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Ohio Department of Agriculture | Forms and Applications

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Administration Forms
Admn_2201-006 Standard Affirmation and Disclosure - Public Funds on Offshore Services

Century Farm Program
Admn_2000-001 Century Farm Registration Form

Farmland Preservation
Farm_2100-001 Ohio Agricultural Security Area (ASA) Program Application
Farm_2100-002 Ohio Agricultural Security Area (ASA) Tax Exemption Agreement
Farm_2100-003 Ohio Agricultural Security Area (ASA) Tax Exemption Application
Farm_2100-004 Present Condition Report Template
Farm_2100-006 Agricultural District Application
Farm_2100-007 2014 LAEPP Application for Local Sponsor Certification
Farm_2100-008 Annual Monitoring Report (2013)
Farm_2100-009 Monitoring Agent List (2013)

Amusement Ride Safety Forms

Amus_3000-001 Ride Application
Amus_3000-003 Accident Form
Amus_3000-004 Portable Itinerary
Amus_3000-005 Permanent Facility Itinerary
Amus_3000-006 Complaint Form
Amus_3000-007 Request for Inspection
Amus_3000-008 Concession License Application
Inflatable Conference Letter and Application
Public Records Request form

Animal Health Forms
Anim_3100-002 ADL-1  Application for Ohio Livestock Dealer's License
Anim_3100-003 ADL-2  Ohio Livestock Dealer's License Application for an Operator of a Livestock Market
Anim_3100-003c ADL-2C  Ohio Livestock Dealer's License Application for an Operator of a Concentration Yard
Anim_3100-004 ADL-3  Application for an Ohio Livestock Dealer's (Multiple Locations)
Anim_3100-005 ADL- 4 Supplementary Information
Anim_3100-007 ADL-6  Ohio Livestock Dealer's License Application for An Operator of a Slaughtering Establishment
Anim_3100-008 Application for License To Feed Garbage
Anim_3100-009 Application for License To Dispose of Raw Rendering Material
Anim_3100-010 Application for License To Collect
Anim_3100-011 Application for Weigher of Livestock License
Anim_3100-013 Employee Designation Form
Anim_3100-014 Small Dealer Application
ANIM_3100-015 Deer License Application (Monitored Herd)
ANIM_3100-016 Deer License Application (Hunting Preserve)
ANIM_3100-017 Deer License Application (Status Herd)
ANIM_3100-018 Deer License Application (Certified Status Herd)

Animal Disease Diagnostic Labs
ADDL Sample Submission Form
ADDL_CAL Form 251B 2-10-2012 Poultry Submission form

Dangerous Wild Animals
Dangerous Wild Animal Registration Form
Dangerous Wild Animal Surety Bond Guaranty
Voluntary Restricted Snake Registration Form

Dangerous Wild Animals Rescue Facility Permit
Affidavit of Compliance with Standards Rescue Facility
Affidavit of No Contact
E-1 Employee Disclosure Form
E-1 Employee Identification Form
Rescue Facility Permit New Application

Dangerous Wild Animals Wildlife Propagation Permit
Affidavit of Compliance with Standards - Propagation
Dangerous Wild Animal Surety Bond Guaranty
E-1 Employee Identification Form
Letter of Proof of Insurance
Wildlife Propagation Permit Application Instructions
Wildlife Propagation Permit New Application

Dangerous Wild Animals Wildlife Shelter Permit
Affidavit of Compliance with Standards
Affidavit of No Contact with the Public
Affidavit of Sterilization
Dangerous Wild Animal Surety Bond Guaranty
E-1 Employee Identification Form
Letter of Proof of Insurance
Wildlife Shelter Application Instructions
Wildlife Shelter Permit New Application

Restricted Snake Possession Permit
Affidavit of Compliance with Standards - Restricted Snake Possession
Affidavit of No Contact with Public - Restricted Snake Possession
Dangerous Wild Animal Surety Bond Guaranty
Letter of Proof of Insurance
Restricted Snake Possession Permit Application Instructions
Restricted Snake Possession Permit New Application

Restricted Snake Propagation Permit
Affidavit of Compliance with Standards - Restricted Snake Propagation
Affidavit of No Contact wiht Public - Restricted Snake Propagation
Dangerous Wild Animal Surety Bond Guaranty
E-1 Employee Identfication Form
Letter of Proof of Insurance
Restricted Snake Propagation Permit Applicatin Instructions
Restricted Snake Propagation Permit New Application

