Form AG-REG-0301 "Application for Egg Production License" - Utah

What Is Form AG-REG-0301?

This is a legal form that was released by the Utah Department of Agriculture and Food - a government authority operating within Utah. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • The latest edition provided by the Utah Department of Agriculture and Food;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form AG-REG-0301 by clicking the link below or browse more documents and templates provided by the Utah Department of Agriculture and Food.

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Download Form AG-REG-0301 "Application for Egg Production License" - Utah

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Department of Agriculture and Food
Office Use Only
LUANN ADAMS
Cust. # _________________
Commissioner
License Type: 2401
TRAVIS WALLER
Director, Regulatory Services
License # _______________
State of Utah
GARY R. HERBERT
Governor
SPENCER J. COX
Lieutenant Governor
APPLICATION FOR EGG PRODUCTION LICENSE
Application for license to sell, offer or expose for sale, distribute, or grade eggs in accordance with the
provisions of the Utah Egg Regulations.
For Calendar Year: ______________
New
Renewal
Registration Fees (fee schedule based on yearly production)
6,000 doz. or less-$100
6,001 to 30,000 doz.-$200
30,001 to 150,000 doz.-$300
More than 150,000 doz.-$400
Complete Business Name ______________________________________________________________
Location/Street Address ________________________________________________________________
City, State, Zip: ______________________________________________________________________
Phone Number _____________________________ Email Address _____________________________
Mailing Address [if different than above (for letters and renewal purposes)]
Address: ____________________________________________________________________________
____________________________________________________________________________________
Legally Responsible Person: _______________________________ Title: ________________________
I hereby attest that the information in this application for license is true, complete and accurate. I hereby
attest that I will follow the Utah Department of Agriculture & Food Guidelines for producer with less
than 3,000 birds.
Signature: _____________________________________________ Date: ________________________
Typed/Printed Name: ____________________________________ Title: ________________________
350 North Redwood Road, PO Box 146500, Salt Lake City, UT 84116-6500
Telephone 801-538-7100  Facsimile 801-538-7126  http://ag.utah.gov
Form AG-REG-0301
Department of Agriculture and Food
Office Use Only
LUANN ADAMS
Cust. # _________________
Commissioner
License Type: 2401
TRAVIS WALLER
Director, Regulatory Services
License # _______________
State of Utah
GARY R. HERBERT
Governor
SPENCER J. COX
Lieutenant Governor
APPLICATION FOR EGG PRODUCTION LICENSE
Application for license to sell, offer or expose for sale, distribute, or grade eggs in accordance with the
provisions of the Utah Egg Regulations.
For Calendar Year: ______________
New
Renewal
Registration Fees (fee schedule based on yearly production)
6,000 doz. or less-$100
6,001 to 30,000 doz.-$200
30,001 to 150,000 doz.-$300
More than 150,000 doz.-$400
Complete Business Name ______________________________________________________________
Location/Street Address ________________________________________________________________
City, State, Zip: ______________________________________________________________________
Phone Number _____________________________ Email Address _____________________________
Mailing Address [if different than above (for letters and renewal purposes)]
Address: ____________________________________________________________________________
____________________________________________________________________________________
Legally Responsible Person: _______________________________ Title: ________________________
I hereby attest that the information in this application for license is true, complete and accurate. I hereby
attest that I will follow the Utah Department of Agriculture & Food Guidelines for producer with less
than 3,000 birds.
Signature: _____________________________________________ Date: ________________________
Typed/Printed Name: ____________________________________ Title: ________________________
350 North Redwood Road, PO Box 146500, Salt Lake City, UT 84116-6500
Telephone 801-538-7100  Facsimile 801-538-7126  http://ag.utah.gov
Form AG-REG-0301