
animal 01 otller arnr11als 01 would endanger put)hi: he.Ji!il
To mv kncwk'!dge. the .arnma!(s) desc:1!.'t:d above al'd on co11rn1uat1on s11.::e\(Si rf app!1ca!1le n:-1g:nnted from an area not quarantined
- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - t - - f o _ r _ r a _ l J _ , o__s_a_n_d_i_,a_s_ll,..1a_v_e_n_o!..!::.~.~.!_1_~_x_p.~~.~~d to r-clbres
-~_P.ORSEMENT FOR INTERNATIONAL EXPORT (IF NEEDED)
NAME, ADDRESS, ,\ND TELEPHONE NUMBER OF ISSUING VETERINARIAN
PRINTED NAME OF USDA VETERINARIAN
t,P1berWiiliams OVM
_ - - - - - -
Fionda
Accredited IB]Yes
No
DATE
I ~~~~\{;a;;~~:~fi~ifftl~~;;~.".::
1
101
;;,;;
.f
I'
1'
U/;P~d_
/,PHIS Form 7001
(NOV 2010)
-- \._,,'
'
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I/,.,
//
.~
'
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8200 Research Plaza
"'_,
~
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15-041
12
1:al 11011J1un1an
(H adtH!Kllial "1r:ds or classes of arnm:;i!~ J-=S11,JnateJ l;y
r eg,iiat,on sh
t:e Llid iv1:::r~a lQ
arv i :;tenneJ1ate r,;;maler or car r:e, for
trans.po11ation, r. cornillC.iCO :..JnhJss occo:nparnerj l,y a heal H-t CrHf1ca,e "".>:ecu1ed ~11d
1:, -;ued b, cl i :-.-,i s~ir11.,' -1 11 J :.:ir: ~ JS ,:;
:.: :;. 0 er i"~ SuL;diap\w A ~\1't :2 1
DATE
G-1-2015
Tlt\DESECRET
Pl
_,
t-t,
.....
l:j
0
TRADE SECRET
(Continuation Sheet)
RAB IFS
8RE!:D-COMMON
OR SCIENTIFIC
AGE
SEX
N,1~ME
00
0
-,
COLOR OR
KILLW VIRUS
Rhesus
DFLD
"
"
PH1065
"
PH1071
Rhesus
lRE/\TMF.NTS
Dote
Type/ Result
Brown
Product
5-29-015
"
"
"
"
"
"
Br0wn
6--t-2015
Product
Date
"
M
"
076
D-H-L
LIVE VIRUS
Date
DFHK
PH1015
of 2
VACCINATION HISTORY
ANIMAL IDENTIFICATION
"
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8200 Research Plaza
Frederick, MD 21702
co
00
/) - (J{/
PAGE
s."
._,
'
'ti
p,
<Q
(D
111
\0
CERTIFICATE NUMBER
UNITED STATES INTERSTATE AND INTERNATIONAL CERTIFICATE OF HEALTH EXAMINATION FOR SMALL ANIMALS
"3
C
'
'_.,.,._
:
>--'
(Page 3
of
4)
This record is author1Zed by law (7 USC 2131-2156). Failure to maintain this record can result in a suspension or
revocation of license and/or impnsonment for not more than 1 year, or a fine of not more than $1,000, or both.
1S(]
EXCHANGE OR TRANSFER
1. INVOICE NO.
2. PAGE
OC151109A
1 of 1
D SALE
3. DATE OF DlSPOSITION
PO # 4500116760
11/9/2015
DONATION
INSTRUCTIONS: Complete applicable Items 1 through 13. Original and one copy to accompany animals. When 4. DEALER'S LICENSE NO.
delivery Is made - Items 14 through 20 must be completed. Oritnal retained by Buyer (Receiver) and copy one
returned to Dealer (Seller or Donor). Copy two to be retained y Dealer (Seller or Donor). Attach Continuation
58-R-0144 AND 58-B-0536
Sheet (APHIS FORM 7020A) as needed.
6. BUYER OR RECEIVER (Name and Address, indude Zip Code}
14-R-0144
A.
