"Initial Application for Agricultural Consultant License" - Louisiana

Initial Application for Agricultural Consultant License is a legal document that was released by the Louisiana Department of Agriculture & Forestry - a government authority operating within Louisiana.

Form Details:

  • The latest edition currently provided by the Louisiana Department of Agriculture & Forestry;
  • 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 printable version of the form by clicking the link below or browse more documents and templates provided by the Louisiana Department of Agriculture & Forestry.

ADVERTISEMENT
ADVERTISEMENT

Download "Initial Application for Agricultural Consultant License" - Louisiana

376 times
Rate (4.3 / 5) 23 votes
L
D
A
F
OUISIANA
EPARTMENT OF
GRICULTURE &
ORESTRY
Mike Strain
, Commissioner
DVM
Agricultural & Environmental Sciences, 5825 Florida Blvd., Suite 1003, Baton Rouge, LA 70806, (225) 925-3796
2020 INITIAL APPLICATION FOR AGRICULTURAL CONSULTANT LICENSE
Owner/Principal Officer:
Company Name:
Mailing Address:
-
City/State/Zip:
Physical Address:
City/State/Zip:
RESIDENT AG CONSULTANT LICENSE FEE $200
.00
.00
NON-RESIDENT AG CONSULTANT LICENSE FEE $500
$
.00
REGISTERED FIELD SCOUT(S)
____ X $10 EACH
$
.00
AMOUNT DUE =
$
.00
INSTRUCTIONS:
Add names of Registered Field Scouts in the space provided on Page 2.
If you need additional forms, contact our office at (225) 925-3796 or pestcert@ldaf.state.la.us
Do not staple payment to your application! Checks or Money Orders are the only accepted methods of
payment. DO NOT MAIL CASH! Make payable to:
LOUISIANA DEPARTMENT OF AGRICULTURE & FORESTRY
Mail to: Louisiana Dept. of Agriculture & Forestry, 5825 Florida Blvd, Ste. 1003, Baton Rouge, LA 70806
Print Name
Signature
Date
AES-07-05 (r.12/19)
OFFICE USE
Transmittal #
Check #
RESIDENT
0800 1605 01__
NON RESIDENT 0800 1605 N1__
Date
FIELD SCOUT
0800 1605 06__
$
.00
Amt.
LDAF ID No.: (Office Use Only)
Page 1 of 2
L
D
A
F
OUISIANA
EPARTMENT OF
GRICULTURE &
ORESTRY
Mike Strain
, Commissioner
DVM
Agricultural & Environmental Sciences, 5825 Florida Blvd., Suite 1003, Baton Rouge, LA 70806, (225) 925-3796
2020 INITIAL APPLICATION FOR AGRICULTURAL CONSULTANT LICENSE
Owner/Principal Officer:
Company Name:
Mailing Address:
-
City/State/Zip:
Physical Address:
City/State/Zip:
RESIDENT AG CONSULTANT LICENSE FEE $200
.00
.00
NON-RESIDENT AG CONSULTANT LICENSE FEE $500
$
.00
REGISTERED FIELD SCOUT(S)
____ X $10 EACH
$
.00
AMOUNT DUE =
$
.00
INSTRUCTIONS:
Add names of Registered Field Scouts in the space provided on Page 2.
If you need additional forms, contact our office at (225) 925-3796 or pestcert@ldaf.state.la.us
Do not staple payment to your application! Checks or Money Orders are the only accepted methods of
payment. DO NOT MAIL CASH! Make payable to:
LOUISIANA DEPARTMENT OF AGRICULTURE & FORESTRY
Mail to: Louisiana Dept. of Agriculture & Forestry, 5825 Florida Blvd, Ste. 1003, Baton Rouge, LA 70806
Print Name
Signature
Date
AES-07-05 (r.12/19)
OFFICE USE
Transmittal #
Check #
RESIDENT
0800 1605 01__
NON RESIDENT 0800 1605 N1__
Date
FIELD SCOUT
0800 1605 06__
$
.00
Amt.
LDAF ID No.: (Office Use Only)
Page 1 of 2
2020 INITIAL APPLICATION FOR AGRICULTURAL CONSULTANT LICENSE – Page 2
*Louisiana Certified Agricultural Consultants
Name
Address
LDAF ID
Certifications
Card Expires
**Louisiana Certified Field Scouts
Certifications
Name
Address
LDAF ID
Card Expires
Expire
Total count of Field Scouts: ___________________
X $10 = _____________
NOTES:
Resident means any person who has been domiciled in Louisiana for 90 days or longer.
Non-Resident means any person who is not a resident of Louisiana. If you are registered with the Secretary of State as an out of state
corporation, you are a non-resident.
*
Only those consultants who are tested and certified in Louisiana are to be listed on your application. We do not have a reciprocal
agreement with any state. Application must include at least one Louisiana certified agricultural consultant.
**
All Field Scouts must be listed by their employer, R.S. 3:3246(F). To register your Field Scout, please include a $10.00 fee for each.
Page 2 of 2
LDAF ID No.: (Office Use Only)
Page of 2