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Farm Products
Fertilizer/Lime Registration
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Massachusetts License Application for
Fertilizer Manufacturer and Distribution
(Primarily Farm Use)
- Print out form and complete
- Submit form in duplicate.
- Enclose check payable to the Commonwealth of Massachusetts.
- Submit $250.00 fee and applications to:
Fertilizer Control Official
Massachusetts Department of Agricultural Resources
251 Causeway Street, Suite 500
Boston, MA 02114-2151
Application is hereby made for a license to manufacture and/or distribute
fertilizer, except
specialty fertilizers, in the Commonwealth of Massachusetts during calendar
year ________.
Firm Name
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Street Address
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City, State, Zip
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Phone
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Date
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Name of Signatory
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Title
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Signature
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*Be sure to submit forms in duplicate.
One copy will be returned to applicant upon certification.
THIS AREA FOR DEPARTMENT USE ONLY ----------------License No.
This certifies that the above named applicant is hereby licensed to manufacture
and/or distribute fertilizer except specialty fertilizers in the state
of Massachusetts
from Jan. 1, _______ to Dec. 31, ________.
Date __________________ By: _______________________________(Fertilizer
Control Official) |
