CPD Form 204 "South Carolina Antifreeze Registration Application" - South Carolina

What Is CPD Form 204?

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

Form Details:

  • Released on March 18, 2020;
  • The latest edition provided by the South Carolina Department of Agriculture;
  • 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 CPD Form 204 by clicking the link below or browse more documents and templates provided by the South Carolina Department of Agriculture.

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Download CPD Form 204 "South Carolina Antifreeze Registration Application" - South Carolina

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South Carolina
DEPARTMENT OF AGRICULTURE
CONSUMER PROTECTION DIVISION
123 Ballard Court, West Columbia, SC 29172
Hugh E. Weathers, Commissioner
SOUTH CAROLINA
ANTIFREEZE REGISTRATION APPLICATION
In accordance with South Carolina State Law 39-51-10, all antifreeze products sold in the State of South Carolina must be
registered with the South Carolina Department of Agriculture on or before the first day of January of each year.
A registration fee of $50 per Branded Product Size must be submitted
along with the products label and application for registration.
S O U T H C A R O L I N A A N T I F R E E Z E L A B E L G U I D E L I N E S
The products label must be submitted for review and must contain the following according to
Section 39-51-60 of the South Carolina Code of Laws:
1. The identity of the product.
2. The name and place of business of the registrant.
3. Net quantity contents in terms of liquid measure.
4. Contains a statement of warning of any hazard of substantial injury to human beings which may
result from the intended use or reasonably foreseeable misuse of the product.
5. If the product is to be diluted with another substance for use, there must be a statement or chart
showing the appropriate amount, percentage, proportion or concentration of the antifreeze to
be used to provide (1) claimed protection from freezing at a specified degree of temperature, (2)
claimed protection from corrosion, or (3) claimed increase of boiling point or protection from
overheating.
The label may not contain any claim that it has been approved or recommended by the Commissioner of Agriculture.
Manufacturer or Registrant
Mailing Address
City, State, ZIP
Phone
Email Address
Registrations will be sent via email if address is provided
1
3/18/20
CPD Form #204
South Carolina
DEPARTMENT OF AGRICULTURE
CONSUMER PROTECTION DIVISION
123 Ballard Court, West Columbia, SC 29172
Hugh E. Weathers, Commissioner
SOUTH CAROLINA
ANTIFREEZE REGISTRATION APPLICATION
In accordance with South Carolina State Law 39-51-10, all antifreeze products sold in the State of South Carolina must be
registered with the South Carolina Department of Agriculture on or before the first day of January of each year.
A registration fee of $50 per Branded Product Size must be submitted
along with the products label and application for registration.
S O U T H C A R O L I N A A N T I F R E E Z E L A B E L G U I D E L I N E S
The products label must be submitted for review and must contain the following according to
Section 39-51-60 of the South Carolina Code of Laws:
1. The identity of the product.
2. The name and place of business of the registrant.
3. Net quantity contents in terms of liquid measure.
4. Contains a statement of warning of any hazard of substantial injury to human beings which may
result from the intended use or reasonably foreseeable misuse of the product.
5. If the product is to be diluted with another substance for use, there must be a statement or chart
showing the appropriate amount, percentage, proportion or concentration of the antifreeze to
be used to provide (1) claimed protection from freezing at a specified degree of temperature, (2)
claimed protection from corrosion, or (3) claimed increase of boiling point or protection from
overheating.
The label may not contain any claim that it has been approved or recommended by the Commissioner of Agriculture.
Manufacturer or Registrant
Mailing Address
City, State, ZIP
Phone
Email Address
Registrations will be sent via email if address is provided
1
3/18/20
CPD Form #204
The following brands of ANTIFREEZE, ANTIFREEZE COOLANT, ANTIFREEZE AND SUMMER COOLANT,
and SUMMER COOLANT are submitted for registration. Please use additional sheets as necessary.
N A M E
S I Z E
S K U
I hereby request registration of these antifreeze products and I certify that the information furnished by me is true and correct.
I understand that by signing my application and making remittance that I have read and understand the laws, rules, and
regulations regarding antifreeze products offered for sale in the State of South Carolina and agree to comply with the same.
Signature
Print Name
Date
Please return this form to:
For additional assistance, please contact:
South Carolina Department of Agriculture
Christina Brundage
Attn: Christina Brundage
803-470-6286
123 Ballard Court
cbrundage@scda.sc.gov
West Columbia, SC 29172
You may obtain additional forms at:
agriculture.sc.gov/resources/forms
F O R O F F I C I A L U S E O N LY
Check #
Check Amount
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CPD Form #204
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