CONTAINER
TAG NO.,
CRATE
ORPEN
NO.
c.
NO.
AN!-
MALS
PREVIOUS
INVOICE
NO.
(If any)
AGE-SEX
E.
D.
JNDMDUAL
!DENT.,
TATTOOS, TAG
NOS.
SPECIES
(if applicable)
H.
F.
G.
NO.
YOUNG
NO.
ADULT
I.
RECEIVER'S USE
).
EST.
WEIGHT
K.
REMARKS
(Condition, etc.)
(kgs.)
2-A
120010
Macaca fascicularis
2.97
TB Test: 11/3/2015
2-B
1302520
Macaca fascicularis
3.15
TB Test: 11/3/2015
1-A
C120738
Macaca fascicularis
3.60
TB Test: 11/3/2015
Buyer's Truck
Dealer's Truck
(Seller or Donor)
AWB#:
13. NAME AND ADDRESS OF TRUCK DRIVER
POOR CONDITION
119. IDLE
120. DATE
--
TRADE SECRET
------------------------
(Page 4
of
4)
TRAD
Acoottlng t o t h e P ~ Reduciioo Ad.of 1995, enegencymaynotcoodudor sponsor.and permoi notrequit&dto rffl)OO(I to, a colMCtJonor
No dog, cal, nonhuman p.-trnale.oradditionalkilldsor clas.se:s ofanimalsdtsignal9d by
lnformatiM unleas 11 dlsplays a valld 0MB oon1rol number. The valid 0MB control numbe.-8 for thia Information collect!On a,e 0579-0038 and 057!k'.l333.
USDAr egulatlon sh ah be de! IY9fed to atr/ I nhmnedl11& handler or car riel fol'
Thatime requndto compl,tl.athlslnformationeoli.ctlon i1 fftimaledtoavarage .25houraper ret~a. lodudingtM ti~ fof'NW~ in&buctlol1s..
tranaportatkif'llncom~. unle-se 9CCOmpan!fldby 1healthcertific.ateexKUtedand
s..arch.n &:on data SOU(UJS,
and malnlllln
the data noMd and
and revlewi the colection oflnforrnaUOf'l.
iswl!ld
:a licen.sed wteriruwian 7 U.S.C. 21.43.9 CFR, Subcti
A, Part 2
WARNING: Anyone who makes
1. TYPE OF ANIMAL SHIPPED (Hlact one only)
2. CERTIFICATE NUMBER - OFFICIAL USE ONLY
~~~~~=."!,
UNITED STATES INTERSTATE AND INTERNATIONAL
CERTIFICATE OF HEALTH EXAMINATION
FOR SMALL ANIMALS
~s:=.~t~g
11
0Dog
Oca1 00ther______
[&J Nonhuman Primate D Ferret D Rodent
15-080
4. PAGE
imprisonment of not
MS or both 18 U.S.C
!mmokalee, FL 3-4142
239-867w2020
USDA license/Of" R
B. PERTINENT VACCINATION TREATMENT, At,,ID TESTING HISTORY
BREED - COMMON
OR SCIENTIFIC
NAME
(1
AGE
SEX
COLOR OR
DISTINCTIVE
MARKS OR
MICROCHIP
RABIES VACCINATION
1 YEAR
02 YEARS D
OTHER VACCINATIONS.
3 YEARS
Dato
Brown
11-6-2015
Brown
11-6--2015
Vaccination Date
Product
(21120010
()) 1302520
(-4)C120738
Cyno
(5)
VETERINARY CERTIFICATION: I certify !hat the animals described in box 7 have been examined by me this date, that the
irrfonnation provided In box 8 Is 1rue end accurate to the bes! of my know!edge, and that the folkJ.Nlng findings have been made
~ To my knowledge, the animal(s) described above and on continuation theet(s) if appltc&ble, originated from an llrea oot quarantined
:::;:::s:~:o
-~~"'OOR'=~:~NAM"'Mc:EN"':"'~"'0"'~7'~,.S~TE"CA'c~=="e"'~"'fN',eN:,:-=1:-P~O~RT~IF_N~ll=DE=D~----------1
to rabies.
