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(See reverse side of form for OMB and EEO Statement)FORM OMB APPROVED: NO. 05810128U. S. DEPARTMENT OF AGRICULTURE
AGRICULTURAL MARKETING SERVICE
LIVESTOCK, POULTRY, AND SEED Programs
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Form OMB Approved No. is the number assigned to a specific form by the Office of Management and Budget (OMB) after it has been approved for use.
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