Agronomic Forms

• Soil sample Information forms
  
  
  • Routine samples (form AD-1)
    
    
  • Diagnostic (problem) samples (form AD-2)
    
    
  • Soil samples for research (form AD-12)
    
    
  • Soil samples for heavy metals analysis (form AD-13)
    
    
• Nematode assay sample information forms
  
  
  • Routine samples (form AD-3)
    
    
  • Continuation page for routine samples
    
    
  • Diagnostic (problem) samples (form AD-5)
    
    
  • Continuation page for problem samples
    
    
• Plant/Waste/Solution/Media sample information forms
  
  
  • Plant tissue samples (form AD-4)
    
    
  • Waste or compost samples (form AD-9)
    
    
  • Source water or nutrient solution samples (form AD-7)
    
    
  • Soilless media samples (form AD-8)
    
    
• Cooperative Research Agreement (form AD-11)
  — prerequisite for ALL samples submitted for research purposes

Food & Drug Protection Division Forms

Drug Program Forms

• Drug Distributor License Verification Affidavit

 

• Out of State

• Application for Prescription Drug Registration
  
  
• Drug Registration Renewal

 

• In State (North Carolina)

• License Application for Wholesale Prescription Drug Distributors
• Drug License Renewal

Antifreeze Program Forms

• Application for N.C. Antifreeze Registration

Animal Feed and Pet