No dog, cat, nonhumai primu, or addltlonlll kind• or c1uu1 o1 animal• dufgriatlid byOMBAPPltOVIID

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

1

D

~:;~ =~.t:~~'. :awing

Prtmaie Product• INC
34200 Doclorl Hammock Rd,
lmmckalH, Florida 34142

D

0

D

[8]

D

Buekahlra corporation
202!! N. Rldga Rd,
Perkalla, PA 18944

USO~ l.l~nH/or R~~~on Numbtr (lf_1pp//ca/Jle) 58-R-01+4
7. ANIMArlD!HTIFICATION

a.

NAME, ANO/OR TATTOO NUMBER
OR OTHER IDENTIFICATION

BREED-COMMON
OR SCIENTIFIC
NAME

AGE

SEX

COLOR OR
DISTINCTIVE
MARKS OR
MICROCHIP

(1lvssM

macaca fatc1culart1

A

M

BROWN

1 YEAR

Pl!JllTINENTVACCINATIQN, TR~TMIENT,ANDTi._8TINO liJITORY.

RABIES VACCINATION

OTHER VACCINATIONS,

D 2 YEARS D 3 YEARS

TREATMENT, ANO/OR TESTS AND RESULTS

Vaccination Date

Product

12) AM!583G

Cate

Product TY.e! and/or Resulla

05-14-15

TB tut neglllva Loi # 442X

05-13-15

(3)
(4)

(5)
(!)

a-:-lf!MARKS OR ADDITIONAL CERTIFICATION 8TA T!M!NTS (WHEN REQIJIREDJ

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 have ver1fttiilli• prtnn-ce Of lh,~mlcriichtp. tt I riili:fochlp ltllite~ In box 7.

[&]

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.

~

ENClOR8EMENTFOR INT!RHATIONAL EXPORT UFNEED~DJ
PRim!D NAME OF USDA VET!RINARIAN

I

[8]

To my kllOYAldge, lhe 1nlmll(1) d11crlblld 1bova Ind on conUnulllon 1hN1(1) If appllcllbll, onglnalad from 1n ll'H not qull'llntned

for rabln Ind hulh11W not b e e n ~ ~ '
HAMI!, AD0Rl!8I, AND Tl!LIEPHONE NUMISl!R OF IUUIHO V!T!RINARIAN

I UCINII! NUMIIIR AND ITATI!

Dr. Amber Wl81ama

VM 13112

34200 Or. Hammock Rold
lmmokllee, FL:M142
F'hone: 2311 881·2020

Accradbd(8]Yn
No
If YII, plNH comp1etiliilow

n

NATIONALACCRl!DrrATIONNUMll!R.
I()
._

07539'1

...,
0

"'
""
"

NOTE: lnlemfllonlll thlpm1nt1 may r119ufuartlftcat1on by~.J1eqfdl11d velartn~n •
..,.., _ , Ul'II:

Of: OSDA VETERINARIAN

Apply IJS04 SN/ or Stamp hera

i,...

"'
'1-l
0

"'

~
&

"'

=
"'·
~

...,
0

s
i

§

"
C

Q

. -~ ··-··--·

(NOV 2010)

DATE

~11,UINOVETER,t~--

,f ~-:.;;:

r uzt:.l.b...e.J._.....11Ji.a. u.1. h . .,.

·-·· •_o:·. :.i..::: .•

Thia certlflcale Is valid for 30 days efter~nce

I

.__,.

..

DATE

::::;c:,

: ..·. t. :. .·

·- ~

,•.•. ·--~

0.2~---·
·...";!"-.•,.·•.·a:-

Trade Secret

.. ·...::····;.·

1:1

-;:;;

"3C:

~"'

0

a

"'

8

..
CERTIFICATE NUMBER

PAGE

RABl[S

BREED-COMMON

COLOR OR

AGE

SEX

Rhesus

A

M

Brown

DFKH

"

"

"

"

DFKM

"

"

DFKE

OR SCIFNTIFIC
NAME

"

DFLT

"

"

DFNL

"

DISTINCTIVE MARKS

"

"
"

DFLV

"N

3

...,,

0

<A

"

OFPI

"

"

DFPK

"

"

DFTJ

"

DFVA

"

DFXX

"

"

·--

"

"

D-H-L

LIVE VIRUS

Product

Date

Product

OTHER VACCINATIONS, TESTS OR
TREATMHITS

Date

Type/ Fesult

1-3-2015

TB test negative Lot# 442X

"

"

"

"

"

"

"

"

"

"
"

"

"

"

"

"

"

"

"

"

"

"

"

"

"

"

"

"

DFPG

- KILLED VIRUS

Date

"

DFKN
DFKP

of

VACCINATION HISTORY

ANIMAL IDENTIFICATION

AND/ OR TATTOO NUMBE:R

3

RML
903 South 4th Street
Halilton, MT 59840

Primate Products. Inc.
7780 NW 53 Street
Miami, FL 33166

COMPLETE USDA TAG, COLLAR

tn

0

'-:i

NAME, ADDRESS AND TELEPHONE NUMBER OF CONSIGNEE

NAME, ADDRESS AND TELEPHONE NLJMRFR OF OWNER/CONSIGNOR

-

'-'
~

....

."

UNITED STATES INTERSTATE AND INTERNATIONAL CERTIFICArE OF HEALTH EXAMINATION FOR SMALL ANIMALS
(Continuation Sheet)

0
Hi

N
'O

"
"

"

-

"

"

"
.. _.--...l!.. ___

'"

l

,fl
..

0

,:;;

"3
"a

~

s

"'

.,

0
Hi

);l
;!!

-

0
"l

CERTIFICATE NUMBER
UNITED STATES INTERSTATE AND INTERNATIONAL CERTIFICATE OF HEALTH EXAMINATION FOR SMALL ANIMALS

Cl!

0,

0

-.l

"""
"'...,

~
(Continuation Sheet)

PAGE

ANIMAL IDENTIFICATION

DF73

OR SCIENTIFIC

u,

RABIES

Rhesus

DFAB

"
"
"

DFBG

COLOR OR

D-H-L

·- KILLED VIRUS - LIVE VIRUS

OTHER VACCINATIONS, TESTS OR
TREATMENTS

AGE

SEX

Date

Type/ Result

A

M

Brown

1-3-2015

TB test negative Lot# 442X

"

"

"

"

NAME

.

DFBD

0

VACCINATION HISTORY

BREED-COMMON

DFA1

DFAG

3

RML
903 South 4th Street
Halilton, MT 59840

Primate Products. Inc.
7780 NW 53 Street
Miami, FL 33166

AND/ OR TATIOO NUMBER

of

NAME, ADDRESS AND TELEPHONE NUMBER OF CONSIGNEE

NAME, ADDRESS AND TELEPHONE NUMBER OF OWNER/CONSIGNOR

COMPLETE USDA TAG, COLLAR

2

DISI INCTII/E MARKS

Date

"
"

"

"
"

Product

Date

Product

"
"

"
"

"

"

"

"

"

.

"

"

"

"

"

"

"

"

"

"

"

DFBT

"

"

DFCC

"

"

DFDO

"

DFDC

"

DFEM
DFEV

"

DFEW

"

.

"

.

"
"

"

"

"

"

"

"

"

DFHH

"

"

"

"

DFHJ

"

"

"

"

"

DFHN

.

DFHT

"

"

"

"

"

"

DFJW

"

"

DFJZ

"

"

DFKB

"

"

DFKD

.

"

):

"

"

DFFD

,.f,lll'

"

"

DFCH

"

"

"

"

"
"
"

,.

"

"
"

"

"

.f:

-\

I

AcconlingtotheP-Reduction Act of 1995, an .. oocymaynotconduct0< ,pomo,, andape«oni• "°'""""""''o ,e,pondto, a cofe<tionol

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 rt«for

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.

r, U.S.C 21.43.9, CFR. S • ~ e r A. Part 2l

2. CERTIFICATE NUMBER· OFFICIAL USE OHL Y

Ocat OOther

15-021

0

[RI

4. PAGE
1 of3

u.s.c.

5. NAME, ADDRESS, AND TELEPHONE NUMBER OF OWNER (CONSIGNOR)

S. NAME, ADDRESS, AND TELEPHONE NUMBER Of RECIPIENT AT DESTINATION (CONSIGNEE)

Primate Products, tnc.

RML

~.3 S

7780 NW 53 Street
Miami, FL 33166

~

4th Street

H!lllloli. MT 59840
4Q6475-9688

239-867-2020

USDA Licensefor Reaistration Number (;f aoolicablal 58-R-0144
7. ANIMAL IDENTIFICATION
NAME, ANDIOR TATTOO NUMBER
OR OTHER IDENTIFICATION
,.(1)ruw

BREED -COMMON
OR SCIENTIFIC

8. PERTINENT VACCINATION, TREATMENT, AND TESTING HISTORY

AGE

SEX

COLOR OR
DISTINCTIVE
MARKS OR

NAME

MICROCHIP

o,

RABIES VACCINATION
YEAR 02YEARS

D

OTHER VACCINATIONS,
TREATMENT, AND/OR TESTS AND RESULTS

3 YEARS

Vaccination Date

Date

Product

Product Type and/or Resdis

-

~"

r

.

-

J.2)/H<:.

-3

0MB APPROVED
0579--0036
0579-0333

lfQflsport&tton 1n commerce, unless ac:co,npanied by a heal 1h certtftcate executed and

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

M

(5) DF43

(G} DF57

M

9. REMARKS OR ADDITIONAL CERTIFICATION STATEMENTS (WHEN REQUIRED)

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.

ENDORSEMENT FOR INTERNATIONAL EXPORT (IF NEEDED)
PRINTED NAME Of USDA VETERINARIAN

NAME, ADDRESS, AND TELEPHONE NUMBER OF ISSUING VETERINARIAN
Thomas

LICENSE NUMBER AND STATE
12304

J Rowell, DVM

34200 Drs. Hammock Road
lmmokalee, FL 34142

Ffolida

D

Accr<dimll.KIYn
No
H yes, plo ... ~ below

NATIONAL ACCREOOATION NUMBER
055303
NOTE: lnlemationail shinments

SIGNATURE OF USDA VETERINARIAN

Apply USDA Seal or Stamp here

<
APHIS Form 7001
(NOV2010)

mFN

reqUH'e cerffication bV an accredrted ...etertnaian.

~IG-~-~1~ QfJSSUJNG YE-lERtNARfMf------

DATE

This certificate is valid for 30 days after issuance

-

-

I

!DATE

2-10-2015

'

TD Anll ~BCR.R'.t, W"J"
(S

Jo

s

afa,a)

(Page 1

2)

of

Document ID - 2923341 Page 1 of 2

This rl!l.ord 1s authorize
revoca~on of license a

USC 2131·2156). Failure to ITlilinta1n this record can result in a suspension or
onment for not more than 1 year, or a fine of not more than $1,000, or both.

.5. DEPARTMENT OF AGRICULTURE
AND PLANT HEALTH INSPECTION SERVICE

FORM APPROVED 0MB

See reverse side for

additional information.

NO. 0579-0036

2. PAGE

: 1. INVOICE NO.

IOC150203A

1

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

5. SELLER OR DONOR (Name and Address, include Zip Code)

) 6. BUYER OR RECEIVER (Name and Address, include Zip Code)

Primate Products, Inc.
34200 Doctors Hammock Road
Immokalee, FL 34142 USA

COl - Charles River Labs, Inc.

6995 Longley Lane
Reno, NV 89511 USA

17. USDA LICENSE NO. {tfany)

14-R·0144

8. IDENTIFICATION OF ANIMALS BEING DELIVERED

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

1

100342
-- ------ ·---·-- _Macaca fascicularis -

-

1
1

I

I

I

101808

Macaca fascicularis

1101936

Macaca fascicularis

1

110321

Macaca fascicularis

31-8

1

1104738

Macaca fascicularis

25-8

1

110708
110886

1-8

i

31-C

I

1

I

I

Buyer's Truck

I

(Condition, etc.)

I
I

F
F

I
I

!
\

F

I

i
I

F

I

I
!

!I

---·

_2_.z:1_

I

TB Test: 1/19)2015 _____

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

3.481 TB Test: 1/21/2015

F

3.341 TB Test: 1/22/2015

Macaca fascicularis

F

2.75

TB Test: 1/19/2015

Macaca fascicularis

F

3.07

TB Test: l/22/201S

I

!

'
-

·- -~--i--

I

------

!

I
I

I

I

I

!

I

I

I

I
II
I
I

II

DELIVERY BY COMMERCIAL CARRIER

0

i

I

M

I

I

3.04 TB Test: 1/22/2015

I

I

I
f .
I

i

10. TRUCK LICENSE NO.

9. DELIVERY BY (''X" one)

0

F

I

IMacaca fascicularis

I

--

) K

REMARKS

(kgs.)

---l- F -rI

Macaca fascicularis

101350

I

1

EST.
WE[GHT

NO.
ADULT

i

1110268

31-A

-·-

Macaca fascicularis

1100766

i
!

1

I

--

I

1

).

I

:
i

I

RECEIVER'S USE

I.

IH

G.

NO.
YOUNG

(if applicable}

I

l

F.

I
I

11. BILL OF LANDING NO.

Dealer's Truck
(Seller or Donor)

AWB#:

13. NAME AND ADDRESS OF TRUCK DRIVER

12. NAME AND ADDRESS OF COMPANY OR FIRM
JKL Secure Freight Lines
2613 Empire Ranch Road #21907

JKL Secure Freight Lines

2613 Empire Ranch Road #21907
Carson City, NV 89721 USA

Carson City, NV 89721 USA

j'

DELIVERY RECEIPT - TO BE COMPLETED BY EJUYER OR RECEIVER

\ 14. ANIMALS DELIVERED WERE ("X"one)
!N APPARENT GOOD CONDffiON
POOR CONDffiON
REJECTED (Attach explanation for rejection)
•,.....1-5-.T-O-T-AL_N_U_M_B_E_R_R-EC_E_IV_E_D~~--l0---r-11-6.-N-Uc--Mcc-BE_R_D_EA_D-~~------='---,1~1-7-.N-U-M-:B-=-ER-ALIV-:--:E=-------------.
2

O

I

18. BY (Signature)

1

APHIS FORM 7020
(JAN 90)

O

119. mLE
(Replaces VS FORM 16-20, which is now obsolete, and
APHIS form 7020 (10-80) which may be used.)

O

· 120. DATE

TRADE SECRET·

(Page 2

of

2)

Document ID -300214-1 Page 2 of2

TRADE SECRET
I

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.

