Form WM-24 "Application for a Weighmaster License" - New York

What Is Form WM-24?

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

Form Details:

  • Released on January 1, 2020;
  • The latest edition provided by the New York State Department of Agriculture and Markets;
  • 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 WM-24 by clicking the link below or browse more documents and templates provided by the New York State Department of Agriculture and Markets.

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Download Form WM-24 "Application for a Weighmaster License" - New York

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WM-24 (Rev 01/20)
FOR OFFICE USE
New York State
New
Renew
Department of Agriculture and Markets
License No. _____________
Bureau of Weights and Measures
Check No. _____________
10B Airline Drive
Albany, NY 12235
R No
D No
518-457-3146
Make checks payable to:
Commissioner of Agriculture and Markets
APPLICATION FOR A
WEIGHMASTER LICENSE
(New or Renewal Application)
Fee - $15.00
Instructions provided on next page. Please print clearly. Incomplete applications will be returned.
Applicant Name (last, first)
Social Security No.*
__ − __
__
__
__
__
__
__
__
Are you renewing?
YES
NO
Are you adding a new location?
YES
NO
Previous license No. if applicable:
Employer name and physical address (New York 911 address).
Federal Employer ID No.*
__
__ -
__ __ __ __ __ __ __
Work phone (where we
(
)
can best reach you):
Email address (optional)
own
Scale owner and physical address where primary scale is
Do you or your employer,
or have access to a certified stationary
located.
scale located in the State of New York suitable for determining
weights used in commercial transactions?
YES
NO
State briefly your training/experience to perform Weighmaster duties
(Not Required for License Renewals).
Note: Your application for a license is subject to denial and/or revocation, if, after a hearing, it is determined that this
applicant, licensee, officer, director, partner or share/stockholder, has been convicted of, or has pled guilty to, a felony
in any court of the United States or any State or territory thereof, with respect to an offense involving fraud, filing a
false instrument or similar.
I understand that any false statement
Applicant Signature
Date
made in this document is punishable
pursuant to Penal Law Section
210.45.
AUTHORIZATION AND PURPOSE
*Disclosure of your social security and Federal employer identification numbers is mandatory and is authorized by Section 5 of the New York State Tax
Law. This information is collected to enable the Department of Taxation and Finance to identify individuals, businesses and others who have been
delinquent in filing tax returns or may have understated their tax liability, and to generally identify persons affected by the Tax Law administered by the
Commissioner of Taxation and Finance, and for any other purpose authorized by the Tax Law.
The authority to solicit the information requested on this application is found in Article 16 Section 195 of the Agriculture and Markets Law. This information
is collected to enable the Department to evaluate your application to determine if the license should be issued and to assist in enforcement and
administration of the Agriculture and Markets Law.
WM-24 (Rev 01/20)
FOR OFFICE USE
New York State
New
Renew
Department of Agriculture and Markets
License No. _____________
Bureau of Weights and Measures
Check No. _____________
10B Airline Drive
Albany, NY 12235
R No
D No
518-457-3146
Make checks payable to:
Commissioner of Agriculture and Markets
APPLICATION FOR A
WEIGHMASTER LICENSE
(New or Renewal Application)
Fee - $15.00
Instructions provided on next page. Please print clearly. Incomplete applications will be returned.
Applicant Name (last, first)
Social Security No.*
__ − __
__
__
__
__
__
__
__
Are you renewing?
YES
NO
Are you adding a new location?
YES
NO
Previous license No. if applicable:
Employer name and physical address (New York 911 address).
Federal Employer ID No.*
__
__ -
__ __ __ __ __ __ __
Work phone (where we
(
)
can best reach you):
Email address (optional)
own
Scale owner and physical address where primary scale is
Do you or your employer,
or have access to a certified stationary
located.
scale located in the State of New York suitable for determining
weights used in commercial transactions?
YES
NO
State briefly your training/experience to perform Weighmaster duties
(Not Required for License Renewals).
Note: Your application for a license is subject to denial and/or revocation, if, after a hearing, it is determined that this
applicant, licensee, officer, director, partner or share/stockholder, has been convicted of, or has pled guilty to, a felony
in any court of the United States or any State or territory thereof, with respect to an offense involving fraud, filing a
false instrument or similar.
I understand that any false statement
Applicant Signature
Date
made in this document is punishable
pursuant to Penal Law Section
210.45.
AUTHORIZATION AND PURPOSE
*Disclosure of your social security and Federal employer identification numbers is mandatory and is authorized by Section 5 of the New York State Tax
Law. This information is collected to enable the Department of Taxation and Finance to identify individuals, businesses and others who have been
delinquent in filing tax returns or may have understated their tax liability, and to generally identify persons affected by the Tax Law administered by the
Commissioner of Taxation and Finance, and for any other purpose authorized by the Tax Law.
The authority to solicit the information requested on this application is found in Article 16 Section 195 of the Agriculture and Markets Law. This information
is collected to enable the Department to evaluate your application to determine if the license should be issued and to assist in enforcement and
administration of the Agriculture and Markets Law.
Instructions for Completing the Application
(This page does not need to be submitted with the application)
General: Section 192-f of Agriculture and Markets Law Article 16 requires a weight ticket issued by a licensed Weighmaster
for the bulk sale or transportation of:
1.
coal,
2. coke,
3. feed for domestic animals,
4. fertilizer,
5. lime and,
6. household goods (e.g. moving companies)
Learn more about Article 16, Section 192-f.
Name of Applicant and Social Security Number: Print your full legal name and Social Security number. If there are
changes from your previous license, make changes on this form. If you are not due for a license renewal (e.g. you get
married) you may contact us for a new license. If you are renewing your license, only the last four digits of your social
security number is required.
Have you ever had a NY Weighmaster License? Answer “YES” if you have ever been issued a Weighmaster license in
New York State under this or any other name. If yes, include license number in the box. Otherwise answer “NO”.
Employer name and address; Federal Employer ID: Please enter the full legal or corporate name of your employer in
New York. Address must be the physical location at which you work in New York, where we can come to observe you
performing your duties and inspect the weight tickets you have issued. Do not enter P.O. Box addresses here. Also,
provide the 9 digit Federal ID No. of your employer.
Work Phone: Phone number where we can direct questions to you regarding your application and payment.
Email Address: This is optional and will allow us to contact you quickly with questions or provide you information.
Do you or your employer own or have access to a certified stationary scale located in the State of New York
suitable for determining weights used in commercial transactions? You must have access to a suitable scale, tested
by Weights and Measures to be issued a Weighmaster license. If you are uncertain of the status of the scale you use
you should contact the owner/operator of the scale or contact your local Weights and Measures Bureau.
Scale owner and address: Write the name of the business that owns the scale and the physical address at the scale
location where you perform your weighing. We need this information to verify the status of the scale and/or to conduct
scale inspections. Do not enter P.O. Box addresses here. If address is the same as your work location, enter “SAME”.
State briefly your training/experience to perform weighmaster duties: You must be able to use the scale properly
and prepare proper weight tickets conforming to the statute. Describe what training or experience you have. For
example, “3 months weighing net and gross of trucks coming in and out of yard” or “2 weeks training by other
Weighmaster on how to prepare weight tickets”. Weighmasters renewing their expiring licenses may leave this area
blank.
Signature and Date: Sign name as you would sign weight tickets.
Your application package must include a check or money order for $15 per license payable to the “Commissioner of
Agriculture and Markets”.
For additional assistance completing this application
please call (518) 457-3146 or visit
https://agriculture.ny.gov/weights-measures
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