Online Form | Legacy Verified

Section 1: GENERAL INFORMATION

1.1 Contact Information:

Company Name/Ranch Name:

Date of Application:

Primary Contact Name:

Primary Contact Best Phone:

Company/Ranch Address (+PO Box if Applicable):

Company/Ranch Shipping Address:

Primary Contact Best Email Address:

Date Approval is Needed By:

1.2 Additional Ranch Locations:

Please list and identify additional ranch locations: (In addition to Ranch Head Quarters.)

Ranch/Pasture Name

Short answer

Location (City and State)

Short answer

Miles from Ranch HQ

Short answer

Section 2: SOURCE AND AGE

2.1 How many calves is the Ranch planning to put into the Legacy Verified Program(s)?

2.2 How many cows do you run?

2.3 Do you record Individual Calving birthdates or just First and Last Calf Born?

2.4 Calving Information: (Operations with multiple calving seasons must identify each group differently.)

Calving Date Range (Ex: 1/1/18 – 3/1/18

Short answer

Number of Calves in Calving Group (Season)

Short answer

Identification: (Tag Descriptions, Brands, Notches ie: Green Panel Tag LE; Open A LH)

Short answer

2.5 Have the calves ever moved off of the ranch? (No longer under Ranch Management)

Yes – Please Describe Circumstance:

Please Describe Circumstance:

2.6 Does the Ranch have any purchased calves onsite?

Yes – Please List Type

Yes – Please List Type (Pairs, Stockers, Grafted Calves, etc):

2.7 If you answered “yes” to the above question, how do you identify purchased cattle to make sure these animals are not marketed/sold as program animals?

If you answered “yes” to the above question, how do you identify purchased cattle to make sure these animals are not marketed/sold as program animals?

N/A

2.8 When will you apply the Program Compliant Tags? (Calving, Branding, Weaning, Etc.)

When will you apply the Program Compliant Tags? (Calving, Branding, Weaning, Etc.)

N/A – SAV Cattle Move Directly to an APPROVED location.

2.9 How do you plan to market your cattle?

Section 3: SIGNATURE

By signing this Application, you are confirming that all of the information on this document is true and correct to the best of your knowledge and you are consenting to the scheduling of an audit to verify that the requirements to the program have been me

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Date Signed

Printed Name of Responsible Party

*Please do not forget to include the documents listed on the first page of this Application. We cannot proceed with an audit until we have those

records.

Referred By:

Promo Code:

Please feel free to contact us if you have any questions or concerns.

Legacy Verified, LLC

PO Box 1896

Elizabeth, CO 80107

877-895-2374 (O)

877-965-6782 (F)

info@legacyverified.com