The health certificate shall provide the following information:

1. (1)

   1. (A) The entry permit number from the State Veterinarian's office in Arkansas.
   2. (B) Telephone number for obtaining permits: Monday - Friday 8:00 a.m. to 4:30 p.m. (501) 225-1598
2. (2) Date and time of shipment;
3. (3) Name, address, and phone number of purchaser;
4. (4) Name, address, and phone number of producer or shipper;
5. (5) Quantity;

6. (6) Type of poultry:

   1. (A) Broilers;
   2. (B) Males (broiler-breeder or commercial);
   3. (C) Pullets (broiler-breeder or commercial);
   4. (D) Hens (broiler-breeder or commercial);
   5. (E) Turkeys; or
   6. (F) Other;
7. (7) Other information (if any) about the breed of poultry; and

8. (8) Should be certified by one (1) of the following criteria:

   1. (A)

      1. (i) This is to certify that I have examined the above described poultry and find same to be free of avian influenza, and to the best of my knowledge avian influenza (H5N2) has not been diagnosed in the area and this flock did not originate within an avian influenza quarantined area.
      2. (ii) In case of doubt, the certifying veterinarian or his or her designee shall require a negative AGID serology test; or
   2. (B) This is to certify that the above mentioned flock was diagnosed as avian influenza negative on the basis of a negative AGID – avian influenza serology test.

Codification Notes: "AGID" means agar gel immunodiffusion.