"Application for Dealers License to Sell Restricted Fertilizer" - Nevada

Application for Dealers License to Sell Restricted Fertilizer is a legal document that was released by the Nevada Department of Agriculture - a government authority operating within Nevada.

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RFDL No.:
STATE OF NEVADA
DEPARTMENT OF AGRICULTURE
405 South 21st Street
Sparks, Nevada 89431
APPLICATION FOR DEALERS LICENSE TO SELL RESTRICTED FERTILIZER
Application is hereby made for a license to sell fertilizer which is classified as Restricted to consumers or users for calendar year
ending December 31, 20____ .Remittance payable to Nevada Department of Agriculture in amount of $25.00 is enclosed herewith.
Dealer / Company Name & Address
Company:
Attention:
Dealer Name:
E-Mail:
Address:
Telephone/Fax:
City, State, Zip:
List Agent(s) by Name and Location
include contact email and phone number
I hereby certify that the information appearing on this application is true and correct; that each person licensed to sell Restricted Fertilizer to
consumers or users will maintain and keep records for a period of 2 years on all sales of Restricted Fertilizer including all information required by
NRS 588.295.
Signature:
Date _ _ _ _ _ _ _ _ _ _ _
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Title_ _ _ _ _ _ _ _ _ _
N a m e :
- - - - - - - - - - - - - - - - - - - - - - - -
RFDL No.:
STATE OF NEVADA
DEPARTMENT OF AGRICULTURE
405 South 21st Street
Sparks, Nevada 89431
APPLICATION FOR DEALERS LICENSE TO SELL RESTRICTED FERTILIZER
Application is hereby made for a license to sell fertilizer which is classified as Restricted to consumers or users for calendar year
ending December 31, 20____ .Remittance payable to Nevada Department of Agriculture in amount of $25.00 is enclosed herewith.
Dealer / Company Name & Address
Company:
Attention:
Dealer Name:
E-Mail:
Address:
Telephone/Fax:
City, State, Zip:
List Agent(s) by Name and Location
include contact email and phone number
I hereby certify that the information appearing on this application is true and correct; that each person licensed to sell Restricted Fertilizer to
consumers or users will maintain and keep records for a period of 2 years on all sales of Restricted Fertilizer including all information required by
NRS 588.295.
Signature:
Date _ _ _ _ _ _ _ _ _ _ _
_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Title_ _ _ _ _ _ _ _ _ _
N a m e :
- - - - - - - - - - - - - - - - - - - - - - - -