No dog, cal, nonhuman prima.te, ~r add11ional ki.n?s or cl<.lsses of animals designated by
USDA r egula!lon sh all be dal ivared lo any, ntermed1ate handler or car ner for

:::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

UNITED STATES DEPARTMENT OF AGRICULTURE
ANIMAL AND PLANT HEALTH INSPECTION SERVICE

UNITED STATES INTERSTATE AND INTERNATIONAL
CERTIFICATE OF HEALTH EXAMINATION
FOR SMALL ANIMALS

4. PAGE

1 of 3
· fr. NAME, ~DRESS, AND TELEPHONE NUMBER OF RECIPIENT AfDESTINATION (CONSIGNEE)

5. NAME, ADDRESS, AND TELEPHONE NUMBER OF OWNER (CONSIGNOR)
PTLC/Primate Products, Inc.
34200 Ors. Hammock Rd.
lmmokatoo, FL 34142
239-867-2020

·.~

C01
,,
6995 LOr:ig!ey lane
Reno, ,NV 89511
1756?2-2166

USDA License/or Realstrnlion Number {if aoolicable) 56-R-0144
7. ANIMAL IDENTIFICATION

NAME, AND/OR TATIOO NUMBER
OR OTHER IDENTIFICATION

(11 1006073

8. PERTINENT VACCINATION, TREATMENT, AND TESTING HISTORY

BREED - COMMON
OR SCIENTIFIC
NAME

AGE

Cyno

A

SEX

COLOR OR
DISTINCTIVE
MARKS OR
MICROCHIP

RABIES VACCINATION

D

1 YEAR

D

2 YEARS

Vaccinalion Dale

D

OTHER VACCINATIONS,
TREATMENT. ANO/OR TESTS ANO RESULTS

3 YEARS
Product

BROWN

M

Date

Producl Type and/or Resulls

8-1-15

TB test negative Lot# 443X

B-1-2015

TB test negative Loi# 443X

(2 )1011019
(J) 1011039

(4 )1012009

(S)1012015C
5
( )1101005

M

9. REMARKS OR ADDITIONAL CERTIFICATION STATEMENTS (WHEN REQUIRED)

--~-··------···---------·---

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

I have verified the presence of lhe microchip, if a microchip 15 listed m box 7.

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.

D

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.

~~=:~~NO=/=E~~E~::~:M~N=:~~~~~~ce::'=DT~:~~=~=:E~T~=~~:A~AR~\c-!N~XP_O_R_T~(~IF_N_E_E_D_E_o_1_ _ _ _ _ _ _ _ _--< NA~E. ADDRESS, AND TELEPHONE NUMBER OF ISSUING VETERINARIAN

Amber Williams. DVM
34200 Ors. Hammock Road
lmmokalee. FL 34142

1L31C17E2NSFEloNn·dUaMBER AND ST ATE

W

Accredited [8]ves
No
If yes, please complete below
iiATIONAL ACCREDITATION NUMBER

;1,,.rr

075369

NOTE: International shinmenls mav renuire cert1fica1ion bv an actredil;d~€tennarian.

SIGNATURE OF USDA VETERINARIAN

Apply USDA Seal or Stamp here

DATE

~F ISSUING Vir.AR'.'-·

i

, .

)

( .'t-d.+11/:x?/ I/II!#£([{ 11;0_/
APHIS Form 7001
(NOV 2010)

\./

DATE

7-29-2015

!

(

This certificate is valid for 30 days after issuance

TRADE SECRET

(Page 1

of

16)

Document ID - 3002222 Page I 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.

U.S. DEPARTMENT OF AGRICULTURE
ANIMAL AND PLANT HEALTH INSPECTION SERVICE

LJ

SALE

D

EXCHANGE OR TRANSFER

1 of 5
3. DATE OF DISPOSITION

4. DEALER'S UCENSE NO.
SB R

- - 0144

AND SB

C01 - Charles River Labs, Inc.
6995 Longley Lane
Reno, NV 89511 USA

17, USDA UCENSE NO. (if any)

CONTAINER
TAG NO.,
CRATE
OR PEN
NO.

NO.
AN!·
MALS

D

PREVIOUS
INVOICE
NO.

(if any)

E.

AGE-SEX

F.

INDIVIDUAL

IDENT.,

SPECIES

TATTOOS, TAG
NOS.

14-R-0144

8. IDENTIFICATION OF ANIMALS BEING DEUVERED

NO.
YOUNG

(if applicable)

H.

RECEIVER'S USE

I.

G.

K.

J.

NO.
ADULT

38

1

0904142

Macaca fascicularis

F

BA

1

0907196C

Macaca fascicularis

F

EST.
WEIGHT

REMARKS

(kgs.)

(Condition, etc.)

3.54 TB Test: 7/30/2015
3.41

TB Test: 7/30/2015

'

1

BB

- 8 - 0536

16. BUYER OR RECEIVER (Name and Address, include Zip Codd)

Primate Products, Inc.
34200 Doctors Hammock Road
Immokalee, FL 34142 USA

' C.

PO # 4500116233

8/17/2015

DONATION

5. SELLER OR DONOR (Name and Address, include Zip Code)

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.

FORM APPROVED 0MB
NO. 0579--0036

1. INVOICE NO.

RECORD OF ACQUISmON, DISPOSmON OR TRANSPORT
OF ANIMALS {Other than Dogs and Cats}

[ii

See reverse side for
additional information.

0909060

Macaca fascicularis

F

3.23

TB Test: 7/30/2015

!
9A

1

0909068

! Macaca fascicularis

F

3.07

TB Test: 7/30/2015

4B

1

0912112

Macaca fascicularis

F

3.49

TB Test: 7/30/2015

6A

1

1001036

Macaca fascicularis

F

3.28

TB Test: 7/30/2015

SA

1

1002124

Macaca fascicularis

F

3.46 i TB Test: 7/30/2015

SB

1

1002178

Macaca fascicularis

F

3.65

TB Test: 8/4/2015

6A

1

1003136

Macaca fascicularis

F

3.38

TB Test: 7/30/2015

23A

1

1004053

Macaca fascicularis

M

4.72

TB Test: 8/4/2015

---

I"·

DELIVERY BY COMMERCIAL CARRIER
9. DELIVERY BY ("X" one)

D

Buyer's Truck

D

10. TRUCK UCENSE NO.
Dealer's Truck
(Seller or Donor)

BILL OF LANDING NO

AWB#:
13. NAME AND ADDRESS OF TRUCK DRIVER

12. NAME AND ADDRESS OF COMPANY OR FIRM
JKL Secure Freight Lines
2613 Empire Ranch Road #21907
Carson City, NV 89721 USA

JKL Secure Freight Lines
2613 Empire Ranch Road #21907
Carson City, NV 89721 USA

DELIVERY RECEIPT • TO BE COMPLETED BY BUYER OR RECEIVER
14. ANIMALS DELIVERED WERE ("X"one)
IN APPARENT GOOD CONDmON

D

15. TOTAL NUMBER RECEIVED
18. BY (Signature)
APHIS FORM 7020

(JAN 90)

74

D

POOR CONDffiON

116. NUMBER DEAD
119. TITLE

D

REJECTED {Attach explanation for rejection)
117. NUMBER ALIVE
120. DATE

(Replaces VS FORM 16-20, which ts now obsolete, and
APHIS form 7020 (10-80) which may be used.)

TRADE SECRET

(Page 2

of

16)

Document ID - 3002222 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.

U.S. DEPARTMENT OF AGRICULTURE
ANIMAL AND PLANT HEALTH INSPECTION SERVICE

D

SALE

EXCHANGE OR TRANSFER

D

FORM APPROVED 0MB
NO. 0579-0036

2.PAGE

1. INVOICE NO.
00508017

. 2 of 5

CONTINUATION SHEET FOR
RECORD OF ACQUISmON, DISPOSmON OR TRANSPORT
Of ANIMALS
(Other than Dogs and Cats)

!x:j

see reverse side for
additional information.

1

3. DATE OF DISPOSITION

PO # 4500116233

8/17/2015
4. DEALER'S LICENSE NO.

DONATION

5. SELLER OR DONOR (Name)

58-R-0144 AND 58-B-0536

6. BUYER OR RECEIVER (Name)

Primate Products, Inc.

COl - Charles River Labs, Inc.
8. IDENTIFICATION OF ANIMALS BEING DELIVERED

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}

1

lA

(1005014

H.

G.

EST.
WEIGHT

NO.
ADULT

NO.
YOUNG

(kgs.}

l

1

J.

-

K.

REMARKS

(Condition, etc.}

Macaca fascicularis

F

2.99 TB Test: 7/30/2015

1005066

Macaca fascicularis

F

3.46 TB Test: 7/30/2015

F

3.46 TB Test: 7/30/2015

M

3.58 TB Test: 7/29/2015

;

6B

RECENER'S USE

I.

i

7A

1

1006058

Macaca fascicularis

26A

1

1006073

Macaca fascicularis

78

1

1006078

Macaca fascicularis

F

3.14 TB Test: 7/30/2015

13B

1

1008016

Macaca fascicularis

F

3.72 TB Test: 7/30/2015

lOA

1

1008080

Macaca fascicularis

F

3.47 TB Test: 7/30/2015

lB

1

1010002

Macaca fascicularis

F

3.25 TB Test: 7/30/2015

14A

1

1010032

Macaca fascicularis

F

3.63 TB Test: 7/30/2015

19A

1

1011004

Macaca fascicularis

F

3.28 TB Test: 7/30/2015

22A

1

1011019

Macaca fascicularis

M

22B

1

1011039

Macaca fascicularis

M

4.24 TB Test: 7/29/2015

--·-··
36B

1

1012009

Macaca fascicularis

M

4.11 TB Test: 7/29/2015

14B

1

1012014

Macaca fascicularis

F

3.22 TB Test: 7/30/2015

26B

1

1012015C

Macaca fascicularis

M

4.65 TB Test: 7/29/2015

15A

1

1012070

Macaca fascicularis

F

3.53 TB Test: 7/30/2015

34A

1

1101005

Macaca fascicularis

M

4.04 TB Test: 7/29/2015

15B

1

1101012

Macaca fascicularis

F

3.28 TB Test: 7/30/2015

37A

1

1101033

Macaca fascicularis

M

3.74 TB Test: 8/4/2015

APHIS FORM 7020A
(JAN 90)

I

:

'

4.50 TB Test: 7/29/2015
--

Replaces VS form 18 20A (9-88) which may be used

TRADESECRET

-

(Page 3

of

16)

Document ID - 3002222 Page 3 of 16
This record is authorized by law (7 USC 2131-2156). Failure to maintain this record can result in a suspension or
revocabOn of license and/or imprisonment for not more than 1 year, or a fine of not more than $1,000, or both.

U.S. DEPARTMENT OF AGRICULTURE
ANIMAL AND PLANT HEALTH INSPECTION SERVICE

See reverse side for
additional information.

1. INVOICE NO.

OC1508017
3. DATE OF DISPOSITION

D

EXCHANGE OR TRANSFER

PO # 4500116233

4. DEALER'S LICENSE NO.

D

DONATION

5. SELLER OR DONOR (Name)

58-R-0144 AND 58-B-0536

6. BUYER OR RECEIVER (Name)

Primate Products, Inc.

COl - Charles River Labs, Inc.
8. IDENTIFICATION OF ANIMALS BEING DELIVERED

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)

1

llA

1101034

E.

AGE-SEX

SPECIES

F.

G.

NO.
YOUNG

NO.
ADULT

Macaca fascicularis
-

! I.

H.
EST.
WEIGHT
(kgs.)

REMARKS
(Condition, etc.)

F

3.19 TB Test: 7/30/2015

F

3.81 TB Test: 7/30/2015

1

1101036

Macaca fascicularis

168

1

1101092

Macaca fascicularis

F

3.18 TB Test: 7/30/2015

1

1102009

Macaca fascicularis

M

4.39 TB Test: 7/29/2015

1

1104005

Macaca fascicularis

M

4.37 TB Test: 8/4/2015

i
27A

-r

RECEIVER'S USE
J.

16A

23B

PAGE

8/17/2015

(Other than Dogs and Cats)
SALE

I'

3 of 5

CONTINUATION SHEET FOR
RECORD OF ACQUISffiON, DISPOSffiON OR TRANSPORT
OF ANIMALS

[JS]

FORM APPROVED 0MB
NO. 0579-0036

.. ~ I - - - - - - - - -

i

2A

1

1103020

Macaca fascicularis

F

3.08 TB Test: 7/30/2015

278

1

1104003

Macaca fascicularis

M

4.02 TB Test: 7/29/2015

28A

1

1104017C

Macaca fascicularis

M

4.28 TB Test: 7/29/2015

30A

1

1105019

' Macaca fascicularis

M

3.61 TB Test: 7/29/2015

28B

1

1105023

Macaca fascicularis

M

4.67 'TB Test: 7/29/2015

17A

1

1105024

Macaca fascicularis

F

3.37 TB Test: 7/30/2015

308

1

1105027

Macaca fascicularis

M

4.13 TB Test: 7/29/2015

34B

1

1105033

Macaca fascicularis

M

4.43 TB Test: 8/4/2015

118

1

1105036

Macaca fascicularis

F

3.68 TB Test: 7/30/2015

12A

1

1105040

Macaca fascicularis

F

3.75 TB Test: 7/30/2015

29A

1

1106003

Macaca fascicularis

M

3.79 TB Test: 7/29/2015

378

1

1106007

Macaca fascicularis

M

4.34 TB Test: 7/29/2015

31A

1

, 1106011

Macaca fascicu laris

M

4.39 TB Test: 7/29/2015

F

3.62 TB Test: 7/30/2015

·-

I

I

I

178

1

APHIS FORM 7020A
(JAN 90)

1106022

Macaca fascicularis

Replaces VS form 18 20A (9-88) which may be used

TRADESECRET

(Pag(a 4

of

16)

Document ID - 3002222 Page 4 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.

U.S. DEPARTMENT OF AGRICULTURE
ANIMAL AND PLANT HEALTH INSPECTION SERVICE

See reverse side for
additional information.

1. INVOICE NO.

4 of 5
3. DATE OF DISPOSITION

EXCHANGE OR TRANSFER

D

PO # 4500116233

8/17/2015

(Other than Dogs and Cats)

D

12. PAGE

OC1508017

CONTINUATION SHEET FOR
RECORD OF ACQUISITTON, DISPOSffiON OR TRANSPORT
OF ANIMALS

~ SALE

FORM APPROVED 0MB
NO. 0579-0036

4. DEALER'S LICENSE NO.

DONATION

5. SELLER OR DONOR (Name}

58-R-0144 AND 58-8-0536

6. BUYER OR RECeIVER (Name}

Primate Products, Inc.

COl - Charles River Labs, Inc.
8. IDENTIFICATION OF ANIMALS BEING DELIVERED

A.

B.

CONTAINER
TAG NO.,
CRATE
ORPEN
NO.

C.

NO.

AN!-

MALS

0.

PREVIOUS
INVOICE
NO.

I

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

1

1107003

Macaca fascicularis

M

4.13 TB Test: 7/29/2015

4A

1

1107004

Macaca fascicularis

F

3.31 TB Test: 7/30/2015

358

1

1107017

Macaca fascicularis

M

4.60 TB Test: 7/29/2015

26

1

1107022

Macaca fascicularis

F

3.21 TB Test: 7/30/2015

24A

1

1109001

Macaca fascicularis

M

4.48 TB Test: 7/29/2015

318

1

1109003

Macaca fascicularis

M

4.20 TB Test: 7/29/2015

32A

1

1109021

Macaca fascicularis

M

4.38 TB Test: 7/29/2015

18A

1

1109036

Macaca fascicularis

F

3.71 TB Test: 7/30/2015

198

1

1109049

Macaca fascicularis

M

3.92 TB Test: 7/29/2015

128

1

1110014

Macaca fascicularis

F

3.58 TB Test: 7/30/2015

328

1

1110029

Macaca fascicularis

M

4.74 TB Test: 7/29/2015

298

1

1110053

Macaca fascicularis

-~

i

----

M

3.40 TB Test: 7/29/2015

I

------1

1111001

Macaca fascicularis

M

4.59 TB Test: 7/29/2015

33A

1

1111017

Macaca fascicularis

M

3.92 TB Test: 7/29/2015

338

1

1111027

Macaca fascicularis

M

3.33 TB Test: 8/4/2015

248

1

1111231

Macaca fascicularis

M

3.21 TB Test: 7/29/2015

1

1112002

Macaca fascicularis

F

4.07 TB Test: 7/30/2015

1

1112008

Macaca fascicularis

F

3.39 TB Test: 7/30/2015

1

1112009

Macaca fascicularis

M

4.84 TB Test: 8/4/2015

36A

i

188

'

I

13A
20A

'

APHIS FORM 7020A
(JAN 90)

Replaces VS form 18 20A (9-88) which may be used

TRADE SECRET

(Page 5

of

16)

Document ID - 3002222 Page 5 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.

