BJDTCP3 Application Form [MS Word Document

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F9-01
Department of Economic Development, Jobs, Transport and Resources
Application to enrol in the Victorian bovine Johne’s disease
Test and Control Program (TCP3) for Cattle Herds
This application form must be completed for herds currently participating in the TCP2 program
and wishing to continue in the new TCP3 program, along with any new herds wishing to join
the TCP3.
Herds wishing to participate in the TCP3 program must be enrolled in the Johne’s disease Calf
Accreditation Program (JDCAP) and have a current Certificate of Compliance. Any Victorian
dairy herd can participate in the JDCAP irrespective of its bjd status without participating in
the TCP3 program. Beef herds are exempt from participation in JDCAP.
The TCP3 is a voluntary program operating with the support of the beef and dairy industries
and administered by the Department of Economic Development, Jobs, Transport and
Resources (DEDJTR). Please refer to the Rules of the TCP3. In order to participate in this
funded program, the applicant is required to complete this application form and sign the
declaration acknowledging they understand and will comply with the rules of the program.
Return application form to: TCP3 Admin Officer, Biosecurity, DEDJTR Bendigo, PO Box
2500, Bendigo Delivery Centre, VIC 3554.
Applicant details
Property Identification Code (PIC): 3 ............................
Herd Owner:....................................................................................................
Herd Manager (if different to above): ............................................................
Land Owner (if different to herd owner): .......................................................
Herd Owner / Manager Contact details:
Phone: ......................................... Fax: ............................. Mobile: ........................................
Email: .......................................................................................................................................
Property Address: ………………………………………………………………………….
……………..…………………………………………………………………………………
Postal Address (if different to above): .......................................................................................
Nominated Veterinary Practice / Veterinarian: .....................................................................
Page 1 of 3
Version Date: 18 June 2015
F9-01
Department of Economic Development, Jobs, Transport and Resources
Dairy / Beef Herd details
Numbers of Milking (or beef) Cows (total): ...............................
Number of Milking (or beef) Cows 4 years and older: ..............................
JDCAP Certificate No: VC ...................
Date of last JDCAP vet audit: .................
BJD herd Prevalence status (strike out non-applicable statuses if known):
Tested High Prevalence / Tested Medium Prevalence / Tested Low Prevalence / RD1 / RD2
Date of last bjd herd test: .......................................
Number of tested positive animals at last test. ........................................
Number of clinical animals in the last 12 months. ..................................
Number of high-risk animals culled for slaughter in the last 12 months. ..........................
Number of high-risk animals remaining in the herd. ........................
Introduced cattle
Number of cattle introduced into the herd in the last 2 years? Cows/Heifers ......... Bulls. .....
Were all these introduced cattle the equivalent or higher bjd status? Yes / No
/ Unknown
Herd owners / managers must ensure that the NLIS database is notified within 7 days of the
introduction of cattle including bulls directly from another property with a different PIC.
The Applicant Declaration on following page must be completed.
Page 2 of 3
Version Date: 18 June 2015
F9-01
Department of Economic Development, Jobs, Transport and Resources
Applicant declaration
I (applicant’s full name) ..................................................................……………
participate in the voluntary TCP3 program administered by DEDJTR.
apply to
I acknowledge that the previous TCP2 program agreement (if herd was participating in TCP2)
will cease on 30th September 2010.
I have read and understand the rules of the new TCP3 program and I agree to comply with
these rules, including the conditions of disposal of test positive animals within 30 days of
receipt of written notification of test results from my veterinarian, and the disposal of Primary
High-Risk animals for slaughter only within 12 months, and disposal of Secondary Risk
animals for slaughter only.
Please note the TCP3 program will be reviewed mid 2011 and the conditions associated with
the operation of the program may change after consultation with industry stakeholders.
I understand that I will be responsible to engaged a ‘DEDJTR approved’ veterinarian (a list is
available from DEDJTR if required) to perform the herd testing and I will be responsible for
any additional veterinary fees (if applicable) over and above the program funded fees as
administered by DEDJTR.
Applicant Name: ...................................................................
Applicant Signature: .............................................................
Witness Name: ......................................................................
Witness Signature: ................................................................
Date: ................................
DEDJTR Approved: ..........................
Date: ....................
Page 3 of 3
Version Date: 18 June 2015
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