~~~:2E
lrrmokalee, FL 34142
239-867-2020
Accredtted[&]Vea
No
075369
veterinarian.
SIGNATURE OF USDA VETERINARIAN
DATE
DATE
11-6-2015
TRAOF .~PrDPrr
According lot he Paperwork Reduction Act of 1995. an aqency rnay nol co"d net or sponsor. and a person rs
1101
information unless 1\ displays a valid 0MB control nurnber The vahd 0MB control numbers for this mforma11on collec\lon are 0579,0036 and 0~7~}-0333.
The time reQu1red lo cmnp\ete this 1nformat1on col lect1on 15 esll mated to average 25 hours per response. including the 11 me for rev 1ew1ng 1n strl1ct1ons.
search1na ex1st1na data sources, aathenna and nm1nta111mn the data needed. and cornp!et111Q and rev1ew1n9_!~e collection of 111forrn;;it1on.
TRADE SECRET
I
USDA r egulal1on sh all be de-1 1vered to any I nlermed1ate handler or car ner for
1ransportation 1n commerce. unless accompanied by a heal tll cert1flcate executed and
issued by a licensed veteru~an~m l7 USC 21 43 9. CFR. Subchaoter A. Part 2\.
Ocat
0Ferret
0579-0036
0579-0333
Oother
0MB APPROVED
15-055
Rodent
4. PAGE
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1 of 3
7. ANIMAL IDENTIFICATION
NAME, AND/OR TATTOO NUMBER
OR OTHER IDENTIFICATION
t 11 1006073
BREED - COMMON
OR SCIENTIFIC
NAME
AGE
SEX
1 YEAR
2 YEARS
Vaccination Date
--
Cyno
OTHER VACCINATIONS,
TREATMFNT. AND/OR TESTS AND RESULTS
3 YEARS
------
Product
BROWN
--"
Date
8-1-15
"
"
--
t 3) 1011039
"
l 4l1012009
151 101201sc
RABIES VACCINATION
----
(2) 1011019
16
COi OR OR
DISTINCTIVE
MARKS OR
MICROCHIP
---
---
---
"
---
"
---
"
.--
)1101005
8-1-2015
-----
VETERINARY CERTIFICATION: I certify that the animals described in box 7 have been examined by me this date. that lhe
information provided in box 8 is true and accurate to the best of my knowledge. and that the following findings have been made
("X" applicable statements).
I l1ave verified the presence of the microchip. ,fa microchip is listed in box 7.
I certify that the anirnal(s) described above and on conltnuation sheet(s). if apphcablc. have been inspected by rne on this dale and
appear to be free of any 1nfectt0us or contagK)us diseases and to lhe best of my knowledge, e.x.posure thereto. which would endanger the
animal or other animals or would endanger public hea!tn.
To my knowledge. the arnmal(s) described above and on continuation sheeHs) 1f arplicable, originated frorn an area not quarantined
for rabies and has/have nol been exoosed to rl!?ies.
Accredited [8]Yes
~~
-----
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TRADE SECRET
TRADE SECRET
CERTIFICATE NUMBER
UNITED STATES INTERSTATE AND INTERNATIONAL CERTIFICATE OF HEALTH EXAMINATION FOR SMALL ANIMALS
(Continuation Sheet)
NAME, ADDRESS AND TEL[PIIONE NUMBER OF OWNER/CONSIGNOR
PAGE
1102009
--- -
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AGE
SEX
NAME
Cyno
COLOR OR
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D-H-L
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DISTINCTIVE MARKS
Date
Product
Date
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..
