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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
Amus_3000-001 Permit Application

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 Annual Monitoring List by Monitoring Agent (2016)
Farm_2100-008 Annual Monitoring Report (2016)
Farm_2100-009 Farmland Sign Replacement Request

Amusement Ride Safety Forms

2017 Inflatable Inspection Conference
Amus_3000-001 Permit Application
Amus_3000-002 Accident Reporting Form
Amus_3000-004 Portable Itinerary
Amus_3000-005 Permanent Facility
Amus_3000-006 Complaint Form
Amus_3000-007 Request for Inspection
Amus_3000-008 Concession License 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 Livestock Dealer 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_CAL Form 251B 2-10-2012 Poultry Submission form
General Sample Submission Form ADDL General Sample Submission Form
HPAI Submission Form

Commercial Dog Breeders
Animal Rescue Registration Form
Background Check Refund Form
Brucella Canis Test Reporting Form
Commercial Dog Breeder Surety Bond Guaranty Form
Dog Retailer Permit Application
High Volume Breeder Permit Application
Minimum Age Requirement for Transporting Dogs into Commerce

Dangerous Wild Animals Rescue Facility Permit
Affidavit of Compliance with Standards Rescue Facility
Affidavit of No Contact Rescue Facility
Affidavit of Sterilization Rescue Facility
Employee Identification Form Rescue Facility
Rescue Facility Application Instructions
Rescue Facility Permit Application
Rescue Facility Permit Renewal Application

Dangerous Wild Animals Wildlife Propagation Permit
Affidavit of Compliance with Standards Wildlife Propagation
Affidavit of No Contact Wildlife Propagation
Employee Identification Form Wildlife Propagation
Letter of Proof of Insurance Wildlife Progagation
Surety Bond Guaranty Wildlife Propagation
Wildlife Propagation Permit Application
Wildlife Propagation Permit Renewal Application
Wildlife Propagation Renewal Permit Application Instructions

Dangerous Wild Animals Wildlife Shelter Permit
Affidavit of Compliance with Standards Wildlife Shelter
Affidavit of No Contact Wildlife Shelter
Affidavit of Sterilization Wildlife Shelter
Dangerous Wild Animal Surety Bond Guaranty
Employee Identification Form Wildlife Shelter
Letter of Proof of Insurance Wildlife Shelter
Wildlife Shelter Permit Application
Wildlife Shelter Permit Application Instructions
Wildlife Shelter Permit Renewal Application
Wildlife Shelter Permit Renewal Application Instructions

Pesticide
Pesticide Applicator Form

Restricted Snake Possession Permit
Affidavit of Compliance with Standards Restricted Snake Possession
Affidavit of No Contact Restricted Snake Possession
Dangerous Wild Animal Surety Bond Guaranty
Employee Identification Form Restricted Snake Possession
Letter of Proof of Insurance Restricted Snake Possession
Restricted Snake Possession Permit Application
Restricted Snake Possession Permit Application Instructions
Restricted Snake Possession Permit Renewal Application
Restricted Snake Possession Permit Renewal Application Instructions

Restricted Snake Propagation Permit
Affidavit of Compliance with Standards Restricted Snake Propagation
Affidavit of No Contact Restricted Snake Propagation Permit
Dangerous Wild Animal Surety Bond Guaranty Restricted Snake Propagation Permit
Employee Identfication Form Restricted Snake Propagation Permit
Letter of Proof of Insurance Restricted Snake Propagation Permit
Restricted Snake Propagation Permit Application
Restricted Snake Propagation Permit Application Instructions
Restricted Snake Propagation Permit Renewal Application
Restricted Snake Propagation Permit Renewal Application Instructions

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
Application for Milk Dealer's License
Application for Milk Hauler License
Application for Milk Processor License
Application for Milk Producer License
Application for Weigher, Sampler or Tester License
Drug Residue Clearing Sample Reporting Form
Drug Residue Screening Reporting Form
Farm Plan Submittal Form
Farm Security Awareness Checklist
Milk Receiving Report
National Milk Drug Residue Database Reporting Form
Processor Plan Submittal Form

Fairs Forms
Annual Financial Report 2017
Chart of Accounts
Contact Sheet 2018
Electronic Filing Application
Fair Date Request 2018
Fair Fund Request 2018
Junior Fair Affidavit 2017
Junior Fair Report 2017
Letter of Supplies 2017
Outstanding Fair Supporter 2017
Redbook Laws
Redbook Table of Contents
Voucher Letter 2017

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
CLM Application
CLM Renewal Applicaton

