Ohio Dept of Agriculture

Ohio Dept. of Agriculture,
Copyright © April, 2007
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Forms & Applications

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Division

Forms for the Administration division

	Century Farm Program

		2000-001: Century Farm Registration Form
	Family Farm Loan Program

		2201-001: Request for Loan Guarantee Application (lender) 2201-002: Agricultural Loan Evaluation 2201-003: Determination of Borrower Eligibility 2201-004: Loan and Guarantee Agreement 2201-005: Power of Attorney - SAMPLE ONLY
	Rural Development Partnership

		2201-001: Request for Loan Guarantee Application (lender) 2201-002: Agricultural Loan Evaluation 2201-003: Determination of Borrower Eligibility 2201-004: Loan and Guarantee Agreement 2201-005: Power of Attorney - SAMPLE ONLY

Forms for the Amusement Ride Safety division

		3000-001: Ride Application Portable 3000-003: Accident Form 3000-004: Itinerary 3000-005: Permanent Facility Itinerary 3000-006: Complaint Form

Forms for the Animal Industry division

		3100-002: ADL-1 Application for Ohio Livestock Dealer's License 3100-003: ADL-2 Ohio Livestock Dealer's License Application for an Operator of a Livestock Market, Yard, or Commission Firm 3100-003c: ADL-2C Ohio Livestock Dealer's License Application for an Operator of a Concentration Yard 3100-004: ADL-3 Application for an Ohio Livestock Dealer's License (Multiple Locations) 3100-005: ADL-4 Supplementary Information 3100-006: ADL-4S Supplementary Information (Slaughtering) 3100-007: ADL-6 Ohio Livestock Dealer's License Application for An Operator of a Slaughtering Establishment 3100-008: Application for License To Feed Garbage 3100-009: Application for License To Dispose of Raw Rendering Material 3100-010: Application for License To Collect 3100-011: Application for Weigher of Livestock License
	Animal Disease Diagnostic Labs

		3102-001: ADDL Sample Submission Form

Forms for the Auctioneer division

		3601-001: Apprentice Auctioneer License Instructions 3601-002: Apprentice Auctioneer License Application 3601-003: Auctioneer License Application Instructions 3601-004: Auctioneer License Application 3601-005: Police Waiver 3601-006: Auctioneer Bond Statement 3601-007: Consent to Service of Jurisdiction 3601-008: Statement of Residency 3601-009: Certification of Apprentice Participation 3601-010: Additional Requirements & Instructions for Non-Resident Applicants 3601-011: States with Reciprocity 3601-012: Auctioneer Supplement Application for Business Applicants 3601-013: Auctioneer Business Change Application Form - for change of address/name, add dba, change sponsor or put license on deposit 3601-014: Request for Auction Education Fund Monies 3601-018: Auctioneer One-Time License Instruction 3601-019: Auctioneer One-Time License Application 3601-020: Auctioneer One-Time Only Bond Statement 3601-021: Auction Firm Instructions (PDF) 3601-022: Auction Firm Application (PDF) 3601-023: Auction Firm Bond (PDF)

Forms for the Dairy division

		Forms_3500-001: Application for Milk Dealer's License Forms_3500-002: Application for Milk Hauler License Forms_3500-003: Application for Milk Processor License Forms_3500-004: Application for Milk Producer License Forms_3500-005: Plan Submittal Form Forms_3500-006: Receiving Report Forms_3500-007: Application for Weigher, Sampler or Tester License Forms_3500-009: Farm Security Awareness Checklist Forms_3500-005a: Plant Plan Submittal Form

Forms for the Food Safety division

		3800-01: Farm Product Registration 3800-02: Farm Market Registration 3800-03: Farmers Market Registration

Forms for the Livestock Environmental Permitting Program division

		3900-034: Inspection Form (PDF Format)
	General Information for PTI/PTO

		3900-GEN-001: General Information (PDF Format) 3900-GEN-002: Certified Livestock Manager (PDF Format) 3900-GEN-003: Compliance Information (PDF Format) 3900-GEN-004: Large CAFF Local Notification (PDF Format; PTI Only) 3900-GEN-005: Major CAFF Local Notification (PDF Format; PTI Only)
	Land Application Appendices-Rules

		3900-APPX F_TBL 1: Most Liming Application Rates (Tiled Fields; PDF Format) 3900-APPX F_TBL 2: Most Liming Application Rates (Non-Tiled Fields; PDF Format) 3900-APPX A: How to Use Appendices (PDF Format) 3900-APPX A_TBL 1: Soils Prone to Flooding (PDF Format) 3900-APPX A_TBL 2: Land Application Restrictions (PDF Format) 3900-APPX B: Available Water Capacity (PDF Format) 3900-APPX C_TBL 6: Calculating Nitrogen (PDF Format)
	Operating Records

		3900-OR-001: Operating Record (PDF Format)
	Permit to Install

		3900-PTI-001: Permit to Install (PDF Format)
	Permit to Operate

		3900-GEN-001: General Information (PDF Format) 3900-PTO-001: Permit to Operate (PDF Format) 3900-PTO-002: Emergency Response Plan (PDF Format) 3900-PTO-003: General Conditions for Permit (PDF Format) 3900-PTO-004: Insect and Rodent Control Plan (PDF Format) 3900-PTO-005: Manure Management Plan (PDF Format) 3900-PTO-006: Mortality Management Plan (PDF Format)

Forms for the Plant Industry division
	Apiary

		4201-001: No Consent Form 4201-002: Application for Apiary Registration
	Fertilizer

		4202-001: Agricultural Additive Registration Application 4202-002: Anhydrous Ammonia System Construction and Operation Application 4202-003: Commercial Fertilizer License Application 4202-005: Liming Material License Application to Manufacture, Sell, or Distribute 4202-006: Non-Agricultural Production Custom Mixed Fertilizer Blender License Application 4202-007: Secondary Containment Construction Application 4202-008: Specialty Fertilizer Products Registration Application
	Grain Warehouse, Feed & Seed

		4203-001: Agricultural Commodity Handler License Application 4203-002: Agricultural Commodity Tester Application 4203-003: Apply Legume Inoculant Application 4203-004: Certificate of Insurance 4203-005: Grain Handled Report 4203-006: Indemnity Fund Claim Form 4203-007: Legume Inoculant Registration 4203-008: Seed Labelers Permit Application 4203-009: Warehouse Receipt on Handler-Owned Commodity 4203-010: Warehouse Receipt Order Form 4202-004: Ohio Feed Registration Application
	Pesticide

		4204-001: Application for Registration of Pesticide 4204-003: Ohio Pesticide License Application (License Term 10/1/07 to 9/30/08) 4204-004: Private Applicator Certification (Renewal) 4204-009: Pesticide Licensing Instructions (Commercial) 4204-010: Insurance Instructions / Explanations 4204-011: Insurance Form SAMPLE 4204-012: Insurance Requirements Letter 4204-014: Pesticide Request for Recertification Credits - ONLINE FORM
	Plant Pest Control

		4205-001: Application for Dealer In Nursery Stock - 2008- PDF 4205-002: Application for Nursery Inspection - 2008 - PDF

Forms for the Weights and Measures division

		4300-011: Tolerance Worksheet: Automatic Multi-Interval/Multiple-Range Scale 4300-012: Tolerance Worksheet: Multi-Interval/Multiple-Range Scale SAMPLE 4300-013: Tolerance Worksheet: Medium-Capacity Scales 4300-014: Tolerance Worksheet: Retail Computing Scales 4300-001: Registration of Service Agency Application 4300-002: Registration of Service Agency Renewal Application 4300-003: Registration for Serviceperson Application 4300-004: Complaint Form 4300-006: Registration of Serviceperson Testing Dates 2008 4300-007: NTEP Vehicle-Livestock Worksheets 4300-008: NTEP Class III Worksheets 4300-009: Timing Device Checklist 4300-010: Fabric/Wire & Cordage/Linear Measure Test Form