AHS-20-48 REBATE FORM ADA

The Louisiana Department of Agriculture and Forestry (LDAF) has worked with cattle producers for decades to eradicate Brucellosis in the state. Louisiana has been declared free of Brucellosis due to the successful program of calfhood vaccination and testing of cattle. LDAF provided calfhood vaccinations to producers in the past at no charge, but is no longer able to provide this service. In order to encourage private veterinary practitioners to vaccinate calves at a reasonable cost, LDAF is offering a one-dollar rebate for each calf vaccinated. This rebate will be available to Louisiana Accredited Veterinarians payable upon submission of this LDAF invoice, the Official Record of Vaccination for Brucellosis with each invoice, and receipt of the practitioner's W-9 tax form.

Date

MonthDayYear

Owner Name:

Vet Invoice:

Vet Name:

Vet address:

City:

State:

Zip Code:

Phone:

"Enter Numbers Only"Format: (000) 000-0000.

Fax:

Email:

example@example.com

Number of Heifer Calves vaccinated:

Rebate Amount: $1.00 per heifer calf

Total Amount Due:

Notes:

We must have a numbered invoice for EACH owner. The "Official Record of Vaccination for Brucellosis" for that owner must be attached to each invoice, or you will not be paid.

File Upload

If record of vaccination is not uploaded, please submit form and record by email, fax, or mail to our office.

Email: VetReports@ldaf.state.la.us

Fax: (225) 237-5555

Address: Animal Health and Food Safety

5825 Florida Blvd., Suite 4000

Baton Rouge, LA. 70806