"Initial Application for Aerial Owner Operator License" - Louisiana

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

Form Details:

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  • 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.

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Download "Initial Application for Aerial Owner Operator License" - Louisiana

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L
D
A
F
OUISIANA
EPARTMENT OF
GRICULTURE &
ORESTRY
Mike Strain DVM, Commissioner
Agricultural & Environmental Sciences, 5825 Florida Blvd., Suite 1003 Baton Rouge, LA 70806, (225) 925-3796
2020 INITIAL APPLICATION FOR AERIAL OWNER OPERATOR LICENSE
Owner/Principal Officer:
Company Name:
Mailing Address:
-
City/State/Zip:
Physical Address:
City/State/Zip:
Type:
Phenoxy
Non-Phenoxy
(Circle One)
.00
LOUISIANA RESIDENT AERIAL OWNER OPERATOR LICENSE FEE $200
LOUISIANA NON-RESIDENT AERIAL OWNER OPERATOR LICENSE FEE $500
.00
EQUIPMENT REGISTRATION FEE
X $50.00
$
.00
$
.00
AMOUNT DUE =
$
.00
INSTRUCTIONS:
Current proof of liability insurance not less than $50,000 for Phenoxy and not less than $25,000 Non Phenoxy
must be filed with this office before a license can be issued. Liability insurance certificates may accompany
this application or be submitted via email to pestcert@ldaf.state.la.us
Must employ at least one Louisiana certified Commercial Pesticide Applicator and provide their information
on Page 2.
Must provide a description of all mechanically powered pesticide application equipment on Page 2.
Do not staple your 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
I (we) do hereby apply for licensing in accordance with R. S. 3:3242 and agree: 1) to maintain liability coverage as
required by R. S. 3:3242(C)(D) and 2) to keep and furnish records to the Commissioner upon request as required by
R. S. 3:3243(G) and the regulations adopted pursuant thereto.
Print Name
Signature
Date
AES-07-06(r.12/19)
OFFICE USE
Transmittal #
Check #
RESIDENT
0800 1605 01 __
NON RESIDENT 0800 1605 N1 __
Date
EQUIPMENT
0800 1605 02 __
$
Amt.
.00
LDAF ID No.: (Office Use Only)
Page 1 of 2
L
D
A
F
OUISIANA
EPARTMENT OF
GRICULTURE &
ORESTRY
Mike Strain DVM, Commissioner
Agricultural & Environmental Sciences, 5825 Florida Blvd., Suite 1003 Baton Rouge, LA 70806, (225) 925-3796
2020 INITIAL APPLICATION FOR AERIAL OWNER OPERATOR LICENSE
Owner/Principal Officer:
Company Name:
Mailing Address:
-
City/State/Zip:
Physical Address:
City/State/Zip:
Type:
Phenoxy
Non-Phenoxy
(Circle One)
.00
LOUISIANA RESIDENT AERIAL OWNER OPERATOR LICENSE FEE $200
LOUISIANA NON-RESIDENT AERIAL OWNER OPERATOR LICENSE FEE $500
.00
EQUIPMENT REGISTRATION FEE
X $50.00
$
.00
$
.00
AMOUNT DUE =
$
.00
INSTRUCTIONS:
Current proof of liability insurance not less than $50,000 for Phenoxy and not less than $25,000 Non Phenoxy
must be filed with this office before a license can be issued. Liability insurance certificates may accompany
this application or be submitted via email to pestcert@ldaf.state.la.us
Must employ at least one Louisiana certified Commercial Pesticide Applicator and provide their information
on Page 2.
Must provide a description of all mechanically powered pesticide application equipment on Page 2.
Do not staple your 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
I (we) do hereby apply for licensing in accordance with R. S. 3:3242 and agree: 1) to maintain liability coverage as
required by R. S. 3:3242(C)(D) and 2) to keep and furnish records to the Commissioner upon request as required by
R. S. 3:3243(G) and the regulations adopted pursuant thereto.
Print Name
Signature
Date
AES-07-06(r.12/19)
OFFICE USE
Transmittal #
Check #
RESIDENT
0800 1605 01 __
NON RESIDENT 0800 1605 N1 __
Date
EQUIPMENT
0800 1605 02 __
$
Amt.
.00
LDAF ID No.: (Office Use Only)
Page 1 of 2
2020 INITIAL APPLICATION FOR AERIAL OWNER OPERATOR LICENSE - Page 2
Insurance Effective
Insurance Expires
Insurance Carrier/Policy*
**Louisiana Certified Commercial Pesticide Applicators If no card has been renewed for the current year, license will be delayed.
May Add Second Page If Too Many To List
Name
Address
LDAF ID
Certifications
Card Expires
***Mechanically Powered Spray Equipment ($50 per equipment) May Add Second Page If Too Many To List
Make
Model
Identification No.
Type Equipment
Decal No.
Total count of equipment:
X $50 =
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.
Please include a current copy of liability insurance with your application OR email a copy to: pestcert@ldaf.state.la.us to avoid
*
delaying the issuance of the license.
Pilots must be certified in Louisiana to qualify for aerial applicators. We have reciprocal agreements with surrounding states, however,
**
the pilot must apply for Louisiana certification to become eligible.
***
Please include Mechanically Powered Pesticide Application Equipment registration fee(s) at the time of application to avoid delaying
the issuance of the license.
Page 2 of 2
LDAF ID No.: (Office Use Only)
Page of 2