For AZDA ASD Use Only Arizona Department of Agriculture (AZDA) New 2025

1. Click ‘Get Form’ to open it in the editor.
2. Begin by selecting the appropriate License Type: either 'EGG DEALER' or 'PRODUCER-DEALER'. This choice determines your business classification.
3. Fill in the Applicant Information section. Enter the Application Date, Name of Applicant, Applicant’s Title, and Phone Number accurately.
4. In the Business Information section, provide your Company Name, Mailing Address, and Physical Plant Address. Ensure all addresses are complete with City, State, and Zip Code.
5. Complete the Company Contact details including Phone Number, Fax Number, and Tax ID Number for identification purposes.
6. Finally, sign and date the form in the Signature section. Ensure that you print your name clearly above your signature to validate your application.

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