Request to Purchase Wild Horses with Limitations USDA Forest Service/Modoc National Forest 225 W 8th Street Alturas, CA 96101 (530) 233-5811 TTY (530) 233-8708 You may submit your form using e-mail or facsimile. E-mail: [email protected] Facsimile: 530-233-8709

1. Purchaser's Information: How did you hear about this program? Today’s Date (mm/dd/yyyy)

Last Name First Name Middle Initial

Street Address

City State ZIP

Phone Alternate Phone E-mail address

2. How many animals are you interested in? Males Females Total Preferred Height(in Hands) Preferred Color

3. How many acres do you have available for the animals? Total Acres

4. What kind of facility do you have available for the animals? Corral Pasture

Describe facility. If PASTURE, also describe fencing.

5. Do you have wild horse, wild burro, or livestock experience? Yes No

If Yes, describe experience.

6. What type of feed and how much do you have available? Hay Grass

Describe Feed.

7. What is your source of water? Tank Lake Stream Pond

Describe water source.

8. Do you have a regular veterinarian available to provide care for the wild horses/wild burros? Yes No

Modoc FS-2260-002 (April 2020) Continued on Page 2 File Code 2260 Retain 75 years Forest Service Manual 2260 Request to Purchase Wild Horses with Limitations Page 1 9. What date would you be ready to pick up the purchased animal(s) Pick-up Date (mm/dd/yyyy)

10. What kind of transportation will you be able to provide for the animal(s)? Note: Drop ramps and one-horse trailers are not acceptable Stock or Horse Trailer Other

Describe transportation.

11. Have you ever been convicted of abuse or inhumane treatment of animals? Yes No

If Yes, Provide conviction details.

12. Have you ever adopted or purchased a wild horse or wild burro from the Forest Service or Bureau of Land Management? Yes No

I Agree to the Following: PURCHASED WILD HORSES AND/OR BURROS CANNOT BE RETURNED TO THE PUBLIC LANDS UNLESS THE FOREST SERVICE HAS ISSUED A PERMIT OR OTHERWISE AUTHORIZED THE PURCHASER TO DO SO, SUCH AS THROUGH A LIVESTOCK GRAZING OR RECREATIONAL PERMIT. BY APPLYING TO PURCHASE WILD HORSES AND/OR BURROS, I CERTIFY THAT I WILL PROVIDE HUMANE CARE FOR SUCH ANIMALS AND WILL NOT SELL OR TRANSFER OWNERSHIP OF ANY SUCH ANIMALS THAT I PURCHASE TO ANY PERSON OR ORGANIZATION THAT INTENDS TO RESELL, TRADE, OR GIVE AWAY SUCH ANIMALS FOR PROCESSING INTO COMMERCIAL PRODUCTS. Purchaser’s Signature Date (mm/dd/yyyy)

NOTICE PURCHASER SHOULD BE AWARE OF CALIFORNIA PENAL CODE SECTION 598 PURSUANT TO SECS. 68 AND 69 OF CH. 39. NOTE: THIS SECTION WAS CALIFORNIA PENAL CODE SECTION 598C. (A) NOTWITHSTANDING ANY OTHER ADDED ON NOV. 3, 1998, BY INITIATIVE PROP. 6.) PROVISION OF LAW, IT IS UNLAWFUL FOR ANY PERSON TO POSSESS, TO IMPORT INTO OR EXPORT FROM THE STATE, OR TO SELL, BUY, GIVE AWAY, CALIFORNIA PENAL CODE SECTION 598D. (A) NOTWITHSTANDING ANY HOLD, OR ACCEPT ANY HORSE WITH THE INTENT OF KILLING, OR HAVING OTHER PROVISION OF LAW, HORSEMEAT MAY NOT BE OFFERED FOR SALE ANOTHER KILL, THAT HORSE, IF THAT PERSON KNOWS OR SHOULD HAVE FOR HUMAN CONSUMPTION. NO RESTAURANT, CAFE, OR OTHER PUBLIC KNOWN THAT ANY PART OF THAT HORSE WILL BE USED FOR HUMAN EATING PLACE MAY OFFER HORSEMEAT FOR HUMAN CONSUMPTION. (8) CONSUMPTION. (8) FOR PURPOSES OF THIS SECTION, "HORSE" MEANS ANY VIOLATION OF THIS SECTION IS A MISDEMEANOR PUNISHABLE BY A FINE EQUINE, INCLUDING ANY HORSE, PONY, BURRO, OR MULE. (C) VIOLATION OF OF NOT MORE THAN ONE THOUSAND DOLLARS ($1,000), OR BY THIS SECTION IS A FELONY PUNISHABLE BY IMPRISONMENT IN THE STATE CONFINEMENT IN JAIL FOR NOT LESS THAN 30 DAYS NOR MORE THAN PRISON FOR 16 MONTHS, OR TWO OR THREE YEARS. (D) IT IS NOT THE INTENT TWO YEARS, OR BY BOTH THAT FINE AND CONFINEMENT. (C) A SECOND OF THIS SECTION TO AFFECT ANY COMMONLY ACCEPTED COMMERCIAL, OR SUBSEQUENT OFFENSE UNDER THIS SECTION IS PUNISHABLE BY NONCOMMERCIAL, RECREATIONAL, OR SPORTING ACTIVITY THAT RELATES TO IMPRISONMENT IN THE STATE PRISON FOR NOT LESS THAN TWO YEARS HORSES. (E) IT IS NOT THE INTENT OF THIS SECTION TO AFFECT ANY EXISTING NOR MORE THAN FIVE YEARS. (AMENDED (AS AMENDED BY STATS. 2011, LAW THAT RELATES TO HORSE TAXATION OR ZONING. (AMENDED (AS CH. 15) BY STATS. 2011, CH. 39, SEC. 19. (AB 117) EFFECTIVE JUNE 30, 2011. AMENDED BY STATS. 2011, CH. 15) BY STATS. 2011, CH. 39, SEC. 18. (AB 117) OPERATIVE OCTOBER 1, 2011, PURSUANT TO SECS. 68 AND 69 OF CH. 39. EFFECTIVE JUNE 30, 2011. OPERATIVE OCTOBER 1, 2011, NOTE: THIS SECTION WAS ADDED ON NOV. 3, 1998, BY INITIATIVE PROP. 6.)

Modoc FS-2260-002 (April 2020) File Code 2260 Retain 75 years Forest Service Manual 2260 Request to Purchase Wild Horses with Limitations Page 2