Form FS-36 "Feed Affidavit" - Hawaii

What Is Form FS-36?

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

Form Details:

  • Released on January 1, 2009;
  • The latest edition provided by the Hawaii Department of Agriculture;
  • 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 FS-36 by clicking the link below or browse more documents and templates provided by the Hawaii Department of Agriculture.

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Download Form FS-36 "Feed Affidavit" - Hawaii

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FS-36
Rev. 1/09
Commodities Branch
Quality Assurance Division
1851 Auiki Street
Honolulu, Hawaii 96819-3100
FEED AFFIDAVIT
Gentlemen:
I certify that the following feeds intended for sale, offered for sale, or distribution within the State of
Hawaii do not contain any pesticide residue or any other adulterant in excess of the tolerances and action
levels established by Chapter 4-45, Hawaii Administrative Rules.
NAMES OR DESCRIPTION OF FEED:
Signature
Company
Address
Name (please print)
Zip
Title
(
)
/
Area Code
Phone No.
Fax No.
Date
FS-36
Rev. 1/09
Commodities Branch
Quality Assurance Division
1851 Auiki Street
Honolulu, Hawaii 96819-3100
FEED AFFIDAVIT
Gentlemen:
I certify that the following feeds intended for sale, offered for sale, or distribution within the State of
Hawaii do not contain any pesticide residue or any other adulterant in excess of the tolerances and action
levels established by Chapter 4-45, Hawaii Administrative Rules.
NAMES OR DESCRIPTION OF FEED:
Signature
Company
Address
Name (please print)
Zip
Title
(
)
/
Area Code
Phone No.
Fax No.
Date