Type/ Result
Date
8-1-2015
Brown
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8-1-2015
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PAGE
VACCINATION HISTORY
RABIES
BREED-COMMON
OR SCIENTIFIC
of
C01
6995 Longley Lane
Reno, NV 89511
ANIMAL IDENTIFICATION
AGE
SEX
COLOR OR
DISTINCTIVE MARKS
NAME
KILLED VIRUS
Date
1203059
Cyno
D-H-L
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Date
Product
TREATMENTS
Date
Type/ Result
8-1-2015
Product
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TRADE SECRET
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I Nu <Jog, cal, rmrrhurnan prnnate. or add,lronal k,n,1s ' classes of arr11rrals des,grraled by
Acco,d11,g to l he Papecwork Re,1uct,orr Act of 1995. an agency may nol corrd uct or sponsor. and aper son ,s uol requ,red to ,espon<J lo. a colleUrorr of
mlorma\1on unless ii displays a vahd 0MB control number The valid OM B conlrol numbers !or this 1nformat1on collect1on are 05790036 and 0579-0333.
0MB APPROVED
The time required to con,plele this 1nforrnat1on cot lectio11 is est1 mated to average 25 h olirs per r espo11se, 1nclud111g tile t, me for reviewing 1n slrucl1011s.
searching existing data sources, Qathennq and niainta111u1q the data needed and comolet111q and rev1ew1no the collection of 111fonnat1on.
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15-056
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4. PAGE
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36
----
--------
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--
---
7.----ANIMAL
IDENTIFICATION
----
\1)0904142
BREED - COMMON
OR SCIENTIFIC
NAME
AGE
SEX
COLOR OR
DISTINCTIVE
MARKS OR
MICROCHIP
Cyno
Brown
121 0907196C
-----
RABIES VACCINATION
1 YEAR
2 YEARS
OTIIER VACCINATIONS.
TREATMENT, AND/OR TESTS AND RFSUL TS
3!~ARS
Product
Vaccination Date
Date
8-2-2015
--- --------
---
--
t 3) 0909060
t4 lo909068
151
161
-.
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0912112
"
--1001036
Cyno
8-2-2015
Brown
-- ----
TB test ncgatlve Lot# 443X
VETERINARY CERTIFICATION: I certify that the arnmals described in box 7 have been examined by me this date. that the
information provided in box 8 is true and accurate to the best of my knowledge, and that the following fmdings have been made
("X" applicable statements).
CJ
I have verified ,,.,e presence of the mcrochi, ,fa microct1i ,s listed ,r1 box 7.
I certify that the animal(s) described above a11d on continuation sheel{s). 1f appllcable, have been inspected by me on this date and
appe~r to be rreP. of ~ny 1nte-ct1nus or contag1011s diseases and to the best of my know1edge, exposure thereto. which would endanger the
animal or other arnmals or would endanger public heallh.
To my knowledge, tt1e anima!{s) described above and on con11nuation sheet(s} 1f applicable, originated from an area not ciuarantmed
for rabies and has/have__~Q!__E.~~n exposed to rabies.
--
Accredited OOYes
No
If yes, please complete below
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7-30-2015
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TRADE SECRET
TRADE SECRET
CERTIFICATE NUMBER
UNITED STATES INTERSTATE AND INTERNATIONAL CERTIFICATE OF HEALTH EXAMINATION FOR SMALL ANIMALS
Ir- 6Sw
(Cont1nuat1on Sheet)
NAME, ADDRESS AND TELEPHONE NUMBER OF OWNER/CONSIGNOR
PAGE
C01
6995 Longley Lane
Reno, NV 89511
ANIMAL IDENTIFICATION
:::l
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VACCINATION HISTORY
BREED-COMMON
OR SCIENTIFIC
AGE
SEX
Ni'.ME
COLOR OR
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RABIES
KILLED VIRUS
Date
1002124
Cyno
1003136
"
"
1005014
"
1005066
"
Product
0-H-l
i LIVE VIRUS
Date
TREATMENTS
Product
Date
Type/ Result
Brown
8-2-2015
"
"
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1006058
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1101012
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Cyno
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8-2-2015
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1s--or0
(Continuation Sheet)
NAME, ADDRESS AND TELEPHONE NUMBER OF OWNER/CONSIGNOR
PAGE
VACCINATION HISTORY
BREED-COMMON
OR SCIENTIFIC
AGE
SEX
NAME
COLOR OR
DISTINCTIVE MARKS
RABIES
Cyno
0-H-L
1107022
Product
TREATMENTS
Product
Date
Brown
Type/ Result
TB test negative Lot# 443X
1109036
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Cyno
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8-2-2015
-------
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Date
8-2-2015
1110014
--------
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C01
6995 Longley Lane
Reno, NV 89511
ANIMAL IDENTIFICATION
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TRADEI SECRET
Accord111g lo I he Paperwork Reduchon Act of 1995. an agency ma.y nol cond ud or sponsor. an~ a person is 110! required lo respond to. a col!ec11on of
1nfonna110n unless 11 displays a valrd 0MB control number The vahd OMS control numbers for this 1nformal1on collect1on are 0579-0036 and 0579-0333.