U.S. DEPARTMENT OF AGRICULTURE
ANIMAL AND PLANT HEALTH INSPECTION SERVICE

See reverse side for
additional information.

FORM APPROVED 0MB
NO. 0579-0036

1. INVOICE NO.

2. PAGE

0(1508017
5 of 5

CONTINUATION SHEET FOR
RECORD OF ACQUISmON, DISPosmoN OR TRANSPORT
OF ANIMALS
(Other than Dogs and Cats)

3. DATE OF DISPOSITION

PO # 4500116233

8/17/2015
--·--

4. DEALER'S LICENSE NO.

~

~ SALE

D

EXCHANGE OR TRANSFER

DONATION

58-R-0144 AND 58-8-0536

------·-··---·

-

6. BUYER OR RECEIVER (Name)

5. SELLER OR DONOR (Name)

Primate Products, Inc.

COl - Charles River Labs, Inc.
8. IDENTIFICATION OF ANIMALS BEING DELIVERED

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

1

1112071

Macaca fascicularis

M

3.96 TB Test: 7/29/2015
l

i

208

----~---

1

1201009

Macaca fascicularis

M

i

4.07 TB Test: 7/29/2015

!

3A

1

1201040

Macaca fascicularis

F

3.67 TB Test: 7/30/2015

21A

1

1202033(

Macaca fascicularis

M

3.17 TB Test: 8/7/2015

258

1

1203059

Macaca fascicularis

M

3.67 TB Test: 7/29/2015

108

1

1204018

Macaca fascicularis

F

3.42 TB Test: 7/30/2015

218

1

1204055

Macaca fascicularis

M

2.93 TB Test: 8/7/2015

TRADE SECRET

APHIS FORM 7020A
(JAN 90)

Replaces VS form 18 20A (9-88) whkh may be used

(Page 6

of

16)

Document ID- 3002222 Page 6 of 16

I

Accord.1ng lo I he Paperwork Reduction Act or 1995
.. an agency.may not cond uc\ or sponsor, and a. p e1son ..is no! r&q.Ulred. lo respond. lo, a colledion or
mformal:ion unlfts!I ii d1sptay5 a vaid 0MB C-Ofllro1 number. The valid 0MB control numbers for !his inforrnahon collecbon are 0579-0036 and 0579,0333.

:::r~~:/:~~~

UNITED STATES INTERSTATE AND INTERNATIONAL
CERTIFICATE OF HEALTH EXAMINATION
FOR SMALL ANIMALS

USDA r egulalion sh all be del

WARNING: Anyone who makes

1n slruclions,
1. TYPE OF ANIMAL SHIPPED (selact one only)

:,~~~:~~~:O~~~ :::~e~~.n~r

Ooog D

:.~c~~:;.

1
:;owing it

~::: ~~1

9fl)'

1~s

O

Ferret

D

OS]9-00JB

15-055

4. PAGE

3. TOTAL NUMBER OF ANIMALS

·!

·co1

1

of

3
7
7
. s:· NAME, ADDRESS, AND TELEPHO~N=E N~u=M=e=E=R~o=F~R=E=c~1p=1E=N=T~A~T~D~E~s=n~N~A~T~ID~N-(~C-D-N~S,~GN=E=E)------

."
; .\
'. \

0MB APPROVED

Rodent

,~'s"~'.;~~e16~1~_s._ 3e"£1A

PTLC/Primate Producls. Inc
34200 ors. Hammock Rd.
lmmokalee, FL 34142

1 nlermedta\e handler or car ner far

and
OST9-0JJJ
2, CERTIFICATE NUMBER - OFFICIAL USE ONLY

Oother_ _ _ _ __

(&] Nonhuman Primate

fraudulent may be subject lo a
fine of not more than $10.000 or

::~s:;;1~1
5, NAME, ADDRESS, AND TELEPHONE NUMBER OF OWNER (CONSIGNOR)

Cal

ivere<I lo

::::::~~~~=v:t:i:~,~~lo ~-;~mr;.~1::/~:R~;i~c:::::~:~";ted

~:t:==:~~~~:~fn1m=nmC:~~ac!~11~s~~:~~~i:,vae~::;;!:i=~~:::=:7h;:~u:c~h:r~~:~~~;:~ 18Wlfl9

UNITED STATES DEPARTMENT OF AGRICULTURE
ANIMAL ANO PLANT HEALTH INSPECTION SERVICE

TRADE SECRET
I

No dog, cal, noohuman pr.ima!l!I, or add1lional k1.nds or ciasses of anim•ls designated by

;,

·

6995 LOngley Lane

.Reno,.NV 89511
21
·-~-;. .],~~- . 66

239-867-2020

t-

USDA license/or Registration Number (if applicable) 58-R-0144

7. ANIMAL IDENTIFICATION
NAME, AND/OR TATIOO NUMBER
DR OTHER IDENTIFICATION

(1>1006073

8. PERTINENT VACCINATION, TREATMENT, AND TESTING HISTORY

BREED - COMMON
OR SCIENTIFIC
NAME

AGE

Cyno

A

SEX

COLOR OR
DISTINCTIVE
MARKS OR
MICROCHIP

M

RABIES VACCINATION

D

1 YEAR

02 YEARS D

Vaccination Dale

Product

BROWN

OTHER VACCINATIONS,
TREATMENT, AND/DR TESTS ANO RESULTS

3 YEARS

Product Type and/or Res_u_l_ls_ _ __

Dale
8-1-15

TB lest negative Lot# 443X

8-1-2015

TB test negative Lo!# 443X

(2 ) 1011019
(J)

1011039

4
{ >1012009

5
( l101201sc

16 )1101005

M

9. REMARKS DR ADDITIONAL CERTIFICATION STATEMENTS (WHEN REQUIRED)

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

I have verified the presence of the microchip, if a microchip is listed ,n box 7.

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.

-ic~~aa;~a;Nos.'T:aa~a"Eiii:AM~E"Ne""T"bii~'c.~cii!NTccDA~E"':"'~T~AE°'T~"'?NccN~caL"-,AN~EXCCP~O~R~T~(~I/F~N~E~E~D=E~DJ~-----------; NAME, ADDRESS, AND TELEPHONE NUMBER OF ISSUING VETERINARIAN
Amber Williams, OVM
34200 Drs. Hammock Road
lmmokalee, FL 34142

1L311C7E2NSF~oNn·dUaMBER AND STATE

AccredltedlX]Yes

O

No

H yes, please complete below

NAiiONAL A·ccR"EDiTATf6N. NiiMBE"R 075369

NOTE. International shioments mav renuire certification bv an Ac(;i'edi~~rinarian.

SIGNATURE OF USDA VETERINARIAN

Apply USDA Seal or Stamp here

DATE

DATE

I

7-29-2015

APHIS Form 7001
(NOV 2010)

L/

I

This certificate is valid for 30 days arter issuance

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

.......... ·-

..

1104003

.
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1104017C
1105019
1105023
1105027
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.
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RABIES
KILLED VIRUS tJ LIVE VIRUS

D-H-L

-

°'

OTHER VACCINATIONS, TESTS OR
TREATMENTS

SEX

COLOR OR
DISTINCTIVE MARKS

Date

Type/ Result

A

M

Brown

8-1-2015

TB test negative Lot# 443X

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1201009

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8-1-2015

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6995 Longley Lane
Reno, NV 89511

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PTLC/Primate Products, Inc
34200 Ors. Hammock Rd.
lmmokalee, FL 34142

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-

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VACCINATION HISTORY

ANIMAL IDENTIFICATION
RABIES

BREED-COMMON
OR SCIENTIFIC

AGE

SEX

A

M

NAME

1203059

COLOR OR
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OTHER VACCINATIONS, TESTS OR

D-H·L

.J KILLED VIRUS U LIVE VIRUS

Date

Cyno

Date

Product

TREATMENTS

Date

Type/ Result

8-1-2015

TB test negative Lot# 443X

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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.

No dog, cat. nonhu!Tiari prirrlate. or 8ddilionaf"kind'S or ciasses of animats desiQ-r18ted
USDA r egulation sh all be del ivered to any i ntermed1ate hendJer or car rter for
transportation in commerce, unless accompanied by a heal th certificate executed and
issuaj by a licensedX_~~_!inaric:11n (7 U.S.C. 21~<;'.:_f_~--~u!>(:::_11:~Pter A, Part 1).

0MB APPROVED
0579-0036
0579-0333

WARNING: Anyone who makes
1. TYPE OF ANIMAL SHIPPED (select one only)
I 2. CERTIFICATE NUMBER - OFFICIAL USE ONLY
a false, fictitious. or fraudulent
Do
DC t
Ooiher
statement on this document. or
og
a
-------15-056
uses such document knowing it
to be false, fictitious. or
~ Nonhuman Primate
Ferret
Rodent
UNITED STATES INTERSTATE AND INTERNATIONAL
fraudulent may be subject to a
CERTIFICATE OF HEALTH EXAMINATION
4. PAGE
3. TOTAL NUMBER OF ANIMALS
fine of not more than $10,000 or
FOR SMALL ANIMALS
imprisonment of not more than 5 ,, I· 36, , :
1 of 3
vears or both (18 U.S.C. 1001).
5. NAME, ADDRESS, AND TELEPHONE NUMBER OF OWNER (CONSIGNOR)
•' 1·
NAME; ADDRESS, AND TELEPHONE NUMBER OF RECIPIENT AT DESTINATION (CONSIGNEE)
'
C01
;
.
PTLC/Primate Products. Inc.
6995 Lot1gley Lane
34200 Ors. Hammock Rd.
UNITED STATES DEPARTMENT OF AGRICULTURE
ANIMAL AND PLANT HEAL TH INSPECTION SERVICE

'X1

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lmmokalee. FL 34142
239-867-2020

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89511
•. J'.75682-2166

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USDA License/or Registration Number (if applicable) 58-R-0144
7. ANIMAL IDENTIFICATION

NAME. ANO/OR TATIOO NUMBER
OR OTHER IDENTIFICATION

<1logo4142

8. PERTINENT VACCI NATION, TREATMENT,_AND TESTING_HISTORY

BREED - COMMON
OR SCIENTIFIC
NAME

AGE

Cyno

A

COLOR OR
DISTINCTIVE
MARKS OR
MICROCHIP

SEX

F

RABIES VACCINATION

D

1 YEAR

D

2 YEARS

D

Vaccination Date

OTHER VACCINATIONS,
TREATMENT, AND/OR TESTS AND RESULTS

3 YEARS
Product

Date

Product Type and/or Results

Brown

8-2-2015

TB test negative Lot# 443X

Brown

8-2-2015

TB test negative Lot# 443X

<2lo907196C
(3) 0909060
4
( )0909068

5
( >0912112

6
( )1001036

I

Cyno

I

A

I

F

I

9. REMARKS OR ADDITIONAL CERTIFICATION STATEMENTS (WHEN REQUIRED)

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

I have verified the presence of the microchip. if a microchip is listed in box 7.

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

animal(s) described above and

sheet(s). if

have been inspected by

on this date and

animal or other animals or would endanger public health.

D

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.

ENDORSEMENT FOR INTERNATIONAL EXPORT (IF NEEDED)
PRINTED NAME OF USDA VETERINARIAN

NAME, ADDRESS, AND TELEPHONE NUMBER OF ISSUING VETERINARIAN

LICENSE NUMBER AND STATE

Amber Williams. DVM

13172 Florida

34200 Ors. Hammock Road
lmmokalee, FL 34142

Accredited [XIYes

D

No

If yes, please complete below

NATIONAL A-ccR·eoii'AiioN· Ni.iMBER 015359
NOTE: International sliipments may require certiflcatton by an accredited veterinarian.
SIGNATURE OF USDA VETERINARIAN

APHIS Form

(NOV 2010)

Apply USDA Seal or Stamp here

DATE

sz:WtlS~2G{~7Rl~r1{'!lit~ I !IJ.

7001
This certificate is valid for 30 days after issuance

7

DATE

i
7-30-2015

TRADE SECRET

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CERTIFICATE NUMBER
UNITED STATES INTERSTATE AND INTERNATIONAL CERTIFICATE OF HEALTH EXAMINATION FOR SMALL ANIMALS
PAGE

ANIMAL IDENTIFICATION

ANO/ OR TATIOO NUMBER

OR SCIENTIFIC

Cyno

1003136

"

.

1005066

.

1006058

"

1006078

"

1008016

RABIES
AGE

SEX

A

F

NAME

1002124
1005014

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1101036

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1101092

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1105036

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.
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.
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.
.

1101034

.

.
"
.
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Product

Type/ Result

"

1012070

Date

TREATMENTS

TB test negative Lot# 443X

"

1012014

Product

OTHER VACCINATIONS, TESTS OR

D-H-L

t, KILLED VIRUS J LIVE VIRUS

Date

"

1103020

°'

8-2-2015

1010032

.

COLOR OR
DISTINCTIVE MARKS

Date

1010002
1011004

0
....,

Brown

.
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1008080

0

VACCINATION HISTORY

BREED-COMMON

"

"

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"

.
.
.

.

"

"

"

"

.
.
.

.

"

.

"

"

"

"

"

"
TB test negative Lot# 443X

"

.

.

.

.

"

.

A

F

Brown

8-2-2015

TRADE SECRET

~&/

0
0

-

of 3

C01
6995 Longley Lane
Reno, NV 89511

PTLC/Primate Products, Inc
34200 Ors. Hammock Rd.
lmmokalee, FL 34142

COMPLETE USDA TAG, COLLAR

2

s
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NAME, ADDRESS ANO TELEPHONE NUMBER OF CONSIGNEE

NAME, ADDRESS AND TELEPHONE NUMBER OF OWNER/CONSIGNOR

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(Continuation Sheet)

PAGE

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VACCINATION HISTORY

ANIMAL IDENTIFICATION
BREED-COMMON
OR SCIENTIFIC
NAME

AGE

Cyno

A

1107022

.
.

1109036
1110014

SEX

"

.

Type/ Result

TB test negative Lot# 443X

.

.

8-2-2015

.

.

"

1201040

.

.

1204018

Cyno

A

F

.

OTHER VACCINATIONS, TESTS OR
TREATMENTS

D-H-L

Brown

F

.

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RABIES
L, KILLED VIRUS U LIVE VIRUS

Date

.

1112008

COLOR OR
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Date

"

.

1112002

---

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of 3

3

C01
6995 Longley Lane
Reno, NV 89511

PTLC/Primate Products, Inc
34200 Ors. Hammock Rd.
lmmokalee, FL 34142

----- -----

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NAME, ADDRESS AND TELEPHONE NUMBER OF CONSIGNEE

NAME, ADDRESS AND TELEPHONE NUMBER OF OWNER/CONSIGNOR

COMPLETE USDA TAG, COLLAR
AND/ OR TATIOO NUMBER

.

