APHIS Form 7001A: United States Interstate and International Certificate of Health 

 Examination for Small Animals (Continuation Sheet) 



CERTIFICATE NUMBER [block 1] 



Insert by hand the preprinted number from block 1 

 of the Form 7001 for which this 7001 A is a continua- 

 tion sheet. 



PAGE [block 2] 



Insert page 2 (or 3, etc.) of X, with X standing for the 

 total number of sheets of Form 700 1 and all 700 1 A 

 forms for this entire shipment. 



NAME, ADDRESS AND TELEPHONE NUMBER OF 

 OWNER/CONSIGNOR [block 3] 



Transfer this information from block 3 of the Form 

 7001. You do not need to repeat the USDA license or 

 registration number. Do repeat the shipper's telephone 

 number, however. 



NAME, ADDRESS AND TELEPHONE NUMBER OF 

 CONSIGNEE [block 4] 



Transter this information from block 4 of the Form 

 7001. You do not need to repeat the USDA license or 

 registration nuinlxr. [)o repeat the recipient's telephone 

 number, however. 



ANIMAL IDENTIFICATION [block 5, lines 11-31 

 as needed] 



The owner or consignor (shipper) fills in this 

 information. 



VACCINATION HISTORY [block 6] 



You fill in this section. If rabies certificates are involved 

 tor the animals on this continuation sheet, attach them 

 (showing your original signature, not a photocopy) 

 at the black arrow on the right-liand side of the Form 

 7001 A. 



16-44 