The lime required to complele ! his 1nformatior1 col!echon ,s est1 mated lo average 25 hours per response. 1nclud1n~ the t1 me for rev1P.w1ng 1n struchons,
searcll1ng e,,;1::>l!ng data sources, gathering and mamlammg the data needed. and completing ,:ind rev1ewm9lhe collechon or 1nforrnal1on
DDog D
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15-057
Rodent
--
4. PAGE
C01
239-867 -2020
I'
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BREED - COMMON
OR SCIENTIFIC
NAME
Cyno
_ ...... __
_ _ _ __!:_._!:'.ERTINENT VACCINATION, TREATMENT, AND TESTING HISTORY
AGE
SEX
COLOR OR
DISTINCTIVE
MARKS OR
MICROCHIP
ID
RABIES VACCINATION
1 YEAR
D2 YEARS D
Vaccination Date
Product
BROWN
OTHER VACCINATIONS.
TREATMENT, AND/OR TESTS AND RESULTS
3 YEARS
Dale
8-7-15
+----------+---+---+-------t--------1--------------1-----+------------------ ----
(2) 1004053
-i3)-1101033
14 ) 1105033
---
15 )1111027
5
1 11~12009
Cyno
Brown
_ _ _ _ _ _ _ _1_r_;_~_7_-2_0_1_s_lc____ _ _ _ _TB
_ test
_ _negative
_ _ _Loi#
_ _443X
_ _ _ _ _ __
----
VETERINARY CERTIFICATION I certify that the animals described in box 7 have been examined by me this date. that the
information provided in box 8 is ,rue and accurate to the besl of my knowledge, and that the following findings have been made
("X" applicable statements)
LJ
l certify that the arnmal(s} described above and on cont1nuation sheel(s). tf applicable, have been inspected by me on this date and
appeM to he tree of any infectious or contagious diseases and to lhe best of my knowledge. exposure thereto. which would endanger the
animal or other animals or would endanger public health.
To my knowledge. lhe animal(s) described above and on conlmuat1on sheet(s) if ?..pplicable. originated from an area not quarantined
for rabies and has/have not been exposed to rabies.
(/F NEEDED)
----------------
13172 Florida
Ac~redlted [8::JYes
No
If yes, please complete below
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DATE
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TRADE SECRET
Accmd,ng tot he Paperwork Reduct,011 Act of 1995, an agency may not cond ucl or sponsor. and a person ,snot reqtmed to respond to. a collection of
1nfom1at1an l1nless I displays a valid OM B control nu111ber. The vahd 0MB cor1trol 1n1mbers ror this 111forn1at1on coller::1ton are 0579-0036 and 0579-0333
The time required to complete this 1nformat1on collect1on 1s estimated to average 25 hours per response including !tie t1 me for 1ev1ew1ng u1stmd1on~.
searching ex1st1r1g data sources. gathering and rna1nta~ning ltle data 11eeded, a-nd ~0111elehr~o and reviewma the collec\1011 or information.
