"Application to Buy and Sell Live Poultry" - New Hampshire

Application to Buy and Sell Live Poultry is a legal document that was released by the New Hampshire Department of Agriculture, Markets & Food - a government authority operating within New Hampshire.

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STATE OF NEW HAMPSHIRE
DEPARTMENT OF AGRICULTURE, MARKETS & FOOD
DIVISION OF ANIMAL INDUSTRY
APPLICATION TO BUY AND SELL LIVE POULTRY
In accordance with the provisions of RSA 428:9-21, as amended, relating to the buying, and selling of live
poultry which is to be sold or used for food purposes.
I / We,
____________________________________________________________________________________________________
(Name of person, partnership, firm or corporation)
Phone number
doing business at
___________________________________________________________________________________________
(Name and number of Street)
(Town or City)
(State)
(Zip)
hereby apply for a license to engage regularly in the business of buying and selling, live poultry which is to
do
be sold for food purposes. The applicant hereby agrees to conform to all provisions of the law and the rules and
regulations authorized hereunder.
If applicant is a partnership, firm or corporation, list hereunder the names and legal addresses of the officers or
members.
____________________________________________________________________________________________________________
(Name)
(Street)
(Town)
(State)
(Zip)
_______________________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________________
I understand that this application is for a “Cash Buyers” license only.
I further understand that under this license the failure to pay for all poultry on a United States currency, certified check,
cashier’s check or traveler’s check basis only at time of sale shall be deemed sufficient cause for revoking license.
I declare the foregoing statements are true under penalties of perjury.
__________________________________________________
(Signature of Applicant)
BUYER’S LICENSE FEE:
$20.00
MAKE CHECK PAYABLE TO:
Treasurer State of NH
MAIL TO:
NH Department of Agriculture, Markets & Food
P O Box 2042
Concord, NH 03302-2042.
STATE OF NEW HAMPSHIRE
DEPARTMENT OF AGRICULTURE, MARKETS & FOOD
DIVISION OF ANIMAL INDUSTRY
APPLICATION TO BUY AND SELL LIVE POULTRY
In accordance with the provisions of RSA 428:9-21, as amended, relating to the buying, and selling of live
poultry which is to be sold or used for food purposes.
I / We,
____________________________________________________________________________________________________
(Name of person, partnership, firm or corporation)
Phone number
doing business at
___________________________________________________________________________________________
(Name and number of Street)
(Town or City)
(State)
(Zip)
hereby apply for a license to engage regularly in the business of buying and selling, live poultry which is to
do
be sold for food purposes. The applicant hereby agrees to conform to all provisions of the law and the rules and
regulations authorized hereunder.
If applicant is a partnership, firm or corporation, list hereunder the names and legal addresses of the officers or
members.
____________________________________________________________________________________________________________
(Name)
(Street)
(Town)
(State)
(Zip)
_______________________________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________________________
I understand that this application is for a “Cash Buyers” license only.
I further understand that under this license the failure to pay for all poultry on a United States currency, certified check,
cashier’s check or traveler’s check basis only at time of sale shall be deemed sufficient cause for revoking license.
I declare the foregoing statements are true under penalties of perjury.
__________________________________________________
(Signature of Applicant)
BUYER’S LICENSE FEE:
$20.00
MAKE CHECK PAYABLE TO:
Treasurer State of NH
MAIL TO:
NH Department of Agriculture, Markets & Food
P O Box 2042
Concord, NH 03302-2042.