Mississippi Registration for New Soil or Plant Amendment Product - Mississippi

This "Mississippi Registration for New Soil or Plant Amendment Product" is a document issued by the Mississippi Department of Agriculture and Commerce specifically for Mississippi residents with its latest version released on May 25, 2017.

Download the up-to-date fillable PDF by clicking the link below or find it on the forms website of the Mississippi Department of Agriculture and Commerce.

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MISSISSIPPI REGISTRATION
FOR NEW SOIL OR PLANT AMENDMENT PRODUCT
INSTRUCTIONS:
1.
Submit application along with 1 label for each product to be registered
2. Pay registration fees (due for EACH PRODUCT)
$25.00 for products sold in 10lbs or greater packaging;
$75.00 for material sold in packages of 10lbs or less or one gallon or less;
OR $75.00 for products sold in both weight categories.
PERMIT #
For online registration: access
https://www.ms.gov/mdac/registration_suite
MAIL TO:
BUREAU OF PLANT INDUSTRY
P.O. BOX 5207
MISSISSIPPI STATE, MS 39762
This application is hereby made for the registration in the State of Mississippi of a brand of Soil or Plant Amendment
materials under a label* and guarantee of which the following is an EXACT copy:
Guarantor:
__________________________________________________________________________
Address:
__________________________________________________________________________
_________________________________________________________________________
__________________________________
Telephone:
Email Address: __________________________________ Contact Person : ________________________
Brand Name AND Product Number/SKU, if known:_____________________________________________
________
_________
Sold only in 10 pounds and less packages
Sold in packages greater
than 10 pounds or greater
or one gallon and less.
than one gallon
Net Wt. of Package: _______________________________
Amending Ingredients: (List)
Guaranteed:
_______________________________________________
___________
PERCENT
_______________________________________________
___________
PERCENT
_______________________________________________
___________
PERCENT
_______________________________________________
___________
PERCENT
_______________________________________________
___________
PERCENT
_______________________________________________
___________
PERCENT
Inert Ingredients: (List)
_______________________________________________
___________
PERCENT
_______________________________________________
___________
PERCENT
*Submit one actual label in pdf format for each Soil and Plant Amendment Product registered.
Email labels to
bpifflsp@mdac.ms.gov
or mail on CD or thumb drive
___________________________________
_______________________________
State of
, County of
For the county and state named, and, after being sworn, affirms that the foregoing is a true and correct statement of the registration and
guaranteed analysis of the Soil or Plant Amendment material named, as required by law, and that each and every package or bulk shipment will
be labeled as shown, except that the net weight will be declared and that the commodity so registered and guaranteed will be sold in accordance
with the provisions of the Mississippi Soil and Plant Amendment Law and that this registration and guaranty is made for and on behalf of:
__________________________
_________________________________________________,
Location
______________________________________________________________________________
Name of Firm
_________________________________________________
________________________
Name and Official Position of Executive Signing
Date
Rev 5/25/17
MISSISSIPPI REGISTRATION
FOR NEW SOIL OR PLANT AMENDMENT PRODUCT
INSTRUCTIONS:
1.
Submit application along with 1 label for each product to be registered
2. Pay registration fees (due for EACH PRODUCT)
$25.00 for products sold in 10lbs or greater packaging;
$75.00 for material sold in packages of 10lbs or less or one gallon or less;
OR $75.00 for products sold in both weight categories.
PERMIT #
For online registration: access
https://www.ms.gov/mdac/registration_suite
MAIL TO:
BUREAU OF PLANT INDUSTRY
P.O. BOX 5207
MISSISSIPPI STATE, MS 39762
This application is hereby made for the registration in the State of Mississippi of a brand of Soil or Plant Amendment
materials under a label* and guarantee of which the following is an EXACT copy:
Guarantor:
__________________________________________________________________________
Address:
__________________________________________________________________________
_________________________________________________________________________
__________________________________
Telephone:
Email Address: __________________________________ Contact Person : ________________________
Brand Name AND Product Number/SKU, if known:_____________________________________________
________
_________
Sold only in 10 pounds and less packages
Sold in packages greater
than 10 pounds or greater
or one gallon and less.
than one gallon
Net Wt. of Package: _______________________________
Amending Ingredients: (List)
Guaranteed:
_______________________________________________
___________
PERCENT
_______________________________________________
___________
PERCENT
_______________________________________________
___________
PERCENT
_______________________________________________
___________
PERCENT
_______________________________________________
___________
PERCENT
_______________________________________________
___________
PERCENT
Inert Ingredients: (List)
_______________________________________________
___________
PERCENT
_______________________________________________
___________
PERCENT
*Submit one actual label in pdf format for each Soil and Plant Amendment Product registered.
Email labels to
bpifflsp@mdac.ms.gov
or mail on CD or thumb drive
___________________________________
_______________________________
State of
, County of
For the county and state named, and, after being sworn, affirms that the foregoing is a true and correct statement of the registration and
guaranteed analysis of the Soil or Plant Amendment material named, as required by law, and that each and every package or bulk shipment will
be labeled as shown, except that the net weight will be declared and that the commodity so registered and guaranteed will be sold in accordance
with the provisions of the Mississippi Soil and Plant Amendment Law and that this registration and guaranty is made for and on behalf of:
__________________________
_________________________________________________,
Location
______________________________________________________________________________
Name of Firm
_________________________________________________
________________________
Name and Official Position of Executive Signing
Date
Rev 5/25/17
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