(6) a statement in substantially the following form: State of Alaska)
) ss:
______ Judicial District )
I, __________________________________, as the owner or permit holder responsible for the dairy farm operation identified above, hereby certify as follows:
(A) that no animals on the above farm are currently being treated with recombinant bovine somatotropin (rBST), also known as recombinant bovine growth hormone (rBGH);(B) that no animals on the above farm have received rBST treatments within the past 30 days;(C) that I will provide written notice to the buyer of my milk at least thirty (30) days in advance if I intend to use rBST on my dairy cattle; and(D) that I will not sell milk from animals added to my herd if those animals may have received rBST treatment within the previous 30 days.I declare, under oath, that the above statement is true and correct to the best of my knowledge.
Producer Signature ______
Subscribed and sworn to or affirmed before me at ______ on ________________ .
Notary Public
My Commission Expires