Form Ag 0620 PDF Details

In the world of equine sports and event participation, ensuring the health and safety of the horses involved is paramount. At the heart of this safeguarding effort in Tennessee is the AG-0620 form, officially known as the Equine Interstate Event Permit Application. Managed by the Tennessee Department of Agriculture's Division of Consumer & Industry Services – Animal Health, this vital document serves multiple functions: it stands as a necessary step for owners looking to participate in interstate events, acts as a renewal application for previously issued permits, and functions as a testament to the health and regulatory compliance of the equines in question. The detailed sections of the form collect comprehensive information, including owner and veterinarian details, equine identification (including microchip or tattoo registry when applicable), and health records, notably the Certificate of Veterinary Inspection and Equine Infectious Anemia (EIA) test results, known colloquially as the Coggins test. For new and renewal applications alike, the submission process requires thorough documentation, including digital photos of the equine and the most recent health records. Significantly, the equine event permit—or passport, as it may be known—is valid for six months, underpinning the cyclical nature of compliance and oversight in ensuring the well-being of these animals across state lines. Careful considerations and exceptions within the form, like the rule against digital photographs for identification in Louisiana or the necessity of carrying a microchip scanner for certain chips, highlight the tailored approach to equine health and interstate travel regulation. This intricate process underscores not only the dedication of owners and veterinarians to maintain the highest standards of equine health but also the complex interplay of state regulations in facilitating safe and exciting equine competitions and events.

QuestionAnswer
Form NameForm Ag 0620
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namespet health certificate template equine wisconsin, certificate of veterinary inspection pdf, certificate of veterinary inspection form, certificate of veterinary inspection form pdf

Form Preview Example

EQUINE INTERSTATE EVENT PERMIT APPLICATION

 

TENNESSEE DEPARTMENT OF AGRICULTURE

NEW APPLICATION

 

EQUINE PREVIOUSLY OWNED BY:

 

Division of Consumer & Industry Services – Animal Health

 

P. O. Box 40627, Nashville TN 37204

____________________________

 

Phone: 615-837-5120, Fax 615-837-5250 nimal.health@tn.gov

RENEWAL

 

 

 

PERMIT #_____________________

 

 

 

 

 

 

 

 

 

OWNER NAME

 

 

 

 

EMAIL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

STREET

 

 

CITY

 

STATE

 

ZIP

 

 

 

 

 

 

 

 

 

 

 

 

 

PHONE

 

 

 

 

ALTERNATE PHONE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

VETERINARIAN NAME

 

 

NAME OF CLINIC

 

 

 

 

USDA ACCREDITATION #

 

 

 

 

 

 

 

 

 

 

 

 

STREET

 

 

CITY

 

STATE

 

ZIP

 

 

 

 

 

 

 

 

 

 

 

 

 

VETERINARIAN PHONE

 

 

VETERINARIAN EMAIL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

EQUINE STABLED AT: STREET ADDRESS

CITY

 

 

STATE

 

ZIP

 

 

 

 

 

 

 

 

 

 

 

 

EQUINE BREED

 

COLOR

 

 

SEX

 

 

MICRO CHIP REGISTRY TATTOO

 

 

 

 

 

 

 

 

 

 

NAME

 

 

 

AGE/DOB

CVI NUMBER

CVI ISSUE DATE

 

NEGATIVE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

EIA RESULT

DATE OF EIA/COGGINS TEST

LAB ACCESSION #

 

LAB PERFORMING TEST

 

 

New event permit applications must include the following:

1.A completed Equine Interstate Event Permit Application

2.Original or legible photocopy of the Tennessee Certificate of Veterinary Inspection issued within 30 days of permit application

3.The original or legible photocopy of the Equine Infectious Anemia (Coggins) test record (VS Form 10-11) performed within the last 6 months

4.Digital photos of the left side, right side and front of the horse

Renewal applications must include the following:

1.A completed Equine Interstate Event Permit Application

2.Original or legible photocopy of the Tennessee Certificate of Veterinary Inspection issued within 30 days of renewal permit application

3.The original or legible photocopy of the Equine Infectious Anemia (Coggins) test record (VS Form 10-11) performed within the last 6 months

Documents may be submitted via mailing address above, faxed to (615) 837-5250, or scanned and emailed to animal.health@tn.gov. A travel record must be in the owner/transporter’s possession with each equine movement.

Equine Event Permits (passport) are valid for six months.

Exceptions:

1.Owner/transporter must carry a functional microchip scanner for horses utilizing microchips other than the ISO/ANSI compatible RFID chip 11784/85, 134.2 kHz as the identification method.

2.Digital photographs are not an acceptable form of identification for entry into Louisiana.

3.Owners and veterinarians must comply with any additional equine import requirements of the destination state. Please check with the state of destination prior to entry.

_________________________________________________

______________________________________

Owner Signature

Date

 

AG-0620 (REV. 12/13)

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