"Application for a Single Service Manufacturing License" - Kansas

Application for a Single Service Manufacturing License is a legal document that was released by the Kansas Department of Agriculture - a government authority operating within Kansas.

Form Details:

  • Released on January 1, 2019;
  • The latest edition currently provided by the Kansas Department of Agriculture;
  • 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 Kansas Department of Agriculture.

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Kansas Department of Agriculture
1320 Research Park Dr
Manhattan, KS 66502
Phone 785-564-6700
Fax 785-564-6776
KDA.Dairy@KS.GOV
APPLICATION FOR A SINGLE SERVICE MANUFACTURING LICENSE
For Calendar Year of ____
Registration Fee
________New
January 1- December 31
$100.00
________Renewal
A license is required to manufacture single service dairy containers or to manufacture single service dairy
container closures. "Single service article or container" means any container used in the packaging,
handling, storage or serving of Grade A milk or Grade A milk products and which has a surface in direct
contact with the Grade A milk or Grade A milk product and is intended for one usage only.
Business Name ______________________________________________________
Street Address ______________________________________________________
City
State
Zip Code
Phone Number
County
Federal Tax ID
Mailing Address (if different than above for letters and renewal purposes)
Name of: Owner
Manager
I am familiar with the requirements of the Kansas dairy laws and regulations that apply to the manufactured
of single service dairy containers or single service dairy container closures. I affirm that I will comply with
the requirements of the Kansas dairy laws and regulations and that I will conduct this business in a lawful
manner.
_______________________________
_________________
Signature of Owner/Manager
Date
For Office Use Only
ID _______
Issue Date ________
DSS _______________
Revised 01/19
Kansas Department of Agriculture
1320 Research Park Dr
Manhattan, KS 66502
Phone 785-564-6700
Fax 785-564-6776
KDA.Dairy@KS.GOV
APPLICATION FOR A SINGLE SERVICE MANUFACTURING LICENSE
For Calendar Year of ____
Registration Fee
________New
January 1- December 31
$100.00
________Renewal
A license is required to manufacture single service dairy containers or to manufacture single service dairy
container closures. "Single service article or container" means any container used in the packaging,
handling, storage or serving of Grade A milk or Grade A milk products and which has a surface in direct
contact with the Grade A milk or Grade A milk product and is intended for one usage only.
Business Name ______________________________________________________
Street Address ______________________________________________________
City
State
Zip Code
Phone Number
County
Federal Tax ID
Mailing Address (if different than above for letters and renewal purposes)
Name of: Owner
Manager
I am familiar with the requirements of the Kansas dairy laws and regulations that apply to the manufactured
of single service dairy containers or single service dairy container closures. I affirm that I will comply with
the requirements of the Kansas dairy laws and regulations and that I will conduct this business in a lawful
manner.
_______________________________
_________________
Signature of Owner/Manager
Date
For Office Use Only
ID _______
Issue Date ________
DSS _______________
Revised 01/19