"Non-dealer Declaration" - New York

Non-dealer Declaration is a legal document that was released by the New York State Department of Agriculture and Markets - a government authority operating within New York.

Form Details:

  • The latest edition currently provided by the New York State Department of Agriculture and Markets;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of the form by clicking the link below or browse more documents and templates provided by the New York State Department of Agriculture and Markets.

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Download "Non-dealer Declaration" - New York

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Non-Dealer Declaration
My annual purchases or dealings of farm products grown by New York producers that are
sold wholesale to agricultural, commercial, industrial and institutional users will not exceed
$20,000.
My purchases or dealings from New York producers are only for sale at retail to the ultimate
consumer. Sale at retail to the ultimate consumer shall not include sales to industrial,
institutional, commercial or agricultural users.
I will not be purchasing or dealing in New York farm products (includes Commission
Merchant, Broker and Processor).
Name of Dealer (print)
Authorized Person and Title (print)
Date
Signature
Name and address of succeeding business (if applicable)
Return this form OR the completed application to following address:
NYS Department of Agriculture and Markets
Division of Agricultural Development
10B Airline Drive
Albany, NY 12235.
10B Airline Dr. Albany, N.Y., 12235│ (800) 554-4501 │www.agriculture.ny.gov
Non-Dealer Declaration
My annual purchases or dealings of farm products grown by New York producers that are
sold wholesale to agricultural, commercial, industrial and institutional users will not exceed
$20,000.
My purchases or dealings from New York producers are only for sale at retail to the ultimate
consumer. Sale at retail to the ultimate consumer shall not include sales to industrial,
institutional, commercial or agricultural users.
I will not be purchasing or dealing in New York farm products (includes Commission
Merchant, Broker and Processor).
Name of Dealer (print)
Authorized Person and Title (print)
Date
Signature
Name and address of succeeding business (if applicable)
Return this form OR the completed application to following address:
NYS Department of Agriculture and Markets
Division of Agricultural Development
10B Airline Drive
Albany, NY 12235.
10B Airline Dr. Albany, N.Y., 12235│ (800) 554-4501 │www.agriculture.ny.gov