For Sellers Without a USDA License

USDA Exemption Certification

Under USDA regulations, no auction company or “B”-licensed dealer can accept regulated animals without either the seller's USDA license number or an exemption statement certifying the seller isn't required to have one.

If you have a current USDA license, you do not need this form. Just include your license number on your consignment contract. For complete sellouts by non-licensed kennel owners, you can instead provide a letter of exemption from USDA (APHIS Animal Care, 2150 Centre Ave, Building B, Mail Stop #3W11, Fort Collins, CO 80526-8117 · (970) 494-7478).

Prefer paper? Print a blank copy of this form to send in with your contract.

Seller Information

Full Name *

Address *

City *

State *

Zip Code *

Phone

Identification (both are required)

Used only to verify your exemption. Only auction staff can see it.

Driver License # or Official ID # *

Vehicle Tag # *

Certification & Electronic Signature

I certify that I am exempt from USDA licensing and that I maintain no more than four breeding female dogs.

Type your full name to sign *

Typing your name here constitutes your electronic signature, dated when you submit.