"Grain Inspectors - Renewal Application Form" - Delaware

Grain Inspectors - Renewal Application Form is a legal document that was released by the Delaware Department of Agriculture - a government authority operating within Delaware.

Form Details:

  • Released on February 20, 2009;
  • The latest edition currently provided by the Delaware Department of Agriculture;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of the form by clicking the link below or browse more documents and templates provided by the Delaware Department of Agriculture.

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Download "Grain Inspectors - Renewal Application Form" - Delaware

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DELAWARE DEPARTMENT OF AGRICULTURE
PLANT INDUSTRIES SECTION
2320 S. DUPONT HIGHWAY
DOVER, DELAWARE 19901-5515
Phone: (302) 698-4577
(800) 282-8685
GRAIN INSPECTORS -- RENEWAL APPLICATION
Applicant:
Address:
City/State/Zip
Business:
Address:
City/State/Zip
CURRENT LICENSE NO.
Expiring:
(Check Box)
GRAIN INSPECTED:
CORN:
SOYBEANS:
BARLEY:
WHEAT:
SORGHUM:
OTHER:
___________________________________
MOISTURE DEVICE: (Check Box)
GAC 2500:
GAC 2000:
GAC 2100:
GAC 2100b:
Other:
TRAINING:
List all you have completed.
Other license:
Weighmasters No.:
Expiration date:
Warehouse license:
Expiration date:
A $10.00 fee for two (2) years must accompany application for grain inspectors. All license must be returned to the
Delaware Department of Agriculture within 30 days of termination of employment.
I agree to comply with all the requirements of the Grain Inspection Rules and Regulations.
____________________________________________
Signature of Applicant
Date
PAYMENT:
CHECK:
Amount $
CHECK NO:
Please Make Check Payable To: Delaware Department of Agriculture Seed Laboratory
Charge to my Credit Card: Amount $__________
VISA
MASTER CARD
DISCOVER/NOVUS
Card Number:
Exp Date: ______/_____ 3-Digit Code:
Billing Name:
Telephone No:.
Billing Address:
City/State/Zip:
Authorization Signature:
Date:
_______________________________________________________________________________________________
OFFICE USE ONLY
PAYMENT
CASH
CHECK NO
CREDIT
INVOICE NO
POSTED
ISPECTORS RE-APPLICATION.09.02.20.RCB.WEB
DELAWARE DEPARTMENT OF AGRICULTURE
PLANT INDUSTRIES SECTION
2320 S. DUPONT HIGHWAY
DOVER, DELAWARE 19901-5515
Phone: (302) 698-4577
(800) 282-8685
GRAIN INSPECTORS -- RENEWAL APPLICATION
Applicant:
Address:
City/State/Zip
Business:
Address:
City/State/Zip
CURRENT LICENSE NO.
Expiring:
(Check Box)
GRAIN INSPECTED:
CORN:
SOYBEANS:
BARLEY:
WHEAT:
SORGHUM:
OTHER:
___________________________________
MOISTURE DEVICE: (Check Box)
GAC 2500:
GAC 2000:
GAC 2100:
GAC 2100b:
Other:
TRAINING:
List all you have completed.
Other license:
Weighmasters No.:
Expiration date:
Warehouse license:
Expiration date:
A $10.00 fee for two (2) years must accompany application for grain inspectors. All license must be returned to the
Delaware Department of Agriculture within 30 days of termination of employment.
I agree to comply with all the requirements of the Grain Inspection Rules and Regulations.
____________________________________________
Signature of Applicant
Date
PAYMENT:
CHECK:
Amount $
CHECK NO:
Please Make Check Payable To: Delaware Department of Agriculture Seed Laboratory
Charge to my Credit Card: Amount $__________
VISA
MASTER CARD
DISCOVER/NOVUS
Card Number:
Exp Date: ______/_____ 3-Digit Code:
Billing Name:
Telephone No:.
Billing Address:
City/State/Zip:
Authorization Signature:
Date:
_______________________________________________________________________________________________
OFFICE USE ONLY
PAYMENT
CASH
CHECK NO
CREDIT
INVOICE NO
POSTED
ISPECTORS RE-APPLICATION.09.02.20.RCB.WEB