Department of agriculture form: Fill out & sign online

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Click ‘Get Form’ to open it in the editor.
Begin by entering your COMPANY ID and NAME in the designated fields. This identifies your business and the product you are registering.
Fill out the SUBMITTED BY section with your name, followed by your ADDRESS, CITY, STATE, ZIP, and OHIO COUNTY. Ensure all information is accurate for processing.
Provide your PHONE NUMBER, FAX NUMBER, and E-MAIL ADDRESS for communication purposes.
Indicate the PAYMENT METHOD by selecting either Check, Money Order, or Credit Card. If using a credit card, complete the required fields including Name on Credit Card and Credit Card Number.
In the GUARANTEED ANALYSIS section, list Active Ingredients and Inert Ingredients along with their respective percentages.
Attach any necessary evidence of efficacy to substantiate label claims before submitting the form.
Finally, sign and date the CERTIFICATE OF REGISTRATION to confirm that all information is correct and complete.

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