WARNING: Anyone who makes
UNITED STATES DEPARTMENT OF AGRICULTURE
ANIMAL AND PLANT HEAL TH INSPECTION SERVICE
years or both
5. NAME, ADDRESS, AND TELEPHONE NUMBER OF OWNER (CONSIGNOR)
U S.C. 1001),
(t8
TRADESECRET
No dog, cat. r,on\,i,,nan prnnate. or add,t,onal k,nds or classes of an,,nals des,gnal~ROMB APPROVED
USDA r ogu!al1on sh all be del ;verec1 to
any 1 ntermedtato handler or car rier for
transpor1at1on !11 comtnerce, unless accorriporn~d by a heal th cerl1f1cate executed and
issued by~ licensed vetennanan (7 LJ SC 21.43 9, CFR. Subchapter A, Part 21_ . _
Ocat
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OO _
79 0036
_
0579 0333
15-058
Rodent
4. PAGE
COl
6995 Longley Lane
Reno, NV 89511
775682-2166
--------
--
12 ) 1204055
Cyno
AGE
SEX
Cyno
-------------
COLOR OR
DISTINCTIVE
MARKS OR
MICROCHIP
RABIES VACCINATION
1 YEAR
2 YEARS
OTHER VACCINATIONS,
TREATMENT, AND/OR TESTS AND RESULTS
I
I
3 YEARS
Product
Vacc1nat1on Date
Date
Brown
8-10-2015
- - - - - - - - - - - - - ----
------
~-
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-- -
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--
----
----
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8-10-2015
---
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--
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--
---
---
VETERINARY CERTIFICATION. I certify that the animals described in box 7 have been exam,ned by me this date. tr.at the
information provided in box 8 is true and accurate to the best of my knowledge, and that the following findings have been made
("X" applicat>le statements)
--
I ccr11fy that the arnmal{s) described above and ori cont111wlhon sheet(s). tf applicable, have been inspected by me on this date and
appear to be free of any mfect1ous or c.on1.::ig1ous diseases and to the best of my knowla<iga. exposure thereto. which would endanger lhe
;inrmal or other animals or would endanger public health.
To my knowledge. the animal(s) described above and on cont1nuat1on sheet{s) 1f ~ppl1cahle. origmated from an area not quarantined
for rabies and has/have not been exoosed to rabies.
"-
1317? Florida
AccreditedIB]Yes
No
If yes, please complete below
i-iii:ri6NAL AcckEciir.i>:ri6N-NiiMBER -
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TRADE SECRET
TRADE SECRET
According to t hP. Paperwork R edur.11011 Act of 19!:l~. an ag em.:y may not coild i.1ct--nr s pQi1sor, and~ e~~Oi"l iS-uci1 reqiiire~(l(J rsporn1 t0~a c nllt1chon of
information unless tt displays a vahd OMS control number The vahd 0MB control numbers for lh1s 111form.Jt1on cotlect1on are 0579.Q036 a11rl 0579.0333
The h me required to con,plete this 1riforinatton collecl1on Is estimated tu average 25 hours per response. 1ncludrng tile II me for rev1ewu1g 111 strud1or1s.
searching em,t1ng data so_~_ir~e5:~ gathenng arid n1a1n!a1111ng t11e duta needed. and completing and rev1ew1ng the c~l!ect~n of rnrormahon
oy
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5. NAME, ADDRESS. AND TELEPHONE NUMBER OF OWNER (CONSIGNOR)
Do DC
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0579-0036
0579-0333
15-059
Rodent
4. PAGE
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USDA License/or Reg,strat,on Nurri_ber 0I_appl,cab/e 58-R-0144
__
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8. PERTINENT VACCINATION, TREATMENT, AND TESTING HISTORY
--------------7'-'.-'A-'-N"-l"-M-'-A-"L'-l"'DENTIFICATION
.
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OR OTHE:R IDENTIFICATION
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MICROCHIP
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To n1y knowledge, the animal(s) described above and on continuation sheet{s) 1f ariphcable or1ginatec:i from an are.=i not quarantined
exposed lo
rabies.
13172 Florida
-;cc;~dited [8Jves
No
ti yes, please complete below
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I cerlily that the animal(s) described above and on con11nua\1on sheeHs), if applicable, h::ive been inspected by me on lh1s date and
appear lo be free of any infect1mis or contagious diseases and to the best of my knowledge. exposure thereto, which would endanger the
animal or other animals or would endanger public health.
