Form 101 "Non-certified Seed Sample Record" - Arkansas

What Is Form 101?

This is a legal form that was released by the Arkansas Agriculture Department - a government authority operating within Arkansas. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on February 1, 2009;
  • The latest edition provided by the Arkansas Agriculture Department;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form 101 by clicking the link below or browse more documents and templates provided by the Arkansas Agriculture Department.

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Download Form 101 "Non-certified Seed Sample Record" - Arkansas

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ARKANSAS STATE PLANT BOARD
Form: 101 Rev. 2/2009
NON-CERTIFIED SEED SAMPLE RECORD
This form should be used when submitting samples to the Arkansas State Plant Board Seed Lab. The analysis fee should be included with this form and the seed sample, unless
other arrangements have been made. If you want the Plant Board to print analysis tags ($0.10 each), the variety must be stated and the sample must be taken from cleaned,
bagged seed by a Plant Board Inspector. (If ordering tags, list only one lot per page)
Number of Labels Needed: ____________
:
Send Seed Sample, Paperwork, and Fees to
Arkansas State Plant Board, # 1 Natural Resources Drive, Little Rock, AR 72205
OR
PO Box 1069, Little Rock, AR 72203
:
:
Number of tags needed
Number of tags needed
Analysis Report and/or Charges should be sent to:
Name:
Phone:
Email
Address:
City & State:
Zip:
Send Copy of Analysis to:
($1.00 fee charged for copy)
Address:
City:
State:
Zip:
LAB
SAMPLING
DESCRIPTION OF LOT
USE
INFO
Name of
Amt.
ONLY
**KIND OF TEST
Seed
Enclosed
Amount of
Treatment
For test(s)
Sampled
Kind
Variety
Lot #
Lab
Bag
Bushels or
# of
Other
Comp
GO
PO
by:
Weight
#
Bags
Probes
Remarks:
**Kind of Test:
Comp = % Weed Seed, % Other Crop Kinds, % Inert, % Germination, Number & Kind of Noxious Weeds per Pound; GO = % Germination;
PO = same as a Complete (Comp) without the % germination. (Contact lab at (501) 225-1598 for other tests performed or current analysis fees)
An additional $3.00 handling fee is charged for all samples picked up and sent in by Plant Board Inspectors.
NOTE:
If seed is carryover or already labeled, attach label or copy of labeling.
The Plant Board cannot release testing information unless it is paid for in advance or the customer has a valid charge account.
Sampler Signature:
Date Sampled:
ARKANSAS STATE PLANT BOARD
Form: 101 Rev. 2/2009
NON-CERTIFIED SEED SAMPLE RECORD
This form should be used when submitting samples to the Arkansas State Plant Board Seed Lab. The analysis fee should be included with this form and the seed sample, unless
other arrangements have been made. If you want the Plant Board to print analysis tags ($0.10 each), the variety must be stated and the sample must be taken from cleaned,
bagged seed by a Plant Board Inspector. (If ordering tags, list only one lot per page)
Number of Labels Needed: ____________
:
Send Seed Sample, Paperwork, and Fees to
Arkansas State Plant Board, # 1 Natural Resources Drive, Little Rock, AR 72205
OR
PO Box 1069, Little Rock, AR 72203
:
:
Number of tags needed
Number of tags needed
Analysis Report and/or Charges should be sent to:
Name:
Phone:
Email
Address:
City & State:
Zip:
Send Copy of Analysis to:
($1.00 fee charged for copy)
Address:
City:
State:
Zip:
LAB
