Form FDACS-09056 "Application for Permit to Transport Animal Carcasses/Refuse" - Florida

What Is Form FDACS-09056?

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

Form Details:

  • Released on January 1, 1999;
  • The latest edition provided by the Florida Department of Agriculture and Consumer Services;
  • 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 fillable version of Form FDACS-09056 by clicking the link below or browse more documents and templates provided by the Florida Department of Agriculture and Consumer Services.

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Download Form FDACS-09056 "Application for Permit to Transport Animal Carcasses/Refuse" - Florida

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Remit $200.00 Fee Online at:
Florida Department of Agriculture and Consumer Services
www.FreshFromFlorida.com
Division of Animal Industry
- or -
Bureau of Animal Disease Control
Check or Money Order Payable to
FDACS and remit to:
FDACS
APPLICATION FOR PERMIT TO
ADAM H. PUTNAM
P.O. Box 6710
TRANSPORT ANIMAL CARCASSES/REFUSE
COMMISSIONER
Tallahassee, FL
32314-6710
585.147, Florida Statutes
5C-23.002, Florida Administrative Code
Contact: Phone: 850.410.0900
www.FreshFromFlorida.com/ai
Note: All documents and attachments submitted with this request are subject to public review pursuant to Chapter 119, F.S.
COMPLETE ALL ITEMS (PLEASE PRINT)
Name
Address
City
State ___________ Zip Code
_____________________
Phone
County
_____________________
Do you engage in the business of (receive payment or derive monetary or economic benefit from) transporting or
hauling any dead, dying or diseased animal; any product of an animal that has died other than by slaughter; or any
inedible animal product not meant for human consumption?
Yes
No
If you answered “Yes”, please complete this application and return with the application fee of $200, payable to
the Florida Department of Agriculture and Consumer Services. If “No”, please stop and return this form.
Vehicle Inventory
: (List all vehicles to be used to transport animal carcasses or refuse. Use a separate sheet if necessary)
Year
Make
Model
VIN #
License Tag #
State of Registration
In accordance with section 585.147, Florida Statutes, application is hereby made for permit to transport or haul certain animals
or animal products (carcasses/refuse) within the State of Florida, I certify that:
(1) All vehicles used in the transportation of carcasses or refuse on public highways shall be of such construction as to prevent
seepage or residue from escaping;
(2) All barrels or other containers used for transportation and storage of carcasses or refuse shall be clearly marked
“INEDIBLE” with letters not less than 2 inches in height; and
(3) I agree to comply with the requirements of section 585.147, Florida Statutes, and all rules of the Department adopted
pursuant thereto.
The information given above is true and correct to the best of my knowledge.
Signature of Owner or Agent __________________________________ Title
_______________________________________
Please Print Name
__________________________________ Date
_______________________________________
Witness my hand and official seal, this ______ day of ______, _________.
Org. Code: 42090201000
EO: A2
Object Code: 002059 Fee: $200.00
____________________________________________________________________
NOTARY PUBLIC
(Notary Stamp)
RETURN ALL COPIES WITH FEE
Distribution: Original (Office) Copy (District)
FDACS-09056 Rev. 01/99
Remit $200.00 Fee Online at:
Florida Department of Agriculture and Consumer Services
www.FreshFromFlorida.com
Division of Animal Industry
- or -
Bureau of Animal Disease Control
Check or Money Order Payable to
FDACS and remit to:
FDACS
APPLICATION FOR PERMIT TO
ADAM H. PUTNAM
P.O. Box 6710
TRANSPORT ANIMAL CARCASSES/REFUSE
COMMISSIONER
Tallahassee, FL
32314-6710
585.147, Florida Statutes
5C-23.002, Florida Administrative Code
Contact: Phone: 850.410.0900
www.FreshFromFlorida.com/ai
Note: All documents and attachments submitted with this request are subject to public review pursuant to Chapter 119, F.S.
COMPLETE ALL ITEMS (PLEASE PRINT)
Name
Address
City
State ___________ Zip Code
_____________________
Phone
County
_____________________
Do you engage in the business of (receive payment or derive monetary or economic benefit from) transporting or
hauling any dead, dying or diseased animal; any product of an animal that has died other than by slaughter; or any
inedible animal product not meant for human consumption?
Yes
No
If you answered “Yes”, please complete this application and return with the application fee of $200, payable to
the Florida Department of Agriculture and Consumer Services. If “No”, please stop and return this form.
Vehicle Inventory
: (List all vehicles to be used to transport animal carcasses or refuse. Use a separate sheet if necessary)
Year
Make
Model
VIN #
License Tag #
State of Registration
In accordance with section 585.147, Florida Statutes, application is hereby made for permit to transport or haul certain animals
or animal products (carcasses/refuse) within the State of Florida, I certify that:
(1) All vehicles used in the transportation of carcasses or refuse on public highways shall be of such construction as to prevent
seepage or residue from escaping;
(2) All barrels or other containers used for transportation and storage of carcasses or refuse shall be clearly marked
“INEDIBLE” with letters not less than 2 inches in height; and
(3) I agree to comply with the requirements of section 585.147, Florida Statutes, and all rules of the Department adopted
pursuant thereto.
The information given above is true and correct to the best of my knowledge.
Signature of Owner or Agent __________________________________ Title
_______________________________________
Please Print Name
__________________________________ Date
_______________________________________
Witness my hand and official seal, this ______ day of ______, _________.
Org. Code: 42090201000
EO: A2
Object Code: 002059 Fee: $200.00
____________________________________________________________________
NOTARY PUBLIC
(Notary Stamp)
RETURN ALL COPIES WITH FEE
Distribution: Original (Office) Copy (District)
FDACS-09056 Rev. 01/99