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Form AMAL 1d AGRICULTURAL MARKETING AUTHORITY REGISTRATION AS A LIVESTOCK & LIVESTOCK PRODUCTS PROCESSOR (CAP 18:24, Statutory Instrument 147 of 2012) 2016 MARKETING SEASON 1. Name of Buyer/Trader/Broker…………………………………………………………. Address:…………………………………………………………………………………… ..................................................................................................................................................... ..................................................................................................................................................... Province………………………………………………………………………………………. Contact: Tel…………………………………………………………………………………... Cell: …………………………………………………………………………………………. Email: ………………………………………………………………………………………. 2. Type of animal and estimated total number of animals or quantity of animal products to be bought/sold: Type of Animal/Product Estimated Total Number of Animals/Quantity of Products to be bought/sold Local Imports Exports Cattle Goats Sheep Pigs Poultry Eggs Milk Other Dairy Products Honey Hides & Skins Meat and Meat Products Fish Other (specify) Other (specify) Other (specify) ________________________ Name in full Designation……………………….. _________________________________ Authorised Signatory Company Stamp and date ………………………