SAMPLING
DESCRIPTION OF LOT
USE
INFO
Name of
Amt.
ONLY
**KIND OF TEST
Seed
Enclosed
Amount of
Treatment
For test(s)
Sampled
Kind
Variety
Lot #
Lab
Bag
Bushels or
# of
Other
Comp
GO
PO
by:
Weight
#
Bags
Probes
Remarks:
**Kind of Test:
Comp = % Weed Seed, % Other Crop Kinds, % Inert, % Germination, Number & Kind of Noxious Weeds per Pound; GO = % Germination;
PO = same as a Complete (Comp) without the % germination. (Contact lab at (501) 225-1598 for other tests performed or current analysis fees)
An additional $3.00 handling fee is charged for all samples picked up and sent in by Plant Board Inspectors.
NOTE:
If seed is carryover or already labeled, attach label or copy of labeling.
The Plant Board cannot release testing information unless it is paid for in advance or the customer has a valid charge account.
Sampler Signature:
Date Sampled:
C. Schedule of Fees:
1. REGULATORY SAMPLES -- There are no fees charged for regulatory samples unless copies of test results are
requested, then fees are the same as for service samples.
2. SERVICE SAMPLES
KIND OF SEED
COMPLETE
PURITY OR GERM ONLY
ALFALFA
$16.00
$12.00
BAHIAGRASS
$16.00
$12.00
BARLEY
$16.00
$ 8.00
BEAN (garden & field)
$16.00
$ 8.00
BERMUDAGRASS
$16.00
$12.00
BLUEGRASS
$16.00
$12.00
BLUESTEM
$50.00
$40.00
CLOVER
$16.00
$12.00
CORN
$16.00
$ 8.00
COTTON
$16.00
$ 8.00
DALLISGRASS
$16.00
$12.00
FESCUE
$16.00
$12.00
JOHNSONGRASS
$16.00
$12.00
LESPEDEZA
$16.00
$12.00
LOVEGRASS
$16.00
$12.00
MILLET
$16.00
$12.00
MUSTARD
$16.00
$12.00
OATS
$16.00
$ 8.00
OKRA
$16.00
$ 8.00
PEAS (garden & field)
$16.00
$ 8.00
PEANUTS
$16.00
$ 8.00
RICE
$16.00
$ 8.00
RYE
$16.00
$ 8.00
RYEGRASS
$16.00
$12.00
SORGHUM
$16.00
$ 8.00
SOYBEANS
$16.00
$ 8.00
TURNIP/RAPE
$16.00
$12.00
VETCH
$16.00
$ 8.00
WHEAT
$16.00
$ 8.00
VEGETABLES
$16.00
$12.00
THE TESTING FEE FOR CROPS NOT LISTED WILL BE THE SAME AS A LISTED CROP WITH SIMILAR COMPLEXITY. CALL THE
PLANT BOARD FOR EXACT FEE INFORMATION. (501) 225-1598
ANALYSIS FOR MIXTURES $8.00 - will be charged for each additional component in a mixture.
TETRAZOLIUM TEST (TZ) $15.00 - chemical test for estimating the germination potential (Not an official germination test and
may not be used to label)
VIGOR TESTS $12.00 -determining the potential for rapid uniform emergence and development of normal seedlings under a
wide range of field conditions.
1) Accelerated Aging (soybeans, wheat)
2) Cool Test (cotton)
3) Complete Seedling Count (garden beans)
VARIETAL TESTS $12.00 - tests which help determine, confirm or group seed as to variety:
1) Phenol Test (wheat)
2) Fluorescence Test (oats)
3) Hypocotyl Test (soybeans)
SEED CHARACTERISTICS TEST $12.00 - Examination of 500 grams for varietal characteristics.
HERBICIDE RESISTANCE TESTS: 1) Roundup® Test on Soybeans (400 seed test: $23; 200 seed: $15)
2) STS Test on Soybeans (400 seed test: $32; 200 seed test: $25)
SAMPLING FEE $15.00 - A fee is charged for samples drawn by the Plant Board
HANDLING FEE $3.00 - A fee is charged for samples that are picked up by the Plant Board.
PURITY FIRST $1.00 - Upon request, a preliminary purity report will be given upon completion of the test.
PRIORITY SAMPLES $25.00 - Allows sample to be tested ahead of other samples in the lab. This fee is in addition to the fees
for the tests requested.
ADDITIONAL ANALYSIS REPORTS $1.00 - For each additional requested copy of the analysis report.
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