Form AG04024 "Registration for Processing Wild Game in Minnesota" - Minnesota

What Is Form AG04024?

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

Form Details:

  • Released on September 1, 2021;
  • The latest edition provided by the Minnesota 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 Form AG04024 by clicking the link below or browse more documents and templates provided by the Minnesota Department of Agriculture.

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Download Form AG04024 "Registration for Processing Wild Game in Minnesota" - Minnesota

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625 Robert Street North, Saint Paul, MN 55155-2538
www.mda.state.mn.us
Dairy and Meat Inspection Division 651-201-6300
REGISTRATION FOR PROCESSING WILD GAME IN MINNESOTA
Processing hunter-harvested wild game in Minnesota is considered custom exempt meat processing and regulated under Minnesota law. Most
custom exempt processors need a food handler’s license and custom processing permit to operate in Minnesota, but some individuals who
only process wild game animals may be exempt from this requirement, provided they meet all criteria described in
Minnesota Statutes Chapter
28A.153. These individuals are encouraged to register with the Minnesota Department of Agriculture (MDA) as license-exempt wild game
processors. Registration is voluntary and not required by law.
Privacy Notice: Please be aware that information submitted with this form, including your name and contact information, is classified as public data
under Minnesota law. The MDA is generally required by law to provide public data to anyone who requests it in accordance with the requirements of
Minnesota Statutes Chapter
13.
the Minnesota Government Data Practices Act,
Name of Applicant
Mailing Address
City
State
Zip
Establishment Address (if different from Mailing Address)
City
State
Zip
Phone
Email
Name of person or business to be listed on certificate
(if different from Name of Applicants)
Acknowledgment of Expectations
I understand that in order to be eligible for this exemption I must satisfy all the requirements below (check each item to indicate you
have read and agree to the statement):
I may not operate any other meat, poultry, or food business subject to licensing in Minnesota.
My processing activities are limited to cutting, grinding, and packaging raw wild game products with no added ingredients.
I may not sell or donate any wild game products, and all product packages must be labeled, “Not for Sale.”
I will process no more than 200 deer each year or have $20,000 or less in receipts each year, whichever is greater. It is my
responsibility to keep records of my processing activities.
I will notify the MDA of any change in my business that may affect my license-exempt status.
How would you like to receive your certificate of registration?
Select one option
Electronic copy, sent to the email address I provided on this form
Hard copy, sent to the mailing address I provided on this form
Applicant Signature
Date
Submit your completed registration form by email to
MDA.MeatPoultryEgg@state.mn.us
OR mail to:
Minnesota Department of Agriculture
MDA Use Only
Attention: Meat, Poultry, and Egg Inspection
Date Received
625 Robert Street North
Saint Paul, MN 55155-2538
Signature of Area Supervisor (Date)
Processor Number: 7
In accordance with the Americans with Disabilities Act, this information is available in alternative forms of communication upon request
AG 04024
Page 1 of 1 9/2021
by calling 651-201-6000. TTY users can call the Minnesota Relay Service at 711. The MDA is an equal opportunity employer and provider.
625 Robert Street North, Saint Paul, MN 55155-2538
www.mda.state.mn.us
Dairy and Meat Inspection Division 651-201-6300
REGISTRATION FOR PROCESSING WILD GAME IN MINNESOTA
Processing hunter-harvested wild game in Minnesota is considered custom exempt meat processing and regulated under Minnesota law. Most
custom exempt processors need a food handler’s license and custom processing permit to operate in Minnesota, but some individuals who
only process wild game animals may be exempt from this requirement, provided they meet all criteria described in
Minnesota Statutes Chapter
28A.153. These individuals are encouraged to register with the Minnesota Department of Agriculture (MDA) as license-exempt wild game
processors. Registration is voluntary and not required by law.
Privacy Notice: Please be aware that information submitted with this form, including your name and contact information, is classified as public data
under Minnesota law. The MDA is generally required by law to provide public data to anyone who requests it in accordance with the requirements of
Minnesota Statutes Chapter
13.
the Minnesota Government Data Practices Act,
Name of Applicant
Mailing Address
City
State
Zip
Establishment Address (if different from Mailing Address)
City
State
Zip
Phone
Email
Name of person or business to be listed on certificate
(if different from Name of Applicants)
Acknowledgment of Expectations
I understand that in order to be eligible for this exemption I must satisfy all the requirements below (check each item to indicate you
have read and agree to the statement):
I may not operate any other meat, poultry, or food business subject to licensing in Minnesota.
My processing activities are limited to cutting, grinding, and packaging raw wild game products with no added ingredients.
I may not sell or donate any wild game products, and all product packages must be labeled, “Not for Sale.”
I will process no more than 200 deer each year or have $20,000 or less in receipts each year, whichever is greater. It is my
responsibility to keep records of my processing activities.
I will notify the MDA of any change in my business that may affect my license-exempt status.
How would you like to receive your certificate of registration?
Select one option
Electronic copy, sent to the email address I provided on this form
Hard copy, sent to the mailing address I provided on this form
Applicant Signature
Date
Submit your completed registration form by email to
MDA.MeatPoultryEgg@state.mn.us
OR mail to:
Minnesota Department of Agriculture
MDA Use Only
Attention: Meat, Poultry, and Egg Inspection
Date Received
625 Robert Street North
Saint Paul, MN 55155-2538
Signature of Area Supervisor (Date)
Processor Number: 7
In accordance with the Americans with Disabilities Act, this information is available in alternative forms of communication upon request
AG 04024
Page 1 of 1 9/2021
by calling 651-201-6000. TTY users can call the Minnesota Relay Service at 711. The MDA is an equal opportunity employer and provider.