Name Date
Address
Tel no Holding Number
Owner’s veterinary surgeon
Haulage Name
This vehicle will be submitted to C&D prior to departure or within 24 hours at the farm of origin subject to completion of
DEFRA form to be supplied at the market before departure.
Consigned to: Selby Livestock Auction Mart (50/207/8001)
Date Number of Pigs Slap Mark
DECLARATION
Signed Date
I confirm I have received this FCI on
Name of food business operator: SELBY LIVESTOCK AUCTION MART LTD
Signature
Name of official veterinary and signature