Republic of the Philippines

PROVINCE OF LEYTE
Municipality of Barugo
___________________________________________________________________________

MUNICIPAL AGRICULTURE OFFICE

LIVESTOCK INSPECTION CERTIFICATE (DOMESTIC MOVEMENT)

OWNER’S NAME (Last, First, Middle Name):REBECCA CIRERA YVARRA

FARM MANAGERS NAME (Last, First, Middle Name): ARNULFO A. CIRERA

09066556926
NAME OF FARM: YVARRA’s GRANJA

ADDRESS (Number, Street, Barangay, Municipality, Province) BRGY. BUKID BARUGO LEYTE

ANIMAL

SPECIES SEX AGE WEIGHT QUANTITY

Ready to Lay Chicken 18.3 Weeks 1000

VACCINE BRAND DATE

LOT NUMBER VACCINATION DURATION
AGAINST NAME VACCINATED
Please See Attached Layer Vaccination Program and
CERTIFICATE OF FREE STATUS AVIAN INFLUENZA TYPE A SUBTYPES H5 AND H7
DELIVERY TO: ZUZZETE APURA, DVM
ADDRESS: Sitio Bantilan, Bato Biliran

This is to certify that the above described animal/s has examined by me on the data below attest to
statement indicated:

(Check applicable statement)

( ) Not showing signs of infectious, contagious, and/or communicable disease
( ) The animal/s appears healthy for transport
( ) The animal/s has not been treated from any disease within 14 days

For Swine and Ruminants:

( ) There are no outbreak of the following diseases in the farm and surrounding areas for the past six(6)
months
Ruminants; From CAR, Region 1 and 2 Anthrax and flucking
Swine;FMD,PRRS,PRV ,Bruceliosis, Leptospirosis
( ) That the here tested negative for the following disease within six (6) months
Swine;FMD,PRRS,PRV ,Bruceliosis, Leptospirosis
For Large ruminants,Tuberculosis (TB), Surra and Bruceliosis
For Goat ; Caprine Arthritis Encephalis (CAE) and Bruceliosis
For sheep;CAE ,Bruceliosis and Bluetongue

For Poultry
( ) There are no outbreak of the following diseases in the farm and surrounding areas for the past six(6)
months
Infectous Laryngotroachiotis (IT) ,Infectious Bursal Disease (IBD) ,and Infectous Bronchitis( IB)
( ) For NewCastle Disease ( ND) Compliant with the BAI Memo dated January 15, 2016

BARUGO PADAYON AN GUGMA!

Municipal Hall, Poblacion District I Burgos St., Barugo, Leyte
09423386298/09458857038 lgu.barugo@yahoo.com
 Republic of the Philippines
PROVINCE OF LEYTE
Municipality of Barugo
___________________________________________________________________________

The source farm has no reported causes of NO and no cases of NO has occurred within the three(3)
kilometer radius during the last twenty one days
The poultry showed no clinical signs suspected to ND at the day of examination
The poultry shall be transported in new or appropriately sanitized vehicle/haulers
All Families including chicken manure in the transport vehicle per trip shall be disposed of
properly,

Date Issued: ___________________

NAME (Last, First, Middle Name)

PRC LICENSE NUMBER
ARIEL B. GAM

SIGNATURE :
CONTACT NUMBER :

09171195325
 

BARUGO PADAYON AN GUGMA!

Municipal Hall, Poblacion District I Burgos St., Barugo, Leyte
09423386298/09458857038 lgu.barugo@yahoo.com