"Renewal Application for Registration of Commercial Weighing and Measuring Device Serviceperson" - Delaware

Renewal Application for Registration of Commercial Weighing and Measuring Device Serviceperson is a legal document that was released by the Delaware Department of Agriculture - a government authority operating within Delaware.

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RENEWAL APPLICATION FOR REGISTRATION OF COMMERCIAL WEIGHING AND MEASURING DEVICE SERVICEPERSON
Email to
Valerie.Forbes@delaware.gov
or Mail to: DE Dept. of Agriculture, Weights and Measures, 2320 S. DuPont Hwy, Dover, DE 19901
APPLICANT NAME: ______________________________________________________
DATE: ________________________________
MAILING ADDRESS: _________________________________ CITY: ________________________ STATE: _____ ZIPCODE: __________
APPLICANT PHONE: _______________________ CELL PHONE: _______________________ EMAIL: ______________________________
BUSINESS NAME: ____________________________________________________________________________________________________
MAILING ADDRESS: _________________________________ CITY: ________________________ STATE: _____ ZIPCODE: __________
BUSINESS PHONE: _______________________ FAX: _______________________ EMAIL: ________________________________________
PLEASE CHECK THE DEVICES THAT YOU ARE PRESENTLY REPAIRING/INSTALLING:
Scales
Liquid Measuring Devices
Vehicle Tank Meters
Liquefied Petroleum Gas Meters
Other (please explain): _________________________________________________________________________________________________
I hereby apply for renewal of my Delaware Commercial Weighing and Measuring Device License No. __________________________ expiring on
_______________________, 20____. I hereby agree with all rules, laws, and regulations pertaining to the installation/service or repair of weighing
and measuring devices in the State of Delaware.
___________________________
Signature of Applicant
NOTE: No payment is required for renewal applications. Renewal is required annually.
RENEWAL APPLICATION FOR REGISTRATION OF COMMERCIAL WEIGHING AND MEASURING DEVICE SERVICEPERSON
Email to
Valerie.Forbes@delaware.gov
or Mail to: DE Dept. of Agriculture, Weights and Measures, 2320 S. DuPont Hwy, Dover, DE 19901
APPLICANT NAME: ______________________________________________________
DATE: ________________________________
MAILING ADDRESS: _________________________________ CITY: ________________________ STATE: _____ ZIPCODE: __________
APPLICANT PHONE: _______________________ CELL PHONE: _______________________ EMAIL: ______________________________
BUSINESS NAME: ____________________________________________________________________________________________________
MAILING ADDRESS: _________________________________ CITY: ________________________ STATE: _____ ZIPCODE: __________
BUSINESS PHONE: _______________________ FAX: _______________________ EMAIL: ________________________________________
PLEASE CHECK THE DEVICES THAT YOU ARE PRESENTLY REPAIRING/INSTALLING:
Scales
Liquid Measuring Devices
Vehicle Tank Meters
Liquefied Petroleum Gas Meters
Other (please explain): _________________________________________________________________________________________________
I hereby apply for renewal of my Delaware Commercial Weighing and Measuring Device License No. __________________________ expiring on
_______________________, 20____. I hereby agree with all rules, laws, and regulations pertaining to the installation/service or repair of weighing
and measuring devices in the State of Delaware.
___________________________
Signature of Applicant
NOTE: No payment is required for renewal applications. Renewal is required annually.