A one-pound sample is sufficient for the analysis. It should be sent in a 

 glass jar or tin box to prevent loss of fine particles and a change in the moisture 

 content. In order that the department may have a record of the sample analyzed, 

 and may know whether or not the manufacturer and the dealer are complying 

 with the requirements of the law, the following information should be submitted 

 concerning each sample. 



Brand 



Manufacturer 



Address 



Guarantee: 



Protein 



Fat 



Crude Fiber 



Ingredients 



Dealer 



Address 



Number of bags in lot 



Number of bags sampled 



Your name 



Your address 



Your reason for requesting analysis 



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