IS--or-4'

Date

Product

Product

.

.

.

.

.

.
.

.

Brown

8-2-2015

TB test negative Lot# 443X

.

.

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According tot he paperwork R oduclion Act of 1995, an agency may not cond ucl or sponsor, and •.person is not reqwred to respond to, a collection of

No dog, cal, nonhuman primale.

informatkm untess it displays a valld 0MB control number. The valid 0MB control numbers for ttus mformal•on 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

?' additional kinds or classes of animals designated by

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).

0MB APPROVED

0579-0036
0579-0333

WARNING: Anyone who makes
1. TYPE OF ANIMAL SHIPPED (select one only)
2. CERTIFICATE NUMBER· OFFICIAL USE ONLY
a false, fictitious, or fraudulent
UNITED STATES DEPARTMENT OF AGRICULTURE
Oother
Ooog Ocat
statement on this document. or
15-057
ANIMAL AND PLANT HEAL TH INSPECTION SERVICE
uses such document knowing it
Nonhuman Primate 0Ferret 0Rodent
to be false, fictitious, or
UNITED STATES INTERSTATE AND INTERNATIONAL
fraudulent may be subject to a
CERTIFICATE OF HEALTH EXAMINATION
4. PAGE
3.
TOTAL
NUMBER OF ANIMALS
fine of not more than $10,000 or
FOR SMALL ANIMALS
imprisonment of not more than 5.• 6''.';
1
years or both (18 U.S.C. 1001), '
.-;..· '6. NAME, ADDRESS, AND TELEPHONE NUMBER OF RECIPIENT AT DESTINATION (CONSIGNEE)
5. NAME, ADDRESS, ANO TELEPHONE NUMBER OF OWNER (CONSIGNOR)

[&:I

..

PTLC/Primate Products, Inc.
34200 Ors. Hammock Rd.
lmmokalee, FL 34142
239-867-2020

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,.,

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69\15 LQ~gley Lane

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USDA License/or Reaistration Number (ifapp/icab/e) 58-R-0144

7, ANIMAL IDENTIFICATION
NAME, AND/OR TATTOO NUMBER
OR OTHER IDENTIFICATION

8. PERTINENT VACCINATION, TREATMENT, ANO TESTING HISTORY

BREED - COMMON
OR SCIENTIFIC
NAME

AGE

SEX

COLOR OR
DISTINCTIVE
MARKS OR
MICROCHIP

Cyno

A

F

BROWN

.

.

"

.

F

Brown

1
( >1002178

{

4

>1105033

(5>1111027

"

{5 >1112009

Cyno

1 YEAR D 2 YEARS

D

Vaccination Date

OTHER VACCINATIONS,
TREATMENT, AND/OR TESTS AND RESULTS

3 YEARS
Product

.

(2) 1004053
(3) 1101033

RABIES VACCINATION

D

Date

Product Type and/or Results

8-7-15

TB test negative Lot# 443X

.

.

8-7-2015

TB test negative Lot# 443X

"

.
A

9, REMARKS OR ADDITIONAL CERTIFICATION STATEMENTS (WHEN REQUIRED)

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 have verified the presence of the microchip. if a 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 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)

PRINTED NAME OF USDA VETERINARIAN

NAME, ADDRESS, AND TELEPHONE NUMBER OF ISSUING VETERINARIAN

LICENSE NUMBER AND STATE

Amber Williams, DVM
34200 Ors. Hammock Road
lmmokalee, FL 34142

13172 Florida

D

Accredlted(&]Yes
No
If yes, ~lease complete below

iiA:ri<>NAL ACCREoiiAnoN-NUMB-ER 075369
NOTE: lnlernational shipments

SIGNATURE OF USDA VETERINARIAN

. ---

-

(NOV2010)

--- .

Apply USDA Seal or Stamp here

DATE

mav reauire certification bv an .accredited veterinarian~

s1~;5su~t}G V~TERl~N

/,,y J

11/- ~/ Yj/t :/f{cc/J!~/{<J__/
/

(

)

DATE
8-4-2015

,

This certificate is valid for 30 days after issuance

TRADESECRET
-----···-····----~-

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Accordmg lo! he Paperwork Reduction Ac! of 1995. an agency may no! cond ucl or sponsor. and a person ;s no! requ;red lo respond lo, a collection of
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.

UNITED STATES DEPARTMENT OF AGRICULTURE
ANIMAL AND PLANT HEALTH INSPECTION SERVICE

UNITED STATES INTERSTATE AND INTERNATIONAL
CERTIFICATE OF HEALTH EXAMINATION
FOR SMALL ANIMALS

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

I

nlermed1at& handler or car lier for

I

0579-0036
0579-0333

2. CERTIFICATE NUMBER· OFFICIAL USE ONLY
15-058

D

(g]

'
'

34200 Drs. Hammock Rd.
lmmokalee, FL 34142
239-867-2020

4. PAGE

1

,.

.·•

USDA License/or Reaistration Number (if aoo/icablel 58-R-0144

7. ANIMAL IDENTIFICATION
NAME, AND/OR TATTOO NUMBER
OR OTHER IDENTIFICATION

BREED - COMMON
OR SCIENTIFIC

8. PERTINENT VACCINATION, TREATMENT, AND TESTING HISTORY

AGE

SEX

NAME

COLOR OR
DISTINCTIVE
MARKS OR
MICROCHIP

RABIES VACCINATION
0

1 YEAR

D

2 YEARS

D

OTHER VACCINATIONS,
TREATMENT, AND/OR TESTS AND RESULTS

3 YEARS
Product

Vaccination Dale

Date

Product Type and/or Results

(t) 1202033C

Cyno

A

M

Brown

8-10-2015

TB test negative Lot# 443X

(2 ) 1204055

Cyno

A

M

Brown

8-10-2015

TB test negative Lot# 443X

(3)
(4)

(5)
(6)

9. REMARKS OR ADDITIONAL CERTIFICATION STATEMENTS (WHEN REQUIRED)

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

for rabies and has/have not been exnosed to rabies.

ENDORSEMENT FOR INTERNATIONAL EXPORT /IF NEEDED)
PRINTED NAME OF USDA VETERINARIAN

NAME, ADDRESS, AND TELEPHONE NUMBER OF ISSUING VETERINARIAN

LICENSE NUMBER AND STATE

Amber Williams. DVM

13172 Florida

34200 Ors. Hammock Road
lmmokalee, FL 34142

AccredltedOOYes

D

No

If yes, please complete below

NAfioNAL Acci~·ioiTAfioi.· tiliir.ieeR 075369
NOTE: International sh1oments mav reauire certification bv an accredited veterinari~o,---.
SIGNATURE OF USDA VETERINARIAN

Apply USDA Sea/ or Stamp here

DATE

S'cJiliSSUINGVETERIN~

~Y.(NOV 2010)

0k!

"O

""""
;;
0
....,

C01
6995 LOligley Lane
Reno,.NV 89511
'· ·-775682-2166

-.

s

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........s
....

-"'

· 6. NM:'E, ADDRESS, AND TELEPHONE NUMBER OF RECIPIENT AT DESTINATION (CONSIGNEE)

5. NAME, ADDRESS, AND TELEPHONE NUMBER OF OWNER (CONSIGNOR)
PTLC/Primate Producls, Inc.

~
<Q

0

0MB APPROVED

transp011ation 1n commerce, unless acco mpant-ed by a heal th certificate executed and
issued bv a licensed veterinanan (7 U.S.C. 21.43.9; CFR, Subchaoter A. Part 2).

1. TYPE OF ANIMAL SHIPPED (select one only)
WARNING: Anyone who makes
a false, fictitious. or fraudulent
Oother
0Dog O c a t
statement on this document, or
uses such document knowing it
Nonhuman Primate 0Ferret
Rodent
to be false, fictitious. or
fraudulent may be subject to a
3.
TOTAL
NUMBER
OF
ANIMALS
fine of not more than $10.000 or
imprisonment of not more than 5. 2·.:,.
vears or both 118 U.S.C. 10011. '

0

C

"3
"s.

,

~

ieflr0M ,

DATE
8-7-2015

This certificate is valid for 30 days after issuance

TRADE SECRET

"'
(I)

....w
0

Hi

....

e

0
0

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.

a false. fictitious, or fraudulent

UNITED STATES INTERSTATE AND INTERNATIONAL
CERTIFICATE OF HEALTH EXAMINATION
FOR SMALL ANIMALS

I

No dog, cat, nonhuman primate. or additional kinds or classes of animals designated by

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

statement on this document, or

0Dog

uses such document knowing it
to be false, fictitious, or

(g] Nonhuman Primate

fraudulent may be subject to a
fine of not more than $10,000 or

Ocat

Oother
0Ferret

D

0MB APPROVED
0579-0036
0579-0333

2. CERTIFICATE NUMBER-OFFICIAL USE ONLY

1. TYPE OF ANIMAL SHIPPED (select one only)

WARNING: Anyone who makes
UNITED STATES DEPARTMENT OF AGRICULTURE
ANIMAL AND PLANT HEALTH INSPECTION SERVICE

TRADEI SECRET

"3
=

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s
<..>

C
C

........
........
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...

-

15-059

....,

Rodent

0

:;

4. PAGE

3. TOTAL NUMBER OF ANIMALS

1···

imprisonment of not more than~·

1
j l
vears or both 118 U.S.C. 1001,.' '
":.. '6. NAME; ADDRESS, AND TELEPHONE NUMBER OF RECIPIENT AT DESTINATION (CONSIGNEE)
5. NAME, ADDRESS, AND TELEPHONE NUMBER OF OWNER (CONSIGNOR)

..

l

PTLC/Primate Products, Inc.
34200 Drs. Hammock Rd.
lmmokalee. FL 34142
239-867-2020

"'.~.

'

r, '

.C01
6995 Lpngley Lane
..Reno,,NV 89511
~....... ..1-7~2-2,166

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--

USDA License/or Reoistration Number (if aoo/icab/el 58-R-0144

8. PERTINENT VACCINATION, TREATMENT, AND TESTING HISTORY

7. ANIMAL IDENTIFICATION
NAME, AND/OR TATIOO NUMBER
OR OTHER IDENTIFICATION

BREED - COMMON
OR SCIENTIFIC
NAME

AGE

SEX

COLOR OR
DISTINCTIVE
MARKS OR
MICROCHIP

Cyno

A

M

Brown

(l)1104005

~
(3)
(4)

(5)
(6)

------ ------

--- -----

-----

9. REMARKS OR ADDITIONAL CERTIFICATION STATEMENTS (WHEN REQUIRED)

RABIES VACCINATION

D

1 YEAR

D

2 YEARS

D

OTHER VACCINATIONS,
TREATMENT, ANO/OR TESTS ANO RESULTS

3 YEARS

----- ----- -----Product

Vaccination Date

Date

Product Type and/or Results

8-7-2015

TB test negative Lot# 443X

--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

have verified the presence of the microchip, if a microchip ,s listed 1n box 7.

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.

D

To my knowledge. the animal(s) described above and on continuation sheet(s) if applicable, originated from an area not quarantined

for rabies and has/have not been exnosed to rabies.

NAME, ADDRESS, AND TELEPHONE NUMBER OF ISSUING VETERINARIAN

ENDORSEMENT FOR INTERNATIONAL EXPORT /IF NE.EDE.DI

PRINTED NAME OF USDA VETERINARIAN

LICENSE NUMBER AND STATE
13172 Florida

Amber Williams. DVM
34200 Ors. Hammock Road
tmmokalee. FL 34142

D

Accredlted(g]Yes
No
If yes, please complete below

NAi"ioNAL ;.-ccR·eoii'Ai"ioN-NiiMBE_R _
075369
NOTE: lnternatio~f shtnments mav renuire certification bv an accredite

SIGNATURE OF USDA VETERINARIAN

Apply USDA Seal or Stamp here

DATE

DATE
S~S.AN~VETERG/IA~~ I

r(NOV2010)

an.

-I

1/i

' . ~

al

8-4-2015

This certificate is valid for 30 days after issuance

TRADE SECRET
,---~··------~---~

-;a


IQ
I~

,_.

....
0

Hi

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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.

U.S. DEPARTMENT OF AGRICULTURE
ANIMAL AND PLANT HEALTH INSPECTION SERVICE

EXCHANGE OR TRANSFER

2. PAGE

l. INVOICE NO.

OR150611B

RECORD OF ACQUISITION, DISPOSITION OR TRANSPORT
OF ANIMALS (Other than Dogs and Cats)
SALE

FORM APPROVED 0MB
NO. 0579-0036

See reverse side for
additional 1nformat1on.

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.

DEALER'S LICENSE NO.
SS-R-Ol 44 AND SS .. B·OS 36

i

- ·-· - --·----~ --·-·----- - - - - - -------·-·- - -·· ------~---------- ··--

6. BUYER OR RECEIVER (Name and Address, indude Zip Code)

5. SELLER OR DONOR (Name and Addre,s~ k1clude Z1iJ Code)

N01 - FDA/CSER
10903 New Hampshire Avenue
Silver Spring, MD 20993 USA

Primate Pmducts, Inc.
34200 Doc.tors Hammock Road
Immokalee, FL 34142 USA

7. USDA LICENSE NO. (tf any)

8. IDENTIFICATION OF ANIMALS BEING DELIVERED
B.

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

........- - - · - · - - - - - - r-------··--·-····-----+- ..-

16-A

3.76 , TB Test: 5/26/2015

!OSE

Macaca mulatta

17·6

I 06E

Macaca mulatta

F

2.46

TB Test: 5/26/2015

18-A

i 06!

Macaca mulatta

F

3.60

TB Test: 5/26/2015

F

3. 70

TB Test: 5/26/2015

-------- ---------·--··--------

,061(

18-B
-----------,---~

T ' · - - · · • , , ,. . . . . . . . ~ . .- - - - ... .

21-1\

07N

F

3.70

TB Test: 5i26/2015

19-B

.09X

F

3.90

TB Test: 5/26/2015

16-B

j OBJ

Macaca mulatta

F

3.62

TB Test: 5/26/2015

21-B

Macaca mulatta

F

3. 74 : TB Test: 5/26/2015

20-1\

) Macaca mulat.ta

3.99 : TB Test: 5/26/2015

. DELIVERY BY COMMERCIAL CARRIER
9. DELIVERY BY (X" one)

r-J

. 11. BILL OF LANDING NO

10. TRUCK LICENSE NO.
Dealer's Truck
( Seller or Donor)

Buyer's Truck

AWB#

12. NAME AND ADDRESS OF COMPANY OR FIRM

13. NAME /\ND ADDRESS OF TRUCK DRIVER

Frames' Animal Transportation

Frames' Animal Transportation

1119 Haverford Road

1119 Haverford Road

Ridley Park, P;.\ 19078 USA

Ridley Park, Pi\ 19078 USA
-

· - - - - - ··-~-

-

-----

------·-·

--·--------

-----------·-----·--------------

DELIVERY RECEIPT · TO BE COMPLETED BY BUYER OR RECEIVER

----------------·--. ---·----------··· ·-- - ----------~ ·-·-- ----~--------------~----------- ------··-----~------··-

14. ANIMALS DELIVERED WERE(''.\" anei

JN Al'PARENT GOOD COND[T!ON
15. TOTAL NUMBER RECEIVED

NUMBER DEAD

119. l!TLE

• J 8. BY (Signature)

AP~HS FORM 7020
(J/\N 90)

- (RCP!dli~i VS FGRP.116-20,

whk:h· 15

REJECTED (Attach explanation for rejection)
\ 17.-NUMBER

ALIVE _____________ .
20. DATE

now obsolete, and

!1PHIS fom1 7020 {10-80) which may be used.)

