"Application for Replacement Card" - Georgia (United States)

Application for Replacement Card is a legal document that was released by the Georgia Department of Agriculture - a government authority operating within Georgia (United States).

Form Details:

  • Released on June 1, 2018;
  • The latest edition currently provided by the Georgia 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 printable version of the form by clicking the link below or browse more documents and templates provided by the Georgia Department of Agriculture.

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Structural Pest Section
19 Martin Luther King, Jr. Dr.
Atlanta, Georgia 30334-4201
Phone: (404) 656-3641
APPLICATION FOR REPLACEMENT CARD
This application can be used to request a certified operator or registered employee
replacement card. This application must include a $10.00 replacement card fee made payable
to the Georgia Department of Agriculture. You may also request and pay for replacement
cards online at
www.agr.georgia.gov/structural
Name:_________________________________________DOB:___________________
Address:_______________________________________________________________
Phone Number:_________________________________________________________
Email Address:__________________________________________________________
Current Cert/Reg License Number:_________________________________________
Employer/Company: ____________________________________________________
Company License Number:________________________________________________
Mail application and $10.00 fee for the replacement card to the following address.
Georgia Department of Agriculture
Structural Pest Control Section - Room 411
19 Martin Luther King Jr. Drive
Atlanta, GA 30334-4201
6/2018
Structural Pest Section
19 Martin Luther King, Jr. Dr.
Atlanta, Georgia 30334-4201
Phone: (404) 656-3641
APPLICATION FOR REPLACEMENT CARD
This application can be used to request a certified operator or registered employee
replacement card. This application must include a $10.00 replacement card fee made payable
to the Georgia Department of Agriculture. You may also request and pay for replacement
cards online at
www.agr.georgia.gov/structural
Name:_________________________________________DOB:___________________
Address:_______________________________________________________________
Phone Number:_________________________________________________________
Email Address:__________________________________________________________
Current Cert/Reg License Number:_________________________________________
Employer/Company: ____________________________________________________
Company License Number:________________________________________________
Mail application and $10.00 fee for the replacement card to the following address.
Georgia Department of Agriculture
Structural Pest Control Section - Room 411
19 Martin Luther King Jr. Drive
Atlanta, GA 30334-4201
6/2018