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Poultry exhibition statement of origin 2026

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  1. Click ‘Get Form’ to open the poultry exhibition statement of origin in the editor.
  2. Begin by filling in the section that attests the origin of your poultry. Choose whether they originated from an NPIP Pullorum-Typhoid Clean hatchery or tested negative for Pullorum-Typhoid within the last 90 days.
  3. If applicable, provide the hatchery or dealer's name, address, city, state, zip code, and NPIP number. Ensure all details are accurate for compliance.
  4. Next, enter the date purchased, quantity purchased, breed, and hatch date of your poultry. This information is crucial for proper documentation.
  5. Complete your personal information by entering your name (printed), address, city, state, and zip code in the designated fields.
  6. Finally, specify the name of the county fair/exhibition and its date. Don’t forget to sign and date at the bottom to validate your statement.

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POULTRY EXHIBITION STATEMENT OF ORIGIN

This is to DocHub that the above identified poultry were purchased by: Date Purchased and originate directly from parent stock qualified as Pullorum-Typhoid

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