Auctioneer Program Forms

Auct_3601-001 Apprentice Auctioneer License Instructions
Auct_3601-002 Apprentice Auctioneer License Application
Auct_3601-003 Auctioneer License Application Instructions
Auct_3601-004 Auctioneer License Application
Auct_3601-005 Police Waiver
Auct_3601-006 Auctioneer Bond Statement
Auct_3601-009 Certification of Apprentice Participation
Auct_3601-010 Additional Requirements & Instructions for Non-Resident Applicants
Auct_3601-011 States with Reciprocity
Auct_3601-012 Auctioneer Supplement Application for Business Applicants
Auct_3601-013 Auctioneer Business Change Application Form - for change of address/name, add dba, change sponsor or put license on deposit
Auct_3601-014 Request for Auction Education Fund Monies
Auct_3601-018 Auctioneer One-Time License Instruction
Auct_3601-019 Auctioneer One-Time License Application
Auct_3601-020 Auctioneer One-Time Only Bond Statement
Auct_3601-021 Auction Firm Instructions
Auct_3601-022 Auction Firm Application
Auct_3601-023 Auction Firm Bond

Consumer Protection Laboratory Forms
ADDL_CPL Frm 043D Eff 4-5-12 CPL Sampl Submission Laboratory Analysis Submission Form
ATL Sample Submission Form for Elective Testing
Pre-Sale / Pre-Entry Elective Testing for Detection or Absence of Anabolic Steriods

Dairy Forms
Dairy_3500-001 Application for Milk Dealer's License
Dairy_3500-002 Application for Milk Hauler License
Dairy_3500-003 Application for Milk Processor License
Dairy_3500-004 Application for Milk Producer License
Dairy_3500-005 Farm Plan Submittal Form
Dairy_3500-005a Processor Plan Submittal Form
Dairy_3500-006 Receiving Report
Dairy_3500-007 Application for Weigher, Sampler or Tester License
Dairy_3500-009 Farm Security Awareness Checklist
Dairy_3500-010 Drug Residue Screening Reporting Form
Dairy_3500-011 Drug Residue Clearing Sample Reporting Form

Fairs Forms
2014 Annual Report
2014 Jr. Fair Affidavit
2014 Jr. Fair Report
2014 Letter of Supplies
2014 Outstanding Fair Supporter
2015 Contact Form
2015 Fair Date Request
2015 Fair Fund Request
Chart of Accounts
Electronic Filing Application
Redbook Laws
Redbook Table of contents

Food Safety Forms
Food_3800-01 Farm Product Registration
Food_3800-02 Farm Market Registration
Food_3800-03 Farmers Market Registration

Livestock Environmental Permitting Forms

Annual Report
2013 Annual Report Form

Application Information
3900-001 General Information
3900-001b Supplemental Information
3900-002 Compliance Information
3900-003 Local Notification for Concentrated Animal Feeding Facility (CAFF)
3900-004 Local Notification for Major Concentrated Animal Feeding Facility (MCAFF)
3900-005 Permit to Install
3900-006 Permit to Operate
3900-007 Manure Management Plan
3900-008 Insect and Rodent Control Plan
3900-009 Mortality Management Plan
3900-010 Emergency Response
3900-011 Operating Record
3900-012 CLM Application
3900-013 CLM Renewal Application

Notice Regarding Forms

Meat Inspection Forms

Meat_4400-09 Label application
Meat_4400-18 Exempt request form
Meat_4400-25 Product formulation sheet (submit with form 4400_09)
Meat_4400-29 Cooked/Smoked formulation sheet (submit with form 4400_09)
Meat_4400-39 Custom red meat slaughter record
Meat_4400-39P Custom poultry slaughter record
Meat_4400-PA Blueprint Narrative for processing areas
Meat_4400-RI Request for Information
Meat_4400-SA Blueprint Narrative for slaughter areas

