"Application for License to Weigh, Sample or Test Milk and Cream" - New Hampshire

Application for License to Weigh, Sample or Test Milk and Cream 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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Download "Application for License to Weigh, Sample or Test Milk and Cream" - New Hampshire

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STATE OF NEW HAMPSHIRE
DEPARTMENT OF AGRICULTURE, MARKETS & FOOD
DIVISION OF ANIMAL INDUSTRY
603-271-2404
Application for License to Weigh, Sample or Test Milk and Cream
Application Fee: $5
In accordance with the provisions of RSA Chapter 184:77, the undersigned hereby applies for a
license to:
Q Weigh and Sample Milk & Cream
Q Renewal of Weigher=s & Sampler=s License
Q Babcock Test for Butterfat Content of Milk & Cream
Q Renewal of Babcock Tester=s License
Name of Licensee:_____________________________________________________________
Signature:
_____________________________________________________________
Address:
_____________________________________________________________
_____________________________________________________________
Sex
Height
Weight
Color of Hair
Color of Eyes_______
Are you currently licensed in another state? Q Yes Q No. If Yes, list the state(s)
______________________________________________________________________________
Q Yes Q No
Are you currently driving?
Employed by:
_____________________________________________________________
Address:
_____________________________________________________________
_____________________________________________________________
Date:
_____________________________________________________________
Make checks payable to:
Treasurer, State of New Hampshire
License fee is non-refundable
Mail application and fee to:
NH Department of Agriculture, Markets & Food
Division of Animal Industry
P. O. Box 2042
Concord, NH 03302-2042
STATE OF NEW HAMPSHIRE
DEPARTMENT OF AGRICULTURE, MARKETS & FOOD
DIVISION OF ANIMAL INDUSTRY
603-271-2404
Application for License to Weigh, Sample or Test Milk and Cream
Application Fee: $5
In accordance with the provisions of RSA Chapter 184:77, the undersigned hereby applies for a
license to:
Q Weigh and Sample Milk & Cream
Q Renewal of Weigher=s & Sampler=s License
Q Babcock Test for Butterfat Content of Milk & Cream
Q Renewal of Babcock Tester=s License
Name of Licensee:_____________________________________________________________
Signature:
_____________________________________________________________
Address:
_____________________________________________________________
_____________________________________________________________
Sex
Height
Weight
Color of Hair
Color of Eyes_______
Are you currently licensed in another state? Q Yes Q No. If Yes, list the state(s)
______________________________________________________________________________
Q Yes Q No
Are you currently driving?
Employed by:
_____________________________________________________________
Address:
_____________________________________________________________
_____________________________________________________________
Date:
_____________________________________________________________
Make checks payable to:
Treasurer, State of New Hampshire
License fee is non-refundable
Mail application and fee to:
NH Department of Agriculture, Markets & Food
Division of Animal Industry
P. O. Box 2042
Concord, NH 03302-2042