TRADE SECRET
oI JO { a~ed

f££8l6Z - m 1uaumaoa

(o,:

Jo

,: a6ea)

f111s record is authorized by law (7 USC 2131·2156). 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.

FORM APPROVED 0MB

See reverse srde for
addit1ona1 information.

NO. 0579-0036

U.S. DEPARTMENT OF AGRICULTURE
ANIMAL AND PLANT HEALTH INSPECTION SERVICE

CONTINUATION SHEET FOR
RECORD OF ACQUISITION, DISPOSITION OR TRANSPORT
OF ANIMALS
(Other than Dogs and Cats)

3. DATE OF DISPOSITION

PO II N01-FDA

6/11/2015

, 4. DEALER'S UCENSE NO.

SALE

EXCHANGE OR TRANSFER

DONATION

58-R-0144 AND 58-B-0536

5. SELLER OR DONOR (Name)

Primate Products, Inc.
8. IDENnFICATION OF ANIMALS BEING DEUVERED
A.

,c

8.

CONTAIN[R
TAG NO.,
CRATE
OR P[N
NO

NO.

l

D.
IND[VIO!JAL
IDENT
TATTOOS .. TAG i

PREV[CUS

I

IN·JOICE
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

-L--i Macaca mulatta

3.35

OGR

Macaca mulatta

3.54

D9FA

Macaca mulatta

3.94 i TB Test: 5/2612015

---·~-·-~·~--

19-A

E.

10-3

'

Test: 5/26/2015

!

Macaca mu!atta

3. 98 . TB Test: 5/26/2015

; Macaca mulatta

3.77 TB Test: 5/26/2015

12-8
11-A

14-A

DF38

-- l

------

·-;oF:i~i---r~ia~aca-rn~latta

·.1.·

r

M

!

l

----·l----·--· ·----···~-...________.__
j Macaca mulatta
M

i.
.

3 89~est: 5/26/2015
:

; DF3P

15-A

1

11-B

•DFf8

Macaca mJ\atta

DFTZ

Macaca mulat.ta

10-A

DFVS

Macaca rnulatta

3.36 • TB Test: 5/26/2015

13-A

DfVC

Macaca mulatta

3.91 TB Test:

~lilG!Cil ~1ulatta-

3.34 TB Test: 5/26/2015

l

15-B

'

-----~~-~---~---~-------1----~---------- --

14-8

.. ··-· ------·-··-· ···-------···-··· +--DF4C
j Macaca mulatta

I

-· ,r---~-------

4.32 . TB Test: 5/26/2015

!

·l-----[
____4.15---. ····- --5/26/2015
---- ---- !
M

M

.

c--·--···--·c-··------

TB Test:

3.18 'TB Test: 5/26/201',

I

13-B

.

f. - r ----

l2-A - - --- t"

, DFVF

,

: _______ :oFzE-----~caZa~~i;iatta

5/26/2015

J

TB Test: 5/26/2015

TRADE SECRET
APHIS FORM 7020A
(JAN 90)

Rev/aces VS form 18 JOA (q·88) which may be used

0 I JO Z .~.d fff8l6Z - m JUatunJO(l
(Ol

J.O

;,; afrea)

____________ _____
,

1

1

I WARNING Anyan,:; who makes
alalsc.f1ct1t1ous oriraudt1len1

Ii

I

UNITED STATES INTERSTATE AND INTERNATIONAL
CERTIFICATE OF HEAL TH EXAMINATION
FOR SMALL ANIMALS

[ZJ

D

,,,_

OMS APPROVED
, _ ~~~
05 9 00 0

•-

0578-0333

2. CERTIFICATE NUMBER· OFFICIAL USE ONLY

15-042
Roden;


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.

.

PAGE

1 of 2

..-,... --,---'-'-"-'--l--c-'6.-N-A-M=E=,-A-D-CCD-CR·ESS, AND TELEPHONE NUMBER 6F-RECiPiENT AT DESTINATION (CONSIGNEE)

PTLC.'Pnmate Products tnc
34200 Ors Hammock Rd
Jmmokaiee FL 34142
239-867 -2020

N01-FDA CBER
10903 New Hampsirne Avenue
_Silve1Spring. MD 20993
,., L 240ct!02-7372

-~SOA License/or Registration Number (if aqpl1cable) 56-R-0144

--·

7. ANIMAL IDENTIFICATION
------

NAME. ANDIOR T.O.TTOO Nc1Mi3ER
OR OTHER IDENTIFICATION

I
i

I

I

11104R

I
I

Rilesus
----··~·

-± "
i

(5) 06K

.

·------·

8. PERTINENT VACCINATION, TREATMENT, AND TESTING HISTORY

I
BREcED - COMMON
OR SCll::NTIFIC
NAME

r==

'51 o7N

,

I

'I

-

Oc,1

statement 01; On~ document. o'.
g
...
' ---,. ...
uses such documenl knowing it
Nonhuman Pnmate 0Ferret
to be f;;ilse. fict1t1ous. or
fraudulent may· be subiect to a
t·---·---·
,,118 al nol mo,e than 1o.. OOO or I 3. TOTAL NUMBER OF AN!MALS
1mpnsor1merl! of not more than 5
24
ears or \10th (18 Li S.C. 1001)

- 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

1. TYPE OF ANIMAL SHIPPED (select one only)
00ther

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

,

I

I

SEX

AGE
1

---·-

D

i

I
I
I

A

I

:
I

i

t--

I -r

D

·-~~~~~.!~~~on Uate

2 YEARS

I

I

I I

,_.,__

I

________ __J_

I

II

TREATMENT. ANDtOR TESTS AND RESl;LTS
__

!

Date

Product Ty~~ndl_o_r_R_e_su_l_ts_ _ _ __

\

5-29-15

I

TB test negative Lot# 442X

I

I

T..

I

---

F

9. REMARKS OR ADDITIONAL CERTIFICATION-STATEMENTS~ REQUIRED)

3 YEARS

OTHER VACCIN~~-NS,

I
I

i

---

D

Product

I

BROWN

I

I

'

1 YEAR
~-

l

i

I

l'(A81ES VACCINATION

I

I

i
1

COLOR OR
D1STINC1IVE
M.t,RKS OR
MICROCHIP

·1

------1----·

i

-·--+--

··------

-------· - - - ' - - - - - ' - - - - - - - - - - - - - - - - - - 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 have veriried U1e pr<-Jsence of the rnicrochip. if a m1c.roct\1p is l1~1ed 1n box 7.

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,

To my knowledge, !he animal(s) described above and on con!mua11on
rabies and has/have not beer, 1!:2':.E:~!d to rabtes

ENDORSEMENT FOR INTERNATIONAL EXPORT IF NEEDED
PRINTED NAME OF USDA VETERINARIAN

sheetts) if applicable.

NAME, ADDRESS, AND TELEPHONE NUMBER OF ISSUING VETERINARIAN
A
W
mber 111,ams, DVM

rl

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0

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8
1:

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I Accredited[Z]Yes
No
If yes, please complete below

lI

NATIONAL ACCREDITATION. NUMBER

):f%;:z~I; V~0~£:!~/(~ I~~\ ,

------\

0

0

from an area not quarantined

I

34200 Ors. Harnrnock Road
lrnmokalee. FL 34142

....~
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ongmated

LICENSE NUMBER AND STATE
1317° Florida
"

---c-c--=-=-c-c-c---c.,----:-----r-=-==-----t-lcc,O'c1ccEc--cc·l=-nccteccH=lac-c=t10~1_:?~~~!1ents mar,rcquirc certifis:;ation b an accredit
SIGNATURE OF USDA VETERINARIAN

APH!S Form 700i
(NOV 2010)

Apply USDA Seal or Stamp here

I DATE

-I

J
1 his certificate is valid for 30 days\e_ft&r issuance

ve!e1maria1

1

075369
1

DATE

15-26-2015

I

I
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,

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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

2

N01-FDA.CBER
10903 New Hampshire Aven~e
I Silver Spring MD 20993

PTLC/Prnnate Products. Inc
34200 Drs. Hammock Rd
lmmokalee. FL 34142
ANIMAL IDENTIFICATION
BREED ·COM MON
OR S.UENfL~!C

AGE

VACCINATION HISTORY

SEX

NAM[

R,~BIES

Tl

CDIOR OR
_ DiSTlNll!Vf.:. IV1Af;KS

KlLLE D VIRUS

R~esus

A

F

Product

OTHER V,~CCIN/\TIONS, TES rs OR
TREATMf:NTS

D-H-L

UVL V!RUS

Date

Type/ Result

Brown

5-29-015

I TR test negative Lot# 442X

Brown

5-29-2015 I TB test negative Lot# 442X

Date
09X

~+--

NAME, ADDRCSS AND 1lLEYHONL NUMBLH 0~ lCNSIGNtt

NAMF:. ADDRESS AND fELEPhONE NUMBER CF O'v\'NERICONSi(iNUR

COMPLETE USC'A TAG, CCLL/\R
AND/ OR l AHOO NUMBER

2

~ C' Lf

Date

Product

OBJ

OBK
OEX
OFL.

OGR

F

D9FA

M

DF2Z

DF38
DF3N
DF3P
DF4C
DFT8
DFTZ
DFV5

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c,r;µd,J,/ 1ttilc12riur RADE SECRET
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(Page 5

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10)

Document ID - 2978333 Page 5 of IO
\i-rN U dSC 2131~2156). Failure to maintain th1,; n·ronJ CrJr'
:rrpr1s;:;r,rnent fer not rno"e ~h2n 1 YF:.Jr, or zi finP of n!Jt mere

. l. !~NOICE r,10.

U.S. DEPARTMENT OF AGRICULTURE

ANIMAL AND PLANT HEALTH INSPECTION SERVICE

OR150iil 1A

RECORD OF ACQUISITION, DISPOSITION OR TRANSPORT
OF ANIMALS {Other than Dogs and Cats)
SALE

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

J.\l5TRtY..:'TiC'·JS· Cc1mc1!r.te cippl1G1b'c fri~rris l rhrouqh 13. Original an1 ore
flel;vi:;ry lEi rrarJe · Item:; ;.<-1 tr.rouqb 21 mJst ti-: completed. Cr'y1na!
returried to Or:aler ( Se!ltr or Onno~j. Cq;v t·tJO to be rr::~a1ned by

4. DEALER'S UCU/SE NO

Sht~·-=~ (AP:ilS FCRM 702'.'JA) as n('.f:(:td

6. BL/fER OP RECEIVER (/IJ,1n7fl and 1-'lL--tdr2ss/ 1ndude Zit) Cxle)

SELLER or1_ DONOR (Name and Address;. include Z1i-, Corie)

Primate Products, Inc.
34200 Doctors Hammock Road
lr1'rnokalee, FL 34142 USA

~101- lRf'/NIAID
8200 Research Plaza
Fredrorick, MD 21702 USA

7. USDA IJCENSE 110 (if an:1!

8. IDENTlF[CA TJON OF MllM{•.LS BEil'IG CEUVERED
B.
CON·

~10

TAiNER
T!...G NO,,

AN!-

PREVIOUS
:1'lVOICC

Mil.LS

NO

CRA!E

E.

D

C

l'IDl\JlDIJ,'.L
EST

_ IDE~].__ ~,
: ,A,TTO(..J'.),

~ws.

(J iiny,

1

CR PEN
NO

I

WE;c;1--ff

SPEC1ES

"tJ

HE~AR:<S

(:..~·1r.drtion, et,..-.)

(\";:s.)

(iiapplicable) :

4-;l.

OSM

1 Macaca

rnulatta

F

3.99

TB Test:

s12r,;201s

5-A

;A6V091

Maoca rnulatta

F

7.83

TB ,est: 6/ l/2015

2-A

'DF79

Macaca rn,1latta

M

5.00

TB Test: 6/1/2015

2B

: DFBGA

Macaca rnulatta

M

4 96

TB Test: 6/1/2015

3-;.\

DFCX

Macaca rnulatta

M

•l.92

TB Te;t: 6/1/2015

u.

; DFEZ

, Macaca rnuialta

M

4.95

TBTcst:6/1/2015

l ·B

DFHK

Macaca r1ulatta

M

5.02 · TB Test: 6/1.12015

3-B

DFLD

; Macaca mulattJ

M

5.33

Macaca mulatta

F

3.69 , TB Test: 5/26/2015

Macaca mulatta

F

7.05

;076
S-6

PH 1015

TB Test: 6/1/2015

TB Test: 6/1/2015

DELIVERY BY COMMERCIAL CARRIER
9. DEUVERY BY ('.\" one)
Buyer's Tr,JCk

11. BILL OF t..AclOlrlG NO

10. TRUCK LJCENSE NO.

-·· Dealer's Truck
(Seller or Doner)

';\'NB#:

. 13. NAME AND ADDRESS Of TRLCK DR[VER

1.2. NAME AND .ADDRESS OF COMPANY OR FIRM
frames' Animal Transportation

Frames· Animal Transportation

11 l.9 Haverford Road

11 l iJ Havecforcl Road

Ridley Park, P,\ 190 78 USA

R:c!ley Par',, PA 19078 USA

DELIVERY RECEIPT· TO BE COMPLETED BY BUYER OR RECEIVER
14. ANIMALS DELIVERED WERE ('.\"one)
IN APP/\RENT GOOD COND[T[ON
-

15 TOTAL NUMBER RECEIVED
18. BY (Signature)

APIUS FORM 7020
(J1\N 90 !

12

--·····---

-

"

-·----··

16. NUMBE;z DE..'.D
19. TJTLE

o'Fs;11ete~-i1nd

(Rep!aces-V5FCJfi'r:i16-i1X vvhich Is now
APHJS form 7020 ( 10-80) which mav l!e used.!

REJECTED (,4ttacl, e\Dlan,,t,an for rejection)
------~---·; 17. NUMBER ALIVE

20. DATE

.. TRADE SECIIBT

(Page 6

of

10)

Document ID - 2978333 Page 6 of 10
Thi.:: rr:c'.)rd ;r, Juthonzcd by law (7 ,JSC -:?.I3t-2l56). Fai:ure tG rna1rita1n thLc;
rc nr:0t·!on cf :1c~nse ard/or 1r-'pw;c,r·rP1-:int fm not more tha:1 1 '/ear, or a f1pe
1

nor

Se.!:"~ rev<:~rse
'or
add1t1ona I ,nf,,,,.,,.,,,,nn

c;:ir- ·0·:;uH.1n
ni11rr~ than

L PAGE

1. [NVO[CE NO.

