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

Form AG-03032 is a Minnesota Agriculture Department form also known as the "Application For Certificate Of Free Sale For Animal Feed". The latest edition of the form was released in November 29, 2016 and is available for digital filing.

Download an up-to-date Form AG-03032 in PDF-format down below or look it up on the Minnesota Agriculture Department Forms website.

ADVERTISEMENT
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

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

1036 times
Rate
4.6(4.6 / 5) 62 votes
ADVERTISEMENT