Annex A

Meat Inspection Legend Stamp Order Form
(English form example)

Manufacturer

Name:

Address:

Stock Number	Description	Quantity	R = Replacement A = Add	Total Inventory Now in Stock
	Brass legend stamp 1 inch
	Brass legend stamp 1½ inches
	Brass legend stamp 2 inches
	Needlepoint legend stamp 1½ inches
	Needlepoint legend stamp 2 inches
	Brass faced "T-EU" stamp
	EQUINO stamp
	Oval brass faced export stamp
	Oval needlepoint export stamp
	Rubber faced export stamp complete with all letters and numbers
	Letter set A-Z
	Number set 0-9
	Plastic 14 inch handle
	Aluminum 11½ inch handle only
	Brander only (no head)
	1 inch engraved brass head
	1 inch engraved brass head
	2 inch x 1¾ inch engraved oval brass head

Person ordering:

Name:

Title:

Signature:

Date:

Billing address:

For government use only

Authorized by Inspector in charge:

Name:

Signature:

Date:

Ship to:

Address:

Inspector-in-Charge, establishment number

Regional Supervisor

Regional Office

Original to Stamp Manufacturers

Copy 1 to Regional Office

Copy 2 to Inspector in charge

Instructions

Refer to Chapter 1, Section 1.4.5.3.1.5