U.S. DEPARTMENT OF AGRICULTURE
ANIMAL AND PLANT HEALTH INSPECTION SERVICE

OR 150611A

CONTINUATION SHEET FOR
RECORD OF ACQUISITION, DISPOSITION OR TRANSPORT
OF ANIMALS

FGR:-1 APPROI/EU 0',18
NO D579-0Q3fi

2 of 2

, 3. DATE OF DISPOSITION

PO /.' NOJ-(f'.F

6/11/2015

(Other than Dogs and Cats)

4. DEALCR'S ucrnsE NO

SALE

:y_

EXCHANGE OR TRANSFER

DONATION

5. Sl:LLER OR DGr·IOR (N,me!

Sfl·R-0144 AND 58-B-053(,

6. BUYi::R Of<. Rl:CElVER (Name!

Primal 2 Products, Inc.

~101
8 DUJTIFIC.AT!ON OF AMMJ\l.S f3FIIIG DELlVERED

A

;\(X ·SU

D

H

'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

F

6.82 ; TB fest: 6/1/2015

PH 1071

Mac2ca rnulatta

r-

8.54 TB T0st: 6/1/2015

TRADE SECRET

1\PHIS FORr-,1 7020A
(JAN 90)

Rcofac2s VS form 18 20A (9-88)

w/71'--i'

mav be used

0

-;;;

"3C:
"'s.

'al

0

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

[WARNING Anyo,i~ wl1011 al\es
a false 11cl1t1ous or fraudulent

I

UNITED STATES DEPA.RTMENT OF flGR!CULTURE
ANIM,-\L AND PLANT HEALTH INSPECTION SERVICE

UNITED STATES INTERSTATE AND INTERNATIONAL
CERTIFICATE OF HEALTH EXAMINATION
FOR SMALL ANIMALS

statement on this document or
uses such oocume'll krwvvmg 1t
to he false. ficti\ious. or

fraudulent may be subject 10 a
fine uf 1101 more iilan s to 000 or
11npnsonment of not niore U1a~ 5,
______ ..J_~arsc:rb~i?__l:!_~-~-.:_ 1001).

-----·"
5. NAME, ADDRESS, AND TELEPHONE NUMBER OF OWNER (CONSIGNOR)

1. TYPE OF ANIMAL SHIPPED (select one only}
0Do·
Cat
'"'ther

I'

D
rvl , ..
D
D
!~
I 3. TOTAL NUMBER OF.ANIMALSg

D

v

Ferret

OMS APPROVED

0579-0036
oi~,1\1-0:~:n

2. CERTIFICATE NUMBER - OFFICIAL USE ONLY

--------

Nonhuman Pr,rnate

.

Redel t

! 4. PAGE
I 1 of 2

_

_ L _ _ _ ___

...

6. NAME, ADDRESS, AND TELEPHONE NUMBER OF RECIPIENT AT DESTINATION (CONSIGNEE)

Frederick.MD 21702

239-867-2020

· 301·631-7279
1

USDA Licenseior Reg isl ration Nu111ber (ii applicaQJeJ_~_".:.R-0144

·-·

7. ANIMAL IDENTIFICATION
,-

'

'

T

.

'

NAME. ,.NQIOR TA' TGO ,sUMBER
OR OTHER iOENTIFICAT.ION

l 1J

OSM

\Me' '

' ' '-

.

CYNO

,!
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.

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!

-··----·-

oFBGA.

(SJ DFCX
161 DFEZ

I

I

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1
......- - - - , - -

__

t:

·

MARKS OR
MICROCHIP

/

II

I

11 _____

1

3! DF79

{41

I AG-1I SEX I DI~
'C':K~R OR
Tl~.CTIVE

BREED-COMMON
OR SCIFN ... ll'lf"
· "N

I

12 1 A6V091
<

I

A

I

F

f

'

I

F

I

·----

II

RABIES VACCINATION

D

1 YEAR

D

2 YEARS

D

------:.i---·----·----·------+,---~----·----------·-···---Vaccmat:on Date
Product
l___g~te -·- l~-Product Type andior. Results

BRO\IVN

i s-2s~2c·15

----

~I
M

M

··--- -

I

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--

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1

I

L

I

9 · REMARKS OR ADDlilONAL CERTIF!CA TION STATEMENTS {WHEN REQUIRED)

iE.) test negative Lot# 442X

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

~~--

8. PERTINENT VACCINATION, TREATMENT, AND TESTING HISTORY
~----··

!

I

_ _ , ___

!

i VETERINARY CERTIFICATl()rJ l certify tr,at the animals desuibecl ,n box 7 have been exa11111,ed

by me lh1s r!ate that the

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·!

hc.ive Vf!;-1~e-,~-1.·;;;·~Jres~·f t1·1e nllCrtX:IHp tf

Q

fl,;CfOClllD

1S !iSt.:O!(l 1n l)OX J.

.. ··--·

D

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
apµi: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

D

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

_· - - - - - -

LICENSE NUMBER AND STATE
13172

34200 Drs l-lammoc, Road
lmmokalee. FL 34142

Fionda

Accredited IB]Yes

D

No

If yes, piease complete below

NATIONAL ACCREDITATION NUMBER
075369
SIGNATURE OF USDA VETERINARIAN

Apply USDA Seal o·r Stamp here

DATE

I ~~~~\{;a;;~~:~°fi~ifftl~£~;;~.".::
1
101
;;,;;

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10
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U/;P~d_
/,PHIS Form 7001
(NOV 2010)

-- \._,,'

This cer1ificate is valid for 30 days aHer issuance

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N01-IRFIN!A1D
8200 Research Plaza

34200 Ors Hamrr.ock Rd
lmmokalee FL 34142

N

"'_,
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15-04·1

12

I

?TLC/Primate Products, inc.

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
ar·v i :;tenneJ1ate r,;;maler or car r:e, for
trans.po11ation, r. cornillC.iCO :..JnhJss occo:nparnerj l,y a heal H-t C€rHf1ca,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

a

DATE
G-1-2015

r

(

Tlt\DESECRET

Pl

_,

0

t-t,

.....

s

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0

TRADE SECRET
(Continuation Sheet)

ANO/ UR I Ai T{)O i\/LIM 8tR

RAB IFS

8RE!:D-COMMON
OR SCIENTIFIC

AGE

SEX

A

M

N,1~ME

00

0
-,

=

COLOR OR

KILLW VIRUS

Rhesus

DFLD

"

"

PH1065

"

PH1071

Rhesus

OT'ffR VACCINATIONS, TESTS OR

lRE/\TMF.NTS
Dote

Type/ Result

Brown

Product

5-29-015

TB test negative Lot# 442X

F

"

"

"

F

"

"

"

Br0wn

6--t-2015

TB test negmive Lot# 442X

Product

Date

"

M
"

076

D-H-L

LIVE VIRUS

IJ°IS l":NCTIVF MARKS

Date

DFHK

PH1015

of 2

VACCINATION HISTORY

ANIMAL IDENTIFICATION

"

F
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1/ /{r't/-,;/A((tn°E,lsEcRE,Tl

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N01-IRF/NIAID
8200 Research Plaza
Frederick, MD 21702

PTLC/Primate Products. Inc.
34200 Ors. Hammock Rd.
lrnmokalee, FL 34142

COMP! ETE l!SOA TAG, COLLAR

2

co

00

/) - (J{/
PAGE

s."

._,

NAME, ADDRESS ANO lELEPIIONE NUMBrn Of-CON\IGNF[

NAME, ADDRESS ANO TELEPHONE 1'\JtJtvlBER OF 0 1NNER/L0NS1GN0R

'

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CERTIFICATE NUMBER
UNITED STATES INTERSTATE AND INTERNATIONAL CERTIFICATE OF HEALTH EXAMINATION FOR SMALL ANIMALS

"3
C

'

'_.,.,._
:

>--'

~

(Page 3

of

4)

Document ID - 3031786 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.

U.S. DEPARTMENT OF AGRICULTURE
ANIMAL AND PLANT HEALTH INSPECTION SERVICE

1S(]

D

EXCHANGE OR TRANSFER

FORM APPROVED 0MB
NO. 0579-0036

1. INVOICE NO.

2. PAGE

OC151109A
1 of 1

RECORD OF AC~ISmON, DISPOSmON OR TRANSPORT
OF ANI ALS {Other than Dogs and Cats)

D SALE

See reverse side for
addltiona I information.

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}

5. SELLER OR DONOR (Name and Mdress, include Zip Code}

COl - Charles River Labs, Inc.
6995 Longley Lane
Reno, NV 89511 USA

Primate Products, Inc.

34200 Doctors Hammock Road
Immokalee, FL 34142 USA

7. USDA LICENSE NO. (if any}

14-R-0144

8. IDENTIFICATION OF ANIMALS BEING DELIVERED
B.

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

1

120010

Macaca fascicularis

F

2.97

TB Test: 11/3/2015

2-B

1

1302520

Macaca fascicularis

F

3.15

TB Test: 11/3/2015

1-A

1

C120738

Macaca fascicularis

F

3.60

TB Test: 11/3/2015

DELIVERY BY COMMERCIAL CARRIER
10. TRUCK LICENSE NO.

9. DEUVERY BY (''X" one}

0

Buyer's Truck

D

11. BILL OF LANDING NO.

Dealer's Truck
(Seller or Donor)

AWB#:
13. NAME AND ADDRESS OF TRUCK DRIVER

12. NAME AND ADDRESS OF COMPANY OR ARM

JKL Secure Freight Lines
2613 Empire Ranch Road #21907
Carson City, NV 89721 USA

JKL Secure Freight Lines
2613 Empire Ranch Road #21907
Carson Oty, NV 89721 USA

DELIVERY RECEIPT • TO BE COMPLETED BY BUYER OR RECEIVER
14. ANIMALS DELIVERED WERE ("X" one}
IN APPARENT GOOD CONDITION

D

15. TOTAL NUMBER RECEIVED
18. BY (Signature}
APHIS FORM 7020
(JAN 90)

3

D

POOR CONDITION

116. NUMBER DEAD

REJECTED (Attach explanation for rejection}
117. NUMBER ALIVE

119. IDLE

120. DATE

(Replaces VS FORM 16-20, wh!Ch ,snow obsolete, and
APHIS form 7020 (10-80) which may be used.}

--·

D

TRADE SECRET

-·--·-··--------------------

(Page 4

of

4)

DocumC'nt ID - 3031786 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 no«Md 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

fraudulent mey be subjed to a
fine of not more than $10,000

4. PAGE

imprisonment of not
MS or both 18 U.S.C

5. NAME, ADDRESS, AND TELEPHDNE NUMBER OF OWNER (CONSIGNOR)

RESS, AND TELEPHONE NUMBER OF RECIPIENT AT DESTINATION (CONSIGNEE)

PTLC/Primate Products. Inc.
34200 Ors. Hammock Rd.

!mmokalee, FL 3-4142
239-867w2020

USDA license/Of" R
B. PERTINENT VACCINATION TREATMENT, At,,ID TESTING HISTORY

NAME. AND/OR TATTOO NUMBER
OR OTHER IDENTIFICATION

BREED - COMMON
OR SCIENTIFIC
NAME

(1

AGE

SEX

COLOR OR
DISTINCTIVE
MARKS OR

MICROCHIP

RABIES VACCINATION

1 YEAR

02 YEARS D

OTHER VACCINATIONS.

TREATMENT. AND/OR TESTS AND RESULTS

3 YEARS
Dato

Product Type andlor Results

A

Brown

11-6-2015

TB test negative Lot# 443X

A

Brown

11-6--2015

TB test negalive Loi# 443X

Vaccination Date

Product

(21120010
()) 1302520

(-4)C120738

Cyno

(5)

16·~---------t--------t---l---t------+------+-----------+----1----------9. REMARKS OR ADDITIONAL CERTIFICATION STATEMENTS (WHEN REQUIRED)

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

\X" applicable statements}.
I have varifJed the preaeooo of the mlcrO<:hlp, Ha m!crOGhlp is lisl&d in box 7.
I certify that the anlmal{s) described above and on continuation she&t(s), If llppllcable, have been Inspected by me on this date and
appeac to be free of any lnf9ctlous or contagious di&eases and to lhe best of my kno'<Medg•, expMUre tMrelo, which woukl endeng&r the

animal or other animab or would endanger pubic health.

~ To my knowledge, the animal(s) described above and on continuation theet(s) if appltc&ble, originated from an llrea oot quarantined

:::·;:::s:~:o

for rabies and haslhave not been e

-~~"'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.

