BUFFALO COUNTY IDENTIFICATION CERTIFICATE (One form can be submitted per 4-H family) This form MUST be completed and returned to the Buffalo County Extension Office by June 1.

4-H member(s) Last Name ______First Name(s):______

Address ______

Club ______Phone ______

I hereby certify that the following are owned and being cared for by me as part of my 4-H poultry project in accordance with the requirements and regulations of the Buffalo County 4-H Program. I have read the regulations and understand that the birds I exhibit at 4-H shows during the project year will be among those checked on this form.

______Signature of 4-H member (s)

______Signature of parent/guardian Date

 The Exhibitor must be the age of 8-18 years old as of January 1 of the current 4-H year.  All poultry must be owned and identified by the individual 4-H’er and/or their family/household, by June 1 including and Production Turkeys.  All poultry must be healthy and show no signs of injury or illness.  All poultry that is exhibited at the Buffalo County Fair MUST be identified on this Poultry Identification Certificate  There are no limits on the number identified at this time. If in doubt as to whether you will show the bird, put it on the form.

BREED/VARIETY How How BREED/VARIETY How How Many? Many? Many? Many?

CHICKEN BREEDS Large Fowl BREEDS Bantam Large Fowl -Blue Cochin-Buff Ameraucana-Wheaten Cochin-Frizzle Ameraucana-White Cochin-Golden Laced Ameraucana-Other:______Cochin-Mottled -Other:______Cochin-Partridge Ancona Cochin-Red Andalusian-Blue Cochin-Silver Laced Cochin-White Aseel-Other:______Cochin-Other:______Australorp Cornish-Dark Barnevelder Cornish-White Belgian d'Anver-Porcelain Cornish- White Laced Red Belgian d'Anver-Quail Cornish-Other:______Belgian d'Anver-Other:______Crevecoeur Belgian d'Uccle-Mille Fleur Cubalaya-Other:______Belgian d'Uccle-Other:______Delaware Booted-Other:______Dominique Brahma-Buff -Silver Gray Brahma-Dark Dorking-Other:______Brahma-Light Dutch-Black Buckeye Dutch-Blue Light Brown Campine-Golden Dutch-Cream Light Brown Campine-Other:______Dutch-Light Brown Catalana-Buff Dutch-Other:______Chantecler-Buff Faverolle-Salmon Chantecler-Other:______Faverolle-White Cochin-Barred Fayoumi-Egyptian Cochin-Black Hamburg-Silver Spangled Cochin-Blue Hamburg-Other:______BREED/VARIETY How How BREED/VARIETY How How Many? Many? Many? Many? CHICKEN BREEDS Bantam Large Fowl CHICKEN BREEDS Bantam Large Fowl Holland-Other:______Rosecombs Houdan-Mottled Seabright-Golden Houdan-White Sebright-Silver Japanese-Black Sebright-Other:______Japanese-Black Tailed Buff Serama-White Japanese-Black Tailed White Serama-Other:______Japanese-Other:______Shamo-Other:______Java-Black Sicilian Buttercup Java-Mottled Silkie-Black -Black Silkie-Blue Jersey Giant-Blue Silkie-Partridge Jersey Giant-White Silkie-White Ko Shamo Silkie-Other:______La Fleche Sultan Lakenvelder Sumatra-Black -Other:______Sumatra-Blue Langshan-Black -Light Langshan-Blue Sussex-Red Langshan-White Sussex-Speckled Leghorn-Light Brown Welsummer Leghorns-White White Faced Black Spanish Leghorn-Other:______Wyandotte-Columbian Malay-Black Breasted Red Wyandotte-Silver Laced Malay-Other:______Wyandotte-White Maran-Black Copper Wyandotte-Golden Laced Maran-Wheaten Wyandotte-Other:______Maran-White Yokohama-Other:______Minorca-Black Other Chicken:______Minorca-Buff Other Chicken:______Minorca-White PRODUCTION How Many? -BB Red Broilers Modern Game-Lemon Blue Turkeys Modern Game-Other______DUCK BREEDS How Many? Naked Neck-Red Aylesbury Naked Neck-White Buff Naked Neck- Other:______Call Nankin Campbell New Hampshire Cayuga Rouen Game-BB Red Crested -Blue East Indie Old English Game-Gold Dkwing Magpie Old English Game-Red Pyle Mallard Old English Game-Slvr Dkwing Muscovy Old English Game-Spangled Pekin Old English Game-Other:______Rouen Orpington-Buff Runner Orpington-White Saxony Orpington-Other:______Swedish Phoenix-Golden Phoenix-Silver Plymouth Rock-Barred BREED (Specify Breed) How Many? Plymouth Rock-Partridge Plymouth Rock-Silver Penciled Plymouth Rock-White Plymouth Rock-Other:______TURKEY BREED (Specify Breed) How Many? Polish-Buff Laced Polish-Golden Laced Polish-Silver Laced Polish-White OTHER POULTRY BREEDS How Many? Polish-White Crest Blue Guinea Polish-White Crested Black Peafowl Polish-Other:______Other:______Red Cap MIXED BREEDS (Describe) How Many? How Many?