"
VETERINARY CERTIFICATION: I certify that the animals described 1n box 7 have been examined by me th,s date, that the
information provided in box 8 is true and accurate to the best of my knowledge. and that lhe following f1nd1ngs have been made
("X" applicable statements).
-LJ
D
Date
18-7-2_<:2_5
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DATE
8-4-2015
TRADE SECRET
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CERTIFICATE NUMBER
UNITED STATES INTERSTATE AND INTERNATIONAL CERTIFICATE OF HEALTH EXAMINATION FOR SMALL ANIMALS
(Continuation Sheet)
RABIES
AGE
SEX
NAME
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Date
Type/ Result
Brown
1-3-2015
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Date
DFKH
DFNL
OR SClfNTIFIC
DFLV
of
VACCINATION HISTORY
BREED-COMMON
Rhesus
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DFAB
DFAG
DFBD
DFBG
DFBT
DFDO
DFDC
OR SCIENTIFIC
RABIES
AGE
SEX
NAME
Rhesus
.
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DIS l lNCTIVE MARKS
,,
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DFEW
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Product
Date
Product
Date
Type/ Result
1-3-2015
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DFEV
of
VACCINATION HISTORY
BREED-COMMON
DFCC
DFCH
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PAGE
ANIMAL IDENTIFICATION
DF73
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CERTIFICATE NUMBER
(Continuation Sheet)
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Ocat
0570-00'6
0579-0333
00ttter
OMBAPPROVED
DDog
TRADEl ;ECRET
infofmatioo urie it displays a valklOMB control number. The vaid 0MB control numbers ror this information collectton &re 0579-0036 and 0579-0333_
Th8 lim. required to complete this information c o l ~ is e$1.lmat&d to averugo .25 h Oln per response, Including the ti me forrevi&wlng instruction&,
searchina exiffil'V'I data &Ot.XCes. ~ and ....-..inwv. the data needed and ~ a n d ~ the COllectlofl of information.
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0Femil
15-021
Rodent
4. PAGE
40
1 of 3
RML
7780 NW 53 Street
1!9~~4thS~""t
MT 59840
'
Hiilltoit
Miami, FL 33166
239-867-2020
40l,;37~9688
7. ANIMAL IOENTIFICATION
NAME. ANO/OR TATTOO NUMBER
OR OTHER IDENTIFICATION
BREED -COMMON
OR SCIENTIFIC
NAME
AGE
SEX
COLOR OR
DISTINCTIVE
MARKS OR
MICROCHIP
RABIES VACCINATION
1 YEAR
2 YEARS
Vaccination Date
OTHER VACCINATIONS,
TREATMENT, AND/OR TESTS AND RESULTS
3 YEARS
Date
Product
.J1)nnv
--
.J.._2)(1,i,::
- _,,
--
(<)DFOI
5
I DF43
{6)DF57
VETERINARY CERTIFICATION: I certify that the animab described In box 7 have been examioad by me lhi.a date, lhat the
information provide<t in box 8 is true and accurate to the best of my kflO'lliedge, and that the folo'Mng f1ndmgs have been made
applicable statements).
rx"
tt a ~ is listed in box 7.
ct#y lhal the l!rirnB(s) desaibed above and oo conoouaUoo sheet(s), If applicEIUe, have b&eo llupe(;ted by me oo this date and
appear to be free of aoy lnfedous or cootaglous diseaMS and to the best of my knowtedsJe, e)q)Ol,Ufe thereto, whk:h WCMd end#lgef Ile
animal or other alifnah Of' v.oAd endEllgef poblk: heaft:h.
~my knov.tedge, Ile Mimal(s) described above and on contimation sheet(s) if appltcsble, originated from an ea nol quarantined
&----
Florida
lmmokalee, FL 34142
Accrodlted~Yoo
W. No
DATE
---
<-
----
--
i.ccileoo'.<inoii NUMBER
'
055303
IDATE
2-10-2015
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