TELEPHONE NUMBER OF IS8UtNG VETERINARIAN

~~~:2E

:~::aER AND STATE

34200 Ors. Hammock Road

lrrmokalee, FL 34142
239-867-2020

Accredtted[&]Vea

D

No

If Yff, ~ · " complete bolow
NATIONAL ACCREDITATION NUMBER

075369

veterinarian.
SIGNATURE OF USDA VETERINARIAN

Apply USDA Sul or Stamp here

DATE

DATE

11-6-2015

APHIS Fonn 7001
(NOV2010)

TRAOF .~PrDPrr

According lot he Paperwork Reduction Act of 1995. an aqency rnay nol co"d net or sponsor. and a person rs

1101

I

required to respond lo, a collection ol

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.

WARNING: Anyone who makes
UNITED STA1LS DEPARTMENT OF AGRICULTURE
ANIMAL AND PLANT HEAL TH INSPECTION SERVICE

UNITED STATES INTERSTATE AND INTERNATIONAL
CERTIFICATE OF HEALTH EXAMINATION
FOR SMALL ANIMALS

a false. fictitious. or fraudulent
statement on this document. or
uses such document knowing 1t
\o be false, fict1lious. or
fraudulent may be suUJect to a
fine of not more than $10.000 or
imprisonment of not more than 5

vears or both 118 U.S.C. 1001).
5. NAME, ADDRESS, AND TELEPHONE NUMBER OF OWNER (CONSIGNOR)

TRADE SECRET
I

No dog, cal, r1011h111nan p11111ale. or add1l1onol kinds or classes cl an11nals des,gnaled by

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\.

1. TYPE OF ANIMAL SHIPPED (select one only)
Ooog

Ocat

0Ferret

D

0579-0036
0579-0333

2. CERTIFICATE NUMBER - OFFICIAL USE ONLY

Oother

[8J Nonhuman Primate

0MB APPROVED

15-055
Rodent

3. TOTAL NUMBER OF ANIMALS

4. PAGE

'%;...:,

1 of 3

6. NAME, ADDRESS, AND TELEPHONE NUMBER OF RECIPIENT AT DESTINATION (CONSIGNEE)
C01
6995 Longley Lane
Reno. NV 89511
775682-2166

PTLC/Pnmate Products. Inc.
34200 Ors_ Hammock Rd
lmmokalee. FL 34142
239-867-2020

_ USDA License/or Regis1ra1ion Number (if aeeJrcable) 58-R-0144

7. ANIMAL IDENTIFICATION
NAME, AND/OR TATTOO NUMBER
OR OTHER IDENTIFICATION

t 11 1006073

BREED - COMMON
OR SCIENTIFIC
NAME

AGE

SEX

D

1 YEAR

D

2 YEARS

D

Vaccination Date

--

Cyno

A

OTHER VACCINATIONS,
TREATMFNT. AND/OR TESTS AND RESULTS

3 YEARS

------

Product

BROWN

M

--"

Date

Product Type and/or Results

8-1-15

TB test negative Lot# 443X

"

"

·--

t 3) 1011039

"

l 4l1012009
151 101201sc

RABIES VACCINATION

··----

(2) 1011019

16

COi OR OR
DISTINCTIVE
MARKS OR
MICROCHIP

---

---

8. PERTINENT VACCINATION, TREATMENT, AND TESTING HISTORY

--·-

"

---

"
---

"
.--

)1101005

M

TB test negative Lot# 443X

8-1-2015
··-----

9. REMARKS OR ADDITIONAL CERTIFICATION STATEMENTS (WHEN REQUIRED)

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).

8

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.

D

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 r§l!?ies.

ENDORSEMENT FOR INTERNATIONAL EXPORT 1/F NEEDED)
PRINTED NAME OF USDA VETERINARIAN

NAME, ADDRESS, AND TELEPHONE NUMBER OF ISSUING VETERINARIAN

LICENSE NUMBER AND STATE
13172 Florida

Amber Williams. DVM
34200 Drs. Hammock Road
lmrnokalee, FL 34142

Accredited [8]Yes

D

~~

-----

If yes, please complete below

t-i.ii.rioNAL ii:ccReoirAi'ioN NUMBER :::l

075369

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SIGNATURE OF USDA VETERINARIAN

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DATE

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(NOV 2010)

.

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DATE
7-29-2015

This cerllficate is valid for 30 days after issuance

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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3

C01
6995 Longley Lane
Reno, NV 89511

VACCINATION HISTORY

ANIMAL IDENTIFICATION

AND/ OR TATIOO NUMBER

2

NAME, ADDRESS AND TELEPHONE NUMBER OF CONSIGNEE

PTLC/Primate Products, Inc
34200 Drs. Hammock Rd.
lmmokalee, FL 34142

COMPLETE USDA TAG, COLLAR

If· oS.5"

RABIES

BREED-COMMON
OR SCIENTIFIC

AGE

SEX

A

M

NAME

Cyno

COLOR OR

KILLED VIRUS

D-H-L

I LIVE VIRUS

OTHER VACCINATIONS, TESTS OR
TREATMENTS

DISTINCTIVE MARKS

Date

Product

Date

Product

..

Type/ Result

Date
8-1-2015

Brown

TB

test negative Loi#

"

"

1104003

"

"

"

"

"

"

1104017C

"

"

"

"

"

"

1105019

"

"

"

"

"

"

"

"

.

"

1105023
1105027

"

"

"

"

"

"
"

"

1106003

"

"

"

"

"

1106007

"

"

"

"

"

"

1106011

"

"

"

"

"

"

1107003

"

"

"

"

"

"

1107017

"

"

"

"

"

1109001

"

"

"

"

"

"

1109003

"

"

"

"

"

"

1109021

"

"

"

"

"

"

1109049

"

"

"

"

"

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1110029

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"

"

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"

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1110053

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"

"

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"

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1111001

"

"

"

"

"

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1111017

"

"

"

"

"

"

1111231

"

"

"

"

"

"

1112071

"

"

"

"

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1201009

Cyno

A

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8-1-2015

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1S'-o~<

(Continuation Sheet)

PAGE

NAME, ADDRESS AND H.Lf.PHONE NUMBER OF OWNER/CONSIGNOR

PTLC/Primate Products, Inc
34200 Drs. Hammock Rd.
lmmokalee. FL 34142

3

VACCINATION HISTORY
RABIES

BREED-COMMON
OR SCIENTIFIC

AND/ OR TATIOO NUMBER

of

C01
6995 Longley Lane
Reno, NV 89511
ANIMAL IDENTIFICATION

COMPLETE USDA TAG, COLLAR

3

NAME, ADDRESS AND TELEPHONE NUMBER OF CONSIGNEE

AGE

SEX

A

M

COLOR OR
DISTINCTIVE MARKS

NAME

KILLED VIRUS
Date

1203059

Cyno

OTHER VACCINATIONS, TESTS OR

D-H-L

I LIVE VIRUS

Date

Product

TREATMENTS
Date

Type/ Result

8-1-2015

TB test negative Lot# 443X

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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 0579·0036 and 0579-0333.

USDA r egulation sh all be del

0MB APPROVED

1vered to any I ntermed1ate handler or car ner for
0579-0036
transportation 1n commerce. unless accompanied by a heal lh cert1f1cate executed and
0579-0333
issued bv c1 licensed veterinarian (7 LI_~ C .?~ 43 9, CrR. Subchaoter A, Part 2J.
2. CERTIFICATE NUMBER - OFFICIAL USE ONLY
1. TYPE OF ANIMAL SHIPPED (select one only)

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.

WARNING: Anyone who makes

UNITED STATES DEPARTMENT OF AGRICULTURE
ANIMAL AND PLANT HEAL TH INSPECTION SERVICE

UNITED STATES INTERSTATE AND INTERNATIONAL
CERTIFICATE OF HEALTH EXAMINATION
FOR SMALL ANIMALS

a false. iictitious. or fraudulP-:nt
statement on this document. or
uses such t1ocurnent knowing 1t
to be false. f1clit1ous. or
fraudulent may be subject to a
fine of not more than $10.000 or
,mprisonmentof not more than 5
vears or bolh 118 U.S.C. 1001).

5. NAME, ADDRESS, AND TELEPHONE NUMBER. OF-OWNER(CONS/GNOR)

Ooog

Oou,e,

Ocat

IBJ Nonhuman Primate

OFerret

D

15-056
Rodent

4. PAGE

3. TOTAL NUMBER OF ANIMALS

1 of 3

36

----

6. NAME, ADDRESS, AND TELEPHONE NUMBER OF RECIPIENT AT DESTINATION (CONSIGNEE)
C01
6995 Longley Lane
Reno. NV 89511
775682-2166

PTLC/Pnmate Products, Inc.
34200 Ors. Hammock Rd.
lmmokalee, FL 34142
239-86 7-2020

USDA License/or Registration Number (J/ applicable) 58-R-0144

--------

-

,._

--

··-·

---·

7.----ANIMAL
IDENTIFICATION
----

NAME, AND/OR TATTOO NUMBER
OR OTHER IDENTIFICATION

\1)0904142

8. PERTINENT VACCINATION, TREATMENT, AND TESTING HISTORY

BREED - COMMON
OR SCIENTIFIC
NAME

AGE

SEX

COLOR OR
DISTINCTIVE
MARKS OR
MICROCHIP

Cyno

A

F

Brown

121 0907196C

-----

RABIES VACCINATION

D

1 YEAR

D

2 YEARS

D

OTIIER VACCINATIONS.
TREATMENT, AND/OR TESTS AND RFSUL TS

3!~ARS
Product

Vaccination Date

Date

Product Type and/or Results

8-2-2015

TB test negatlve Lot# 443X

---· -----····---

··---

--

-

t 3) 0909060

.

t4 lo909068
151
161

-.

,.

0912112

"

--1001036

Cyno

A

F

8-2-2015

Brown

9. REMARKS OR ADDITIONAL CERTIFICATION STATEMENTS (WHEN REQUIRED)

-- ---·-·
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 m•crochiµ, ,fa microct1iµ ,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.

D

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.

ENDORSEMENT FOR INTERNATIONAL EXPORT (IF NEEDEDJ
PRINTED NAME OF USDA VETERINARIAN

--

NAME, ADDRESS, AND TELEPHONE NUMBER OF ISSUING VETERINARIAN

LICENSE NUMBER AND ST ATE
13172 Flonda

Amber Williams. DVM
34200 Drs. Hammock Road
lmmokalee, FL 34142

D

Accredited OOYes
No
If yes, please complete below

i,iJi.i10NAL i.:cc:Reoii.i.iiciN-Ni..iMBER :::!

075369

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DATE

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I ( '/
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7-30-2015

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This cerlificate is valid for 30 days after issuance

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

AND/ OR TATTOO NUMBER

:::l
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of 3

NAME, ADDRESS AND TELEPHONE NUMBER OF CONSIGNEE

PTLC/Primate Products, Inc
34200 Ors. Hammock Rd.
lmmokalee. FL 34142

COM PL FTF USDA TAG, COLLAR

2

VACCINATION HISTORY

BREED-COMMON
OR SCIENTIFIC

AGE

SEX

Ni'.ME

COLOR OR
DISTINCTIVE MARKS

RABIES
KILLED VIRUS

Date

1002124

Cyno

A

F

1003136

"

"

1005014

.

"

1005066

"

Product

OTHER VACCINATIONS, TESTS OR

0-H-l

i LIVE VIRUS

Date

TREATMENTS

Product

Date

Type/ Result

Brown

8-2-2015

TB test negative lot# 443X

"

"

"

.

"

"

"

"

"

"

"

"

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1006058

"

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1006078

"

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"

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1011004

"

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.

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"

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1012014

"

"

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"

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"

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1012070

.

1101012

"

"

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"

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1101034

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1101036

"

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1101092

"

"

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1103020

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1105024

"

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"

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"

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1105040

"

"

"

.

"

1106022

"

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1107004

Cyno

A

F

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8-2-2015

"

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1105036

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UNITED STATES INTERSTATE AND INTERNATIONAL CERTIFICATE OF HEALTH EXAMINATION FOR SMALL ANIMALS

1s--or0

(Continuation Sheet)
NAME, ADDRESS AND TELEPHONE NUMBER OF OWNER/CONSIGNOR

PAGE

PTLC/Primate Products, Inc
34200 Ors. Hammock Rd.
lmmokalee. FL 34142

ANO/ OR TATTOO NUMBER

VACCINATION HISTORY

BREED-COMMON
OR SCIENTIFIC

AGE

SEX

A

F

NAME

COLOR OR
DISTINCTIVE MARKS

RABIES

Cyno

OTHER VACCINATIONS, TESTS OR

0-H-L

KILLED VIRUS I LIV[ VIRUS
Date

1107022

Product

TREATMENTS

Product

Date

Brown

Type/ Result
TB test negative Lot# 443X

1109036

"

"

"

"

"

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"

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"

"

"

"

1112002

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"

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1112008

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"

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1201040

"

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"
"

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A

F

Brown

8-2-2015

TB test negative Lot# 443X

-------

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8-2-2015

1110014

--------

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of 3

C01
6995 Longley Lane
Reno, NV 89511
ANIMAL IDENTIFICATION

COMPLETE USDA TAG, COLLAR

3

NAME, ADDRESS AND TELEPHONE NUMBER OF CONSIGNEE

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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

1 WARNING: Anyone who makes
UNITED STATES DEPARTMENT OF AGRICULTURE
ANIMAL AND PLANT HEAL TH INSPECTION SERVICE

UNITED STATES INTERSTATE AND INTERNATIONAL
CERTIFICATE OF HEALTH EXAMINATION
FOR SMALL ANIMALS

a false, fict1!1ous. or fraudulent
statement on this document. or
uses such document knowing 1t
to be false, fictitious. or
fraudulent may be subject to a
fine of not more than $10.000 or
imprisonment of not more than 5
years or both (1_!llJ~S}:> 1001).

No dog, cat. nonhuman pnrnalc. or addt11onat k.1nds or classes of an11nals designaled hy
OMB APPROVED
USIJA r eguiahon sh all be del IVl:Hed to any! ntermed1ate hand!er or car rier for
_
0579 0036
transporta\10~1 in c;arnrnerce. unless accompanied by a heal th certificate ex eculed and
. ._ .
05 79 03 33
issued b a licensed veterinarian 7 U.S.C 21 43 9. CrR. Subcha ter A. Part 2
__ -------· _ · - - · - -

1_ TYPE OF ANIMAL SHIPPED (select one only)

DDog D

C

at

D

[8J Nonhuman Primate
I'--

2. CERTIFICATE NUMBER -OFFICIAL USE ONLY

Olh r
e ---··

D

D

Ferret

15-057
Rodent

·-·-

4. PAGE

3. TOTAL NUMBER OF ANIMALS

6

5. NAME, ADDRESS, AND TELEPHONE NUMBER OF OWNER (CONSIGNOR)

6. NAME, ADDRESS, AND TELEPHONE NUMBER OF RECIPIENT AT DESTINATION (CONSIGNEE)

PTLC/Primate Products. Inc.
34200 Ors. Hammock Rd
lmmokalee, FL 34142

C01

6995 Longley Lane
Reno, NV 89511
775682-2166

239-867 -2020

USDA L1c5'.nselor Registration Number(1fapp/Jcab/e) 58-R-0144
_ _ _ _ _ _ _ _ _ _ _ _ _7_.~A_N_l~_L IDENTIFICATION

