"Application for Registration of Commercial Weighing and Measuring Device Serviceperson" - Delaware

This "Application for Registration of Commercial Weighing and Measuring Device Serviceperson" is a Delaware-specific form released by the Delaware Department of Agriculture on May 15, 2001.

Download the form by clicking the link below, fill it out by hand, and mail it as per the guidelines provided by the department or the applicable legal instructions.

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Download "Application for Registration of Commercial Weighing and Measuring Device Serviceperson" - Delaware

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State of Delaware
Department of Agriculture, Weights and Measures
2320 South Dupont Highway
Dover, DE 19901 (302) 698-4602 or (800) 282-8685 (DE only)
Application for Registration of Commercial Weighing and Measuring Device Serviceperson
__________________________________________
_____________________________________________
Applicant Name and Telephone Number
Firm Name and Telephone Number
_____________________________________________
Firm Correct Mailing
Address, City/St/Zip
Address, City/St/Zip
Years of experience in installation/service or repair of weighing or measuring devices: _____________________________
Have you had any formal training in installation/service or repair of weighing or measuring devices?
When and where: _____________________________________________________________________________________
_____________________________________________________________________________________________________
Are you a registered service person in another state? (Please list states) ___________________________________________
Please check the devices that you are presently repairing/installing:
Scales
Liquid Measuring Devices
Vehicle Tank Meters
Liquefied Petroleum Gas Meters
Other (please explain) ________________________________________________________________________________
Date last attended a training seminar: ____________________________________________________________________
I hereby agree with all rules, laws, and regulations pertaining to the installation/service or repair of weighing and measuring
devices in the State of Delaware.
-----------------------------------------------------------
Signature of Applicant
One Time Registration Fee - $25.00
NOTE: Application must be accompanied with payment
Renewal is required annually
CREDIT CARD PAYMENT
NEW!!
Check/Money Order
Visa
MasterCard
Discover
Please Make Check or Money
Order Payable to:
Billing Name: _________________________________
Delaware Department of
Billing Address: ____________________________
Agriculture
Weights and Measures
Telephone Number: ___________________________
City/St/Zip: ____________________________________
Credit Card Number: ________________________
3-digit code:___________________________________
Expiration Date: ______________________________
Authorization: _____________________________
Doc No. 65-01-11/01/05/15
State of Delaware
Department of Agriculture, Weights and Measures
2320 South Dupont Highway
Dover, DE 19901 (302) 698-4602 or (800) 282-8685 (DE only)
Application for Registration of Commercial Weighing and Measuring Device Serviceperson
__________________________________________
_____________________________________________
Applicant Name and Telephone Number
Firm Name and Telephone Number
_____________________________________________
Firm Correct Mailing
Address, City/St/Zip
Address, City/St/Zip
Years of experience in installation/service or repair of weighing or measuring devices: _____________________________
Have you had any formal training in installation/service or repair of weighing or measuring devices?
When and where: _____________________________________________________________________________________
_____________________________________________________________________________________________________
Are you a registered service person in another state? (Please list states) ___________________________________________
Please check the devices that you are presently repairing/installing:
Scales
Liquid Measuring Devices
Vehicle Tank Meters
Liquefied Petroleum Gas Meters
Other (please explain) ________________________________________________________________________________
Date last attended a training seminar: ____________________________________________________________________
I hereby agree with all rules, laws, and regulations pertaining to the installation/service or repair of weighing and measuring
devices in the State of Delaware.
-----------------------------------------------------------
Signature of Applicant
One Time Registration Fee - $25.00
NOTE: Application must be accompanied with payment
Renewal is required annually
CREDIT CARD PAYMENT
NEW!!
Check/Money Order
Visa
MasterCard
Discover
Please Make Check or Money
Order Payable to:
Billing Name: _________________________________
Delaware Department of
Billing Address: ____________________________
Agriculture
Weights and Measures
Telephone Number: ___________________________
City/St/Zip: ____________________________________
Credit Card Number: ________________________
3-digit code:___________________________________
Expiration Date: ______________________________
Authorization: _____________________________
Doc No. 65-01-11/01/05/15
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