Not For Illegal Sale
Print Name:__________________
Peace River Game Farm
I hereby state that these fowl(s) bought by me from a Mr. Brian Whidden, are not for use in any kind of illegal venture and I was told if they were, that they would not be sold. These fowl are for Personal, Show, or Breeding purposes only, as stated by me. Therefore, this sale and shipment of birds is not in violation of any Animal Welfare Acts or State Laws.
Signed: ___________________________________
Name Printed: ______________________________
Address: __________________________________
__________________________________________
__________________________________________
__________________________________________
Phone: ______________________
Date: _______________________
This form must be filled
out and sent to me for a sale to continue.
Brian Whidden
Peace River Game Farm
P.O. Box 511284
Punta Gorda, FL
33951-1284