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REVOCATION OF LIVESTOCK DEALER LETTER OF AUTHORIZATION

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					                                                              Livestock Identification and Commerce Act
                                                            REVOCATION OF LIVESTOCK DEALER
                                                               LETTER OF AUTHORIZATION
                                                                             F-2 Version 2009-11-15

                                                        (Please print clearly)


TO:          LIVESTOCK IDENTIFICATION SERVICES LTD.
FROM:                                                                                            Client No.
             Name of the owner of the livestock                                                               For LIS Use Only

THIS IS TO CERTIFY THAT:

1.    I am the owner or one of the owners of the livestock and I am authorized to sign this Revocation of
      Livestock Dealer Letter of Authorization on behalf of the owners.
      OR
      I am authorized by the corporation or partnership to sign this Revocation of Livestock Dealer Letter
      of Authorization on behalf of the corporation or partnership.
         Note: Cross off the statement in paragraph 1 that is not applicable

2.    I hereby revoke the Livestock Dealer Letter of Authorization described below:


      Date of Letter of Authorization

      Livestock Dealer                                                                           Client No.
                                                                                                              For LIS Use Only
      City/Town, Prov

      Telephone


      DATED at                                              this                 day of                         20
                          Town/City          Province                 Day                         Month             Year




           Signature of Witness                                         Signature of person signing authorization


           Printed name of witness                                      Printed name


           Address                                                      Address


           Phone number                                                 Phone number

				
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posted:1/30/2011
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