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

Instructions
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

Apiary
PLNT 4201-001 - No Consent to Inspection
PLNT 4201-002 - Application for Apiary Registration

Fertilizer
PLNT 4202-001 - Application for Registration of an Agricultural Additive
PLNT 4202-002 - Application for Construction and Operation of an Anhydrous Ammonia System
PLNT 4202-003 - Application to Manufacture or Distribute Commercial Fertilizer
PLNT 4202-005 - Application to Manufacture, Sell or Distribute Liming Material
PLNT 4202-006 - Application for Non-Agricultural Production Custom Mixed Fertilizer Blenders
PLNT 4202-007 - Application for Secondary Containment Construction
PLNT 4202-008 - Application for Registration of Specialty Fertilizer Products

Grain Warehouse, Feed & Seed
PLNT 4203-001 - Application for Registration of Ohio Feed
PLNT 4203-002 - Application for Agricultural Commodity Testers
PLNT 4203-004 - Certificate of Insurance Form
PLNT 4203-006 - Indemnity Fund Claim Form
PLNT 4203-008 - Application for Seed Labelers Permit
PLNT 4203-010 - Warehouse Receipt Order Form

Pesticide
PLNT 4204 - Change of Information for Applicators
PLNT 4204 - Change of Information for Businesses
PLNT 4204 - RU Pesticide Dealer Sales Report
PLNT 4204-001 - Application for Registration of Pesticides
PLNT 4204-014a - Instructions for Recertification Program Sponsors
PLNT 4204-014b - Application for Applicator Recertification Credits
PLNT 4204-014c - Application for Recertification Program Sponsors
PLNT 4204-016 - Application for Private Pesticide Applicators
PLNT 4204-017 - Application for Private Pesticide Applicator Renewal
PLNT 4204-018 - Application for Pesticide Businesses
PLNT 4204-019 - Application for Commercial Pesticide Applicators
PLNT 4204-NPMA-33 - Wood Destroying Insect Report

Plant Pest Control
PLNT 4205-001 - Application for Dealer in Nursery Stock
PLNT 4205-002 - Application for Nursery Inspection

Soil and Water Conservation Forms

Election Process & Procedure Forms
Election Process and Procedures
SEL-1 Election Legal Notice
SEL-10 Election Results Form
SEL-11 Oath Of Office
SEL-1a Sample Legal Notice Letter
SEL-2 Resident Absentee Ballot Request Form
SEL-3 Non-Resident Firm or Corporation Absentee Ballot Request
SEL-4 Candidate Submission and Ballot Request
SEL-4a Statement of Candidacy
SEL-5 Candidate Petition Form
SEL-6 Resident Election Registry
SEL-7 Non-resident, Firm, Corporation Election Registry
SEL-8 Non-Resident Affidavit
SEL-9 Sample Corporation, Firm, LLC or Trust Affidavit
Voter Eligibility

Financial Forms
Certification of Fiscal Agent
Form 11 - SWCD Request for State Matching Funds
FY 18 Conservation Assistance Grant Application

Miscellaneous SWCD Forms
2017 Conservation Farm Family Award Application
2017 Ohio Conservation Partnership Roster
2017 Resources and Reminders
Annual Plan of Work -SWIMS Help
Annual Plan of Work Template
Application for Exemption from Ohio Revised Code 939.08(A)
Board Reorganization Form
Milkweed Pod Collection Placemat
Milkweed Seed Pod Collection Project
Model Ethics Policy
Model Public Meeting Policy
OSWCC Request for SWCD Board Member Appointment
SWCD Board Member Quick Info Template (fillable)
SWIMS Pollution Complaint Guidance

Online Training
New Employee Online Training (For DSWC ONLY)

Registration Forms
Technician Development Program Course Description
Technician Development program Registration Form- Level 2

Technical Guides
Ohio Pipeline Standards and Construction Specifications

Specialty Crop Promotion Program Forms


Application Information
2017 RFP
2017 SCBG Application
2017 SCBG Process

Quarterly Reports
2015 Quarterly Report
2016 SCBG Quarterly Report
2017 SCBG Quarterly Reports

Reimbursement Request
2015 Reimbursement Request
2016 SCBG Quarterly Reimbursement
2017 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 CHANGES to Registration of Serviceperson Testing Dates 2017
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_4300-016 County & City Weights & Measures Inspector Approved Training 2015
Wght_4300-035 Broken Seal Form
Wght_4300-036 2016 Annual Report - State Summary & A-F
Wght_4300-037 2016 Annual Report G-L
Wght_4300-038 2016 Annual Report M-S
Wght_4300-039 2016 Annual Report T-Z (includes Cities)