Form AG-03032 "Application for Certificate of Free Sale for Animal Feed" - Minnesota

What Is Form AG-03032?

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

Form Details:

  • Released on November 29, 2016;
  • The latest edition provided by the Minnesota 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 fillable version of Form AG-03032 by clicking the link below or browse more documents and templates provided by the Minnesota Agriculture Department.

ADVERTISEMENT
ADVERTISEMENT

Download Form AG-03032 "Application for Certificate of Free Sale for Animal Feed" - Minnesota

Download PDF

Fill PDF online

Rate (4.6 / 5) 62 votes
625 Robert St. N., St. Paul, MN 55155-2538
www.mda.state.mn.us
Food and Feed Safety Division, Ph. 651-201-6027, Fax 651-201-6119
Minn. Stat. Sec. 25.342
Application for Certificate of Free Sale for Animal Feed
The Guarantor must have a Commercial Feed License issued by
the Minnesota Department of Agriculture before this Certificate of Free Sale can be issued.
Business Information
License Number to be Credited Payment:
Guarantor Company (Name of Company on Product label):
MN Commercial Feed License:
Consignee Name:
Mailing Address:
Consignee Address:
City, State, Zip:
City, State, Zip:
Country:
Send Certificate to:
Notes:
MN Commercial Feed License:
Mailing Address:
City, State, Zip:
List Name(s) of Product Intended for Certificate Below
(A label for each product for which the certificate is being requested must be attached.)
Application Fees
Certificate
$ 25.00
600401(3203)
Number of products on certificate:____________ x $50.00 each
$
600401(3203)
Number of duplicate original certificates _____________
$
No Fee
Total Due $
Return this form with your check made payable to:
Minnesota Department of Agriculture
Attn: Cashier
625 Robert Street North
Saint Paul, MN 55155-2538
Licenses are not transferable and fees are not refundable.
I hereby certify that the information contained in and submitted with this form is true and correct.
For Office Use Only
Signature:
Date:
Name (Please Print):
Title:
Contact Telephone:
Fax Number:
Email Address:
In accordance with the Americans with Disabilities Act, this information is available in alternative forms of communication upon request by
AG-03032
calling 651-201-6000. TTY users can call the Minnesota Relay Service at 711. The MDA is an equal opportunity employer and provider.
11/29/16
625 Robert St. N., St. Paul, MN 55155-2538
www.mda.state.mn.us
Food and Feed Safety Division, Ph. 651-201-6027, Fax 651-201-6119
Minn. Stat. Sec. 25.342
Application for Certificate of Free Sale for Animal Feed
The Guarantor must have a Commercial Feed License issued by
the Minnesota Department of Agriculture before this Certificate of Free Sale can be issued.
Business Information
License Number to be Credited Payment:
Guarantor Company (Name of Company on Product label):
MN Commercial Feed License:
Consignee Name:
Mailing Address:
Consignee Address:
City, State, Zip:
City, State, Zip:
Country:
Send Certificate to:
Notes:
MN Commercial Feed License:
Mailing Address:
City, State, Zip:
List Name(s) of Product Intended for Certificate Below
(A label for each product for which the certificate is being requested must be attached.)
Application Fees
Certificate
$ 25.00
600401(3203)
Number of products on certificate:____________ x $50.00 each
$
600401(3203)
Number of duplicate original certificates _____________
$
No Fee
Total Due $
Return this form with your check made payable to:
Minnesota Department of Agriculture
Attn: Cashier
625 Robert Street North
Saint Paul, MN 55155-2538
Licenses are not transferable and fees are not refundable.
I hereby certify that the information contained in and submitted with this form is true and correct.
For Office Use Only
Signature:
Date:
Name (Please Print):
Title:
Contact Telephone:
Fax Number:
Email Address:
In accordance with the Americans with Disabilities Act, this information is available in alternative forms of communication upon request by
AG-03032
calling 651-201-6000. TTY users can call the Minnesota Relay Service at 711. The MDA is an equal opportunity employer and provider.
11/29/16