Form FDACS-08415 "Citrus Health Response Program Application for Participation" - Florida

What Is Form FDACS-08415?

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 April 1, 2007;
  • 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-08415 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-08415 "Citrus Health Response Program Application for Participation" - Florida

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Florida Department of Agriculture and Consumer Services
Division of Plant Industry
CITRUS HEALTH RESPONSE PROGRAM
APPLICATION FOR PARTICIPATION
NICOLE "NIKKI" FRIED
COMMISSIONER
Section 581.184, F.S. / Rule 5B-63.001
3027 Lake Alfred Road, Winter Haven, Florida 33881-1438 / Tel: 863-298-3000 Fax: 863-298-3002
Name of Owner:
Grower C/A#:
Mailing Address:
Number
Street
City
Zip
County
Property Address:
Number
Street
City
Zip
County
Contact Person:
/ Title:
Tel:
List of Grove Properties to be considered for participation in the Fresh Fruit Pre-Harvest Certification Program:
Harvest Date
Tentative
TWP RGE
SEC
Grove Name
/ Block#
Acres
Varieties – List All in Grove
PICS M-BLK
Each Variety
Destination
____ ____ ____
_____________________
______
_______________________________
___________
_____________
____________
____ ____ ____
_____________________
______
_______________________________
___________
_____________
____________
____ ____ ____
_____________________
______
_______________________________
___________
_____________
____________
____ ____ ____
_____________________
______
_______________________________
___________
_____________
____________
____ ____ ____
_____________________
______
_______________________________
___________
_____________
____________
____ ____ ____
_____________________
______
_______________________________
___________
_____________
____________
____ ____ ____
_____________________
______
_______________________________
___________
_____________
____________
____ ____ ____
_____________________
______
_______________________________
___________
_____________
____________
Please use one application per physical property address so that Program personnel can locate your grove for survey purposes.
Please attach a map from a county plat, aerial or PICS Survey Map outlining the grove(s) you wish to have considered.
This form may be duplicated to provide additional pages, if required. Gray areas will be completed by CHRP personnel.
Date received by FDACS
/ DPI in Winter Haven:
Submitted by: ______________________________Date: __________
_____________________
Owner:
/or Agent:
Firm:
FDACS-08415 Rev. 04/07
Florida Department of Agriculture and Consumer Services
Division of Plant Industry
CITRUS HEALTH RESPONSE PROGRAM
APPLICATION FOR PARTICIPATION
NICOLE "NIKKI" FRIED
COMMISSIONER
Section 581.184, F.S. / Rule 5B-63.001
3027 Lake Alfred Road, Winter Haven, Florida 33881-1438 / Tel: 863-298-3000 Fax: 863-298-3002
Name of Owner:
Grower C/A#:
Mailing Address:
Number
Street
City
Zip
County
Property Address:
Number
Street
City
Zip
County
Contact Person:
/ Title:
Tel:
List of Grove Properties to be considered for participation in the Fresh Fruit Pre-Harvest Certification Program:
Harvest Date
Tentative
TWP RGE
SEC
Grove Name
/ Block#
Acres
Varieties – List All in Grove
PICS M-BLK
Each Variety
Destination
____ ____ ____
_____________________
______
_______________________________
___________
_____________
____________
____ ____ ____
_____________________
______
_______________________________
___________
_____________
____________
____ ____ ____
_____________________
______
_______________________________
___________
_____________
____________
____ ____ ____
_____________________
______
_______________________________
___________
_____________
____________
____ ____ ____
_____________________
______
_______________________________
___________
_____________
____________
____ ____ ____
_____________________
______
_______________________________
___________
_____________
____________
____ ____ ____
_____________________
______
_______________________________
___________
_____________
____________
____ ____ ____
_____________________
______
_______________________________
___________
_____________
____________
Please use one application per physical property address so that Program personnel can locate your grove for survey purposes.
Please attach a map from a county plat, aerial or PICS Survey Map outlining the grove(s) you wish to have considered.
This form may be duplicated to provide additional pages, if required. Gray areas will be completed by CHRP personnel.
Date received by FDACS
/ DPI in Winter Haven:
Submitted by: ______________________________Date: __________
_____________________
Owner:
/or Agent:
Firm:
FDACS-08415 Rev. 04/07