NAME. ANO/OR TATTOO NUMBER
OR OTHER IDENTIFICATION

I'

, 1l1002178

BREED - COMMON
OR SCIENTIFIC
NAME

Cyno

_ ...... __
_ _ _ __!:_._!:'.ERTINENT VACCINATION, TREATMENT, AND TESTING HISTORY

AGE

SEX

A

COLOR OR
DISTINCTIVE
MARKS OR
MICROCHIP

ID

I

RABIES VACCINATION

1 YEAR

D2 YEARS D

Vaccination Date

Product

BROWN

F

OTHER VACCINATIONS.
TREATMENT, AND/OR TESTS AND RESULTS

3 YEARS
Dale

Producl Type and/or Results

8-7-15

TB test negative lot# 443X

+----------+---+---+-------t--------1--------------1-----+------------------ ----

(2) 1004053
-i3)-1101033
14 ) 1105033

--·-

15 )1111027

5
1 11~12009

Cyno

A

F

Brown

9. REMARKS OR ADDITIONAL CERTIFICATION STATEMENTS (WHEN REQUIRED)

_ _ _ _ _ _ _ _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

I have verified the prnsence of the m1Crochiµ, if a m1cruchip is hsteJ in box 7.

D

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.

D

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.

ENDORSEMENT FOR INTER.!<ATIONAL EXPORT
PRINTED NAME OF USDA VETERINARIAN

.

(/F NEEDED)

----------------

NAME, ADDRESS, AND TELEPHONE NUMBER OF ISSUING VETERINARIAN

LICENSE NUMBER AND STATE

Amber Williams. DVM
34200 Ors. Hammock Road
lmmokalee, FL 34142

13172 Florida

D

Ac~redlted [8::JYes
No
If yes, please complete below

N-AiioNAL AccR·Eioh=Aiioi.· NU-MBER 075369

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·-----

0

SIGNATURE OF USDA VETERINARIAN

Apply USDA Seal or Stamp here

' DATE

I Sl~NA~UR;EOF ISSUING V~T;Rl~ARrN.
I

\

APHIS Form 7001

(NOV 2010)

(I • / t.
/'_::~ ...., .•,/:,.,
'-.k.-f
/
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This certificate is valid for 30 days after issuance

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DATE
8-4-2015

TRADE SECRET

I

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

UNITED STATES INTERSTATE AND INTERNATIONAL
CERTIFICATE OF HEAL TH EXAMINATION
FOR SMALL ANIMALS

a false. hct111ous, or fraudulent
statement on this document or
uses sur.h rtocurnent knowing it
to be false. ficl1tmus. or
fraudulent may be subiect to a
fine of not rnore than $1 LI. 000 or
imprisonment of not more than 5

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_ . _

1. TYPE OF ANIMAL SHIPPED (select one only)
0Dog

Ocat

2. CERTIFICATE NUMBER - OFFICIAL USE ONLY

D01her

IB] Nonhuman Primate

D

0Ferret

OO _
79 0036
_
0579 0333

15-058
Rodent

3, TOTAL NUMBER OF ANIMALS

4. PAGE

2

1

6, NAME, ADDRE:'ss, AND TELEPHONE NUMBER OF RECIPIENT AT DESTINATION (CONSIGNEE)

PTLC/Primate Products. Inc
34200 Ors. Hammock Rd.
lmmokalee. FL 34142
239-867-2020

COl
6995 Longley Lane
Reno, NV 89511
775682-2166

--------·

-

USDA License/or Reg,stratton Number (1/ ae12ilcable) 58-R-0144
7. ANIMAL IDENTIFICATION
BREED - COMMON
OR SCIENTIFIC
NAME

NAME, ANOIOR TATTOO NUMBER
OR OTHER IDENTIFICATION

--

12 ) 1204055

Cyno

AGE

SEX

A

Cyno

--------·-----·

COLOR OR
DISTINCTIVE
MARKS OR
MICROCHIP

RABIES VACCINATION

D

M

1 YEAR

D

2 YEARS

D

OTHER VACCINATIONS,
TREATMENT, AND/OR TESTS AND RESULTS

I
I

3 YEARS
Product

Vacc1nat1on Date

Date

Brown

8-10-2015

- - - - - - - - - - - - · - ----

M

A

------·

8. PERTINENT VACCINATION, TREATMENT, AND TESTING HISTORY

~-

'1 l 1202033C

-

-- -

Brown

----------

Product Type and/or Resulls

--··

TB test negative Lot# 443X

----

-·---

-.-

8-10-2015
---·

-

131

i._ _____

TB test negative lot# 44 3X

--

14)
-

15)

-,-6)

-

-

--

---

i

9. REMARKS OR-ADDITIONAL CERTIFICATION STATEMENTS (WHEN REQUIRED)

··---

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)

8

I have venfied the presence of the microchip, ,r a m,c,uchip is 1,sted in box 7.

-···

··--

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.

D

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.
·"-·

ENDORSEMENT FOR INTERNATIONAL EXPORT (IF NEEDEQ)__ _
PRINTED NAME OF USDA VETERINARIAN

NAME, ADDRESS, AND TELEPHONE NUMBER OF ISSUING VETERINARIAN

LICENSE NUMBER AND STATE

Amber w,11,ams. DVM
34?00 Ors. Hammock Road
lmmokaJee, FL 34142

1317? Florida

D

AccreditedIB]Yes
No
If yes, please complete below

i-iii:ri6NAL AcckEciir.i>:ri6N-NiiMBER -

::::

075369

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NOTE: lnlernal!onal shinments may requ1r.~ ~ertif1c~llon bv <ln accredited vctcnnari~n.

SIGNATURE OF USDA VETERINARIAN

Apply USDA Seal or Stamp here

DATE

I

(,

00

, I!
' . ,/'Z,Jt__/j/ {·le-

Sl~NAiUi ISSUIN? VETERIN~,7N

---

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DATE
8-7-2015

0

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(NOV 2010)

This certificate is valid for 30 days after issuance

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~µ e~~Oi"l iS-uci1 reqiiire~(l(J r€sporn1 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

1

UNITED STATES DEPARl MENT OF AGRICULTURE
ANIMAL AND PLANT HEAL TH INSPECTION SERVICE

UNITED STATES INTERSTATE AND INTERNATIONAL
CERTIFICATE OF HEALTH EXAMINATION
FOR SMALL ANIMALS

WARNING: Anyone who makes

oy

I
a

Doth

[8J Nonhuman Primate

fraudulent may be subj eel to a

___ _
_l_l'!'ars or bo\11 (18 U.S.C. 1001).
5. NAME, ADDRESS. AND TELEPHONE NUMBER OF OWNER (CONSIGNOR)

I

1. TYPE OF ANIMAL SHIPPED (select one only)

Do DC

false, flctillOtJS, or fraudulent
statement on this docume11l. or
uses such documenl knowing it
to be false. l1c1111ous. or

;i,

fine of not more lhan $10.000 or
imprisonment of not more than 5

Nn oog, cat, nonhrnnan prnn::tte. or add1\1onal kinds or classes of .-rnimals des1g11ated by
USDA r egulat1on sll all be del 1vered to
;;my I ntennP.dlate handler or car r1er for
transportation 1n cornrnerce, unless <JCcompanied by a heal tt1 cert1ftcate executed and
1SSlted b a licensed \e\erinar on (7 USC 21 43 9 CFR Subcl1ap1er A Part 2J

D

r
e --------

Ferrel

D

0579-0036
0579-0333

2. CERTIFICATE NUMBER - OFFICIAL USE ONLY

15-059

Rodent

4. PAGE

3. TOTAL NUMBER OF ANIMALS

I

0MB APPROVED

_.

..

6. NAME, ADDRESS, AND TELEPHONE NUMBER OF RECIPIENT AT DESTINATION (CONSIGNEE)

co,

PTLC/Primate Products. Inc.
34200 Drs. Hammock Rd.
lmmokalee, FL 34142
239-86 7-2020

6995 Longley Lane
Reno, NV 89511
775682-2166

-· ·+----···
USDA License/or Reg,strat,on Nurri_ber 0I_appl,cab/e 58-R-0144

__

_ _
8. PERTINENT VACCINATION, TREATMENT, AND TESTING HISTORY

--------------7'-'.-'A-'-N"-l"-M-'-A-"L'-l"'DENTIFICATION
.
· / '
NAME. AND/OR tAl TOO NUMBER
OR OTHE:R IDENTIFICATION

BREED. COMMON
OR SCIENTIFIC
NAME

---·
77
-1 11-1-10
-4-::0:-0;:-5--------t--===~;~--Cyno

-rn-------:3)
14)

:

AGE

SEX

A

M

I COLO~ OR
RI\B~~~CCINATIO~. - - - - I DIST
INC
D 3 YEARS
MARKS OR
D
1 YEAR D 2 YEARS
MICROCHIP
- ------==-,----------

-'----------=.::

- = : c - · - - - - - j - - - - - · Product

Brown

-------

0

....
0

SIGNATURE OF USDA VETERINARIAN-

QO

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·--...L.-----'------------------

I have verified the presence of tt1e microchip. if a microchip 1s listed 1n box 7

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.

NAME, ADDRESS, AND TELEPHONE NUMBER OF ISSUING VETERINARIAN

LICENSE NUMBER AND STATE

Amber Williams. DVM
34200 Ors. Hammock Road
lmmokalee. F-L 34142

13172 Florida

O

-;cc;~dited [8Jves
No
ti yes, please complete below

Apply USDA Seal or Stamp here

'! OATE

·r~;;~f

1
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f~e~_·:~:~r;;:;:~·~_ '"";

075369
:_,"_~ccred,t;d =rtrreria\.

( t1-SA---Jh Ci/' - ';-/ i (_ L:2'(/i ! 1'14- )

ll..

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test negative Lot# 443X

NATIONAL ACCREoiii.iioN· Ni.iMBER -

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ri

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T[J

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.

...,,,,.,,=======-,,.=====--,,.==-=--=~===--------------t---:"fo~r~ra"'b:',e~s~a:'n':'d'::'h~s/have not been

"

Product Type and_l:>r_R_es_,_,l_ts_ _ _ _ __

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

ENDORSEMENT FOR INTERN.IITl<;)NAL EXPORT (IF NEEDED)
PRINTED NAME OF USDA VETERINARIAN

Date

18-7-2_<:2_5

d~~l=-----i

"""

I

~
j------1-------j----------·
--t-=

9. REMARKS OR ADDITIONAL CERTIFICATION STATEMENTS (WHEN REQUIRED)

~

OTHER VACCINAT;ONS.
TREATMENT. AND/OR TESTS AND RESULTS

[IV[

APHIS Form 7001
(NOV 2010)

\..,.

DATE

8-4-2015

(

This certificate is valid for 30 days after issuance

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

M

NAME

"

"

"

.

"

"

"

"

DFKP

"

DFLT

"

DFPG
DFPI
DFPK
DFTJ

.

.
.

.

DFVA

.

DFXX

"

·--

...

"

COLOR OR

3

0
-,

<.n

.

OTHER VACCINATIONS, TESTS OR

D-H-L

- KILLED VIRUS . LIVE VIRUS

TP,EATMENTS

DISTINCTIVE MARKS

Date

Type/ Result

Brown

1-3-2015

TB test negative Lot# 442X

"

"

"

"

"

Date

DFKH

DFNL

-

OR SClfNTIFIC

A

DFLV

of

VACCINATION HISTORY

BREED-COMMON

Rhesus

DFKN

3

903 South 4th Street
Halilton, MT 59840

DFKE

DFKM

<.n

,.,"cl

PAGE

ANIMAL IDENTIFICATION

AND/ OR TATTOO NUMBE:R

-

RML

Primate Products, Inc.
7780 NW 53 Street
Miami, FL 33166

COMPLETE USDA TAG, COLLAR

!-h

"''°~
=
-.J
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NAME, ADDRESS AND TELEPHONE NUMBER OF CONSIGNEE

NAME, ADDRESS AND TELEPHONE NUMBER OF OWNER/CONSIGNOR

0

~

..

Product

Date

Product

"

"

"

"

"

"

"

"

"

"
"

"

"

"

"
"

"

"

"

"

"

"

"

"

"

"

"

"

"

"

"

"

"

"

"

.

"

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"
"

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UNITED STATES INTERSTATE AND INTERNATIONAL CERTIFICATE OF HEALTH EXAMINATION FOR SMALL ANIMALS

DFAB
DFAG
DFBD
DFBG
DFBT

DFDO
DFDC

OR SCIENTIFIC

RABIES
AGE

SEX

A

M

NAME

Rhesus

.
"

,,

"
,,
,,

COLOR OR
DIS l lNCTIVE MARKS

,,

"

.

"
"

DFEW

,,

"

"
"

.

DFHH

"

"

3

0

<Jo

Product

Date

Product

OTHER VACCINATIONS, TESTS OR
TREATMENTS

Date

Type/ Result

1-3-2015

TB test negative Lot# 442X

,,

"
,,

.

"

,,

,,

"

.

,,

"

.
.

,,

"
,,

"

"
,,

,,

.

DFFD

,,

"

"

D-H-L

- KILLED VIRUS - LIVE VIRUS

,,

,,

,,

,,

"

Brown
,,

,,

"

DFEM
DFEV

of

VACCINATION HISTORY

BREED-COMMON

DFCC
DFCH

2

"'
"'"...,

903 South 4th Street
Halilton, MT 59840

Date

DFA1

"a

PAGE

ANIMAL IDENTIFICATION

DF73

"
,,

,,
"

..

"

"

.

"

"

"

"
,,

"
,,

,,

"

"

"

"

"

"

"

.

"

"

"

DFHN

.

"

"

"

"

DFHT

"

"

"

"

"

DFJW

"

"

"

"

"

DFJZ

"

"

"

DFKB

"

"

'

DFHJ

DFKD

.

RML

Primate Products. Inc.
7780 NW 53 Street
Miami, FL 33166

AND/ OR TATIOO NUMBER

0,
~

"'__,

NAME, ADDRESS AND TELEPHONE NUMBER OF CONSIGNEE

NAME, ADDRESS AND TELEPHONE NUMBER OF OWNER/CONSIGNOR

COMPLETE USDA TAG, COLLAR

H,

;!!
CERTIFICATE NUMBER

(Continuation Sheet)

0

;..
;;;

.

,.
"
"

"

"
,,

"

.

,,

Ac.o<dongtoth<P-R-Aaot 1995, anaooocymaynotoooduao, ,poo,o,, andap.....,;,

UNITED STATES DEPARTMENT OF AGRICULTURE
ANIMAL AND PLANT HEAL TH INSPECTION SERVICE
UNITED STATES INTERSTATE ANO INTERNATIONAL
CERTIFICATE OF HEAL TH EXAMINATION
FOR SMALL ANIMALS

Ocat

0570-00'6
0579-0333

2. CERTIFICATE NUMBER· OFFICIAL USE ONI. Y

00ttter

(&] Nonhuman Pnmate

OMBAPPROVED

lran&pOttation in commerce, untess accompariftd b'f a heal th oerttflcal.e exetul&d and
issued by a lieeosed vetertoarian £7 U.S.C. 21.43.9; CFR, .:::.~... A, PM 2}.

1. TYPE OF ANIMAL SHIPPED (Hlect one onty)

DDog

TRADEl ;ECRET

Nodog,cat.norliunan ptimaa,o,additiooal~nd> ord..,..otanmab-edby
USDA r egulation sh all t,edet iYered to en, I nteonediate haocleror cac n«for

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.

WARNING: Anyone v.fio makes
a false, flctruous, Of fraudufeflt
statement on this document, or
uses such document knowing it
to be false, fictiticJ-.ss, or
frauduJent may be subject lo a
flfle of not mo{e than $10,000 or
imprisorvnool of not mora ltlM 5
vean or both l18 U.S.C. 1001).

"\

I

"°""""""''° r4,pondto, a ,_ot

0Femil

0

15-021
Rodent

4. PAGE

3. TOTAL NUMBER OF ANIMALS

40

1 of 3

6. NAME, ADORESS, AND TELEPHONE NUMBER Of OWNER (CONSIGNOR)

I. NIIME, ADDRESS, AND TELEPHONE NUMBER OF RECIPIENT AT DESTINATION (CONS/GHEE)

Primate Products. Inc.

RML

7780 NW 53 Street

1!9~~4thS~""t
MT 59840

Hiilltoit

Miami, FL 33166
239-867-2020

40l,;37~9688

USDA Ucenso/or Reaistration Number (if aoolicabls) 58-R-01-4-4

7. ANIMAL IOENTIFICATION
NAME. ANO/OR TATTOO NUMBER

OR OTHER IDENTIFICATION

BREED -COMMON
OR SCIENTIFIC
NAME

B. PERTINENT VACCINATION, TREATMENT, AND TESTING lftSTORY

AGE

SEX

COLOR OR
DISTINCTIVE
MARKS OR

MICROCHIP

RABIES VACCINATION

D

1 YEAR

D

2 YEARS

D

Vaccination Date

OTHER VACCINATIONS,
TREATMENT, AND/OR TESTS AND RESULTS

3 YEARS
Date

Product

-

.J1)nnv

--

-

.J.._2)(1,i,::

Product Type and/or Results

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-

3

(<)DFOI

M

5
I DF43

C

{6)DF57

M

9. REMARKS OR ADDITIONAL CERTIFICATION STATEMENTS (WHEN REQUIRED)

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"

~have YElflHed the pn,csence of the rTHa"Oehtp,

tt a ~ is listed in box 7.

c«t#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

&----

kif rabt&s and has/have noc been
to rabies.
NAME, ADDRESS, AND TELEPHONE NUMBER OF ISSUING VETERINARIAN

ENDORSEMENT FOR INTERNATIONAL EXPORT 1/F NEEOEOI
PRINTED NAME OF USDA VETERINARIAN

LICENSE NUMBER AHO STATE
12304

Thomas J Rowell, DVM

Florida

34200 Drs. Hammock Road

lmmokalee, FL 34142

Accrodlted~Yoo

W. No

l!yff,ple ... ~ NAnciilAt:

SIGNATURE OF USDA VETERINARIAN

APHIS Form 7001
(NOV2010)

Apply USDA Se/II or Stamp hero

DATE

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NOTE: International shinmNlts nun, requk"e certl6catim bv ari accredited veterinarian.
SIGNATURE QfJSSUIIIG I I E ' I E R I N A R I - -

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---··-

--

i.ccileoo'.<inoii NUMBER

'

055303

I

IDATE
2-10-2015

I

-"

This certilicale is valid for 30 days atter issuance

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