Plant Health Forms

Plnt_4201-001 No Consent Form
Plnt_4201-002 Application for Apiary Registration

Plnt_4207-001 Submit a sample

Plnt_4202-001 Agricultural Additive Registration Application
Plnt_4202-002 Anhydrous Ammonia System Construction and Operation Application
Plnt_4202-003 Commercial Fertilizer License Application
Plnt_4202-005 Liming Material License Application to Manufacture, Sell, or Distribute
Plnt_4202-006 Non-Agricultural Production Custom Mixed Fertilizer Blender License Application
Plnt_4202-007 Secondary Containment Construction Application
Plnt_4202-008 Specialty Fertilizer Products Registration Application

Grain Warehouse, Feed & Seed
Plnt_4202-004 Ohio Feed Registration Application
Plnt_4203-002 Agricultural Commodity Tester Application
Plnt_4203-004 Certificate of Insurance
Plnt_4203-005 Grain Handled Report
Plnt_4203-006 Indemnity Fund Claim Form
Plnt_4203-008 Seed Labelers Permit Application
Plnt_4203-010 Warehouse Receipt Order Form

Application to Register Pesticide Products
Change of Information Form for Applicators
Change of Information Form for Businesses
Dealer Sales Report
Pesticide Application Business Application
Pesticide Applicator Application
plnt_4204_014-b Application for Request of Recertification Credits
plnt_4204_014-c Application for Approved Sponsor
Plnt_4204-010 Insurance Instructions / Explanations
Plnt_4204-011 Insurance Form SAMPLE
Plnt_4204-012 Insurance Requirements Letter
Plnt_4204-014 INSTRUCTIONS: for Request of Recertification Credits Form
Private Applicator Application (04/01/2014 to 03/30/2017)
Private Applicator RENEWAL (04/01/2014 TO 03/30/2017)

Plant Pest Control
Plnt_4205-001 Application for Dealer In Nursery Stock
Plnt_4205-002 Application for Nursery Inspection

Specialty Crop Promotion Program Forms

Application Information
2014 RFP
2014 SCBG Application
Specialty Crop Block Grant Process

Quarterly Report
2011 Quarterly Report
2012 SCBG Quarterly Report
2013 Quarterly Report
2014 SCBG Quarterly Report

Reimbursement Request
2011 Reimbursement Request
2012 Reimbursement Request
2013 Reimbursement Request
2014 SCBG Reimbursement Request

Weights and Measures Forms

Wght_4300-001 Weights & Measures Device Permit Application
Wght_4300-002 Wght_4300-002 Registration of Service Agency Application
Wght_4300-003 Registration for Serviceperson Application
Wght_4300-004 Complaint Form
Wght_4300-006 Registration of Serviceperson Testing Dates 2014
Wght_4300-007 NTEP Vehicle-Livestock Worksheets
Wght_4300-008 NTEP Class III Worksheets
Wght_4300-009 Timing Device Checklist
Wght_4300-010 Fabric/Wire & Cordage/Linear Measure Test Form
Wght_4300-011 Tolerance Worksheet: Automatic Multi-Interval/Multiple-Range Scale
Wght_4300-012 Tolerance Worksheet: Multi-Interval/Multiple-Range Scale SAMPLE
Wght_4300-013 Tolerance Worksheet: Medium-Capacity Scales
Wght_4300-014 Tolerance Worksheet: Retail Computing Scales
Wght_4300-015 Ohio Metrology customer survey
Wght_4300-035 Broken Seal Form
Wght_4300-036 2013 Annual Report - State Summary & A-F
Wght_4300-037 2013 Annual Report G-L
Wght_4300-038 2013 Annual Report M-S
Wght_4300-039 2013 Annual Report T-Z (includes Cities)

Serviceperson Study Material - Meters
Wght_4300-026 Approval Process
Wght_4300-028 Exam Day Agenda
Wght_4300-029 Agri Chemical Meters EPO
Wght_4300-030 Loading Rack Meter EPO
Wght_4300-031 LPG Meter EPO
Wght_4300-032 Mass Flow Meter EPO
Wght_4300-033 Retail Motor Fuel Dispensers EPO
Wght_4300-034 Vehicle Tank Meter EPO

Serviceperson Study Material - Scales
Wght_4300-016 Approval Process
Wght_4300-019 Hopper Scale EPO
Wght_4300-020 Animal Scale EPO
Wght_4300-021 Jewelery & Precious Metals EPO
Wght_4300-022 Medium Capacity Scale EPO
Wght_4300-023 Small Capacity Scale EPO
Wght_4300-024 Vehicle Scales EPO
Wght_4300-025 Livestock Scale EPO