NCDA&CS Forms

Agronomic Forms

Agronomic Information Sheets to Print, Complete and Submit Via Mail

• Soil Sample Information Sheet
• Problem Soil Sample Information Sheet
• Nematode Assay Information Sheet
• Nematode Problem-Diagnosis Information Sheet
• Plant Analysis Information Sheet
• Waste Analysis Information Sheet
• Solution Analysis Information Sheet

Food and Drug Protection Division Forms

Antifreeze Program Forms

• Application for N.C. Antifreeze Registration (PDF)

Drug Program Forms

• Drug Distributor License Verification Affidavit (PDF)

   

• Out of State

• Application for Prescription Drug Registration (PDF)
• Drug Registration Renewal (PDF)

 

• In State (North Carolina)

• License Application for Wholesale Prescription Drug Distributors (PDF)
• Drug License Renewal (PDF)

Animal Feed and Pet Food Forms

• Registration Instructions
  • Registration Instructions (MS Word)
• Feed Registration Form
  • Feed Registration Form (MS Word )
• Delinquent Registration Fee Form
  • Delinquent Registration Fee Form (MS Word)
• Permit Number Form
  • Permit Number Form (MS Word)
• Forage Analysis Form

Meat & Poultry Inspection Forms

Plant Industry Forms

Seed Dealer Licensing:

• Application For A Seed Dealer's License( 7/25/08)
• Seed License Fee Update Form ( 7/25/08)

Seed and Fertilizer Specialist Forms:

• Fertilizer and Seed Specialist Inspectiion Template (MS Excel Format)

Seed Testing Laboratory:

• Seed Test Request Form
• Seed Test Request Form (MS Word Format)

Seed Pathology Program:

• Endophyte Testing Form ( 01/10/06)

Seed Complaint Arbitration:

• How To File a Seed Performance Complaint(01/07/06)
 
• Seed Performance Complaint (01/07/06)
 
• (Request For Arbitration by North Carolina Seed Board) (01/07/06)
  
• Seed Arbitration Grower Data Form (01/07/06)
  
• Seed Arbitration Initial Inspection Form(01/10/06)
  
• Seed Arbitration Labeler Data Form
  
• Seed Arbitration Grower Loss Data Form

Apiary Services Program:

• 2008 Apiary Registration Form (MS Word Format)

Boll Weevil Program:

• 2006 Cotton Acreage Change Form (MS Word Format)
• 2006 Cotton Acreage Late Reporting Form (MS Word Format)

Gypsy Moth Program:

• Gypsy Moth Slow-the-Spread Regulatory Inspection Form
• NCDA&CS Gypsy Moth Compliance Agreement

Plant Conservation Program:

• ( 01/07/06) Application for Obtaining, Updating, or Renewing
  Protected Plant Conservation or Propagation Permits
• Application for North Carolina Ginseng Dealer Permit (MS Word Format)

Shipping Requirements:

• Federal PPQ Form 526 Application to move living plant pests and noxious weeds.
• Federal permits for shipping soil, seeds, plants, and plant products (various PPQ Forms).
• Plant Pests ( Insects, Plant Disease Organisms, Weeds ) and Other Organisms regulated by state quarantines moved within the boundaries of North Carolina: PPS-1 - Application and Scientific Permit to Move Plant Pests or Regulated Articles

 

Tobacco Plant Importation:

• Tobacco Plant Import Permit / Application

Standards Division Forms

• LP-Gas Dealer Application (You will also need the Statement of Insurance unless your insurance company will supply their Certificate of
  Insurance.
• Statement of Insurance (Required for the LP-Gas Dealer License unless
  the insurance company sends their Cetificate of Insurance.)
• Application for Registration as a Limited Petroleum Device Technician (Required for those who service LP-Gas meters but do not calibrate
  them.)
• A sample meter seal break notification form
• Application for Registration of Gasoline/Diesel Fuel Brand Name
• Application for Registration as a Petroleum Device Technician (Required for those who calibrate fuel meters.)
• Application for Registration as a Scale Technician
• Application for Registration as a Weighmaster
  

Structural Pest Forms

 Applications for Structural Pest Control Credentials

• License Application  (Original issuance, transfer or change of address)

• License Exam Application (9 Page Document) The North Carolina Structural Pest Committee issued a directive effective immediately. All persons applying to take the license exam must submit a Criminal Background Check with your 9 page application. The information to get the background check is placed with the 9-page application.

• Application for Certified Applicator's Card
  (Original issuance, transfer or change of address)

• Application for Registered Technician's Card

• Examination Preregistration Form
  
  

 Other Structural Pest Control Forms

• New Construction Termite Treatment Record

• Pre-treat Sticker

• Application for Assignment of CCUs

  • Requirements used for the approval of certifications units(CCUs)

• NC Waiver of Min. Requirements for Control of S. Termites in Existing Structures

• Subterranean Termite Sub-Slab Treatment Release Form

• Branch Office Registration Form

• Application for Registered Technician School