COUNTRY OF ORIGIN AFFIDAVIT/DECLARATION STATEMENTS

Continuous Country of Origin Affidavit/Declaration:

As an affidavit is deemed by USDA an official record of Country of Origin, I attest through first-hand knowledge, normal business records, or producer affidavit (s) that all livestock referenced by this document or other communications specific to the transaction and transferred are of the United States of America origin. Should the origin of my livestock become other than that described above, I agree to notify the buyer/agent when this occurs.

This affidavit/declaration shall remain in effect until revoked in writing by the undersigned and is delivered to Producers Livestock Marketing Association (agent/buyer).

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Business/Farm/Ranch Names/Location: