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This form, from the United States Department of Agriculture/Food Safety and Inspection Service, by order of the Secretary of Agriculture, has the following fields to fill out:
I certify that the meat or meat food product specified hereon is from animals that received both antemortem and postmortem inspection and were found sound and healthy and that it has been inspected and passed as provided by law and regulations of the Department and is sound and wholesome, and/ or
I certify that the poultry and poultry products specified above come from birds that were officially given an antemortem and postmortem inspection and passed in accordance with applicable laws and regulations of the United States Department of Agriculture and are wholesome and fit for human consumption.