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OHIO DEPARTMENT OF AGRICULTURE

Division of Plant Industry - Grain & Seed Section

8995 East Main Street

Reynoldsburg, OH  43068-3399

(614) 728-6410

DIVISION:

Web FORM:

Last Revised:

FORM EXPIRES:

PLNT-GS

4203-008

08/13/2003

12/31/2004

FOR DIVISION USE ONLY:

LOCATION ID:___________________

PARENT ID:______________________

APPLICATION FOR SEED LABELERS PERMIT

 

LABEL INFORMATION:

Name on Label:
Label Address:
City, State, Zip:
County:                                                                                   Telephone:    (           )
E-Mail Address:                                                                        Fax Number: (           )
Website URL:

 

MAILING ADDRESS (Only complete if different than labeler info above):

Name:
Mailing Address:
City, State, Zip:
County:                                                                                   Telephone:    (           )
E-Mail Address:                                                                        Fax Number: (           )

 

SEED INFORMATION:

List the types of seed your company labels and sells:
 
 
Give the Ohio address(es) or Ohio location(s) where your seed can be found for official sampling:
 
 

The undersigned agrees to the following:

  1. To complete and return for each permit being issued a separate Application form plus a $10.00 application fee per individual permit.

  2. To report sales of seed and to pay the seed inspection fees as specified by the State of Ohio Revised Code.

  3. The Director of Agriculture, per 907.15 RC, may suspend, revoke or refuse to issue a permit to label seed for any violation of Sections 907.01 to 907.17 of the RC.

  4. Each person who receives a permit to use his/her own tags or labels shall:

    a.  Apply his/her tags or labels to all seed which he/she sells.

    b.  Report to the Ohio Department of Agriculture, prior to February 1 of each year, all sales which were made during the period from July 1 to December 31 of the preceding year.

    c.  Report to the Ohio Department of Agriculture, prior to August 1 of each year, all sales which were made during the period from January 1 to June 30 of that year.

    d.  Pay the seed inspection fees for seed sales when the sales are reported.  Any seed returned during a reporting period under a contract consignment or a sale or return shall be deducted from the sales report and fee payment of the following reporting period.

I certify that all information provided on this application is correct to the best of my knowledge.

 

Signature of Applicant

Date

 

Printed Name

 

Title