CO

UN

TRY

OF

OR

IGIN

AFF

IDA

VIT

/DEC

LAR

ATI

ON

As

an

affid

avit

is d

eem

ed b

y U

SDA

as o

n of

ficia

l rec

ord

of C

ount

ry o

f O

rigi

n*, I

att

est

thro

ugh

first

-han

d kn

owle

dge,

nor

mal

bus

ines

s re

cord

s, o

r pr

oduc

er a

ffid

avit(

s) t

hat

all l

ives

tock

ref

eren

ced

by t

his

docu

men

t as

bei

ng in

tend

ed f

or t

he ju

nior

live

stoc

k au

ctio

n ar

e of

Uni

ted

Stat

es o

rigin

. Sh

ould

the

orig

in o

f m

y liv

esto

ck b

ecom

e ot

her

than

des

crib

ed a

bove

, I a

gree

to

notif

y th

e bu

yer/

agen

t w

hen

this

occ

urs.

*

Ori

gin

is d

efin

ed a

s be

ing

both

“B

orn

an

d R

aise

d”

PR

OD

UC

ERS

SEC

TIO

N (

To b

e co

mpl

eted

by

pers

on y

ou a

re p

urch

asin

g liv

esto

ck f

rom

.)

Sign

atu

re o

f Se

ller:

(Per

son

selli

ng t

he li

vest

ock

to t

he in

divi

dual

to

show

/auc

tion

) D

ate:

(Dat

e sa

le a

nd t

rans

fer

of o

wne

rshi

p to

ok p

lace

) N

ame

and

Add

ress

of

Bu

sin

ess/

Farm

/Ran

ch:

(Nam

e an

d lo

cati

on o

f w

here

the

live

stoc

k w

as k

ept

befo

re b

eing

sol

d)

BU

YER

S SE

CTI

ON

(To

be

com

plet

ed b

y st

uden

t pu

rcha

sing

live

stoc

k to

sho

w.)

I at

test

th

at a

ll liv

esto

ck r

efer

ence

d by

thi

s do

cum

ent

that

I h

ave

purc

has

ed a

re o

f U

nite

d St

ates

ori

gin

. Sh

ould

th

e or

igin

of

my

lives

tock

ch

ange

, I a

gree

to

not

ify

the

buye

r/ag

ent

imm

edia

tely

. Si

gnat

ure

of

Bu

yer:

(Ind

ivid

ual p

urch

asin

g liv

esto

ck t

o ra

ise

for

auct

ion)

P

rin

ted

Nam

e of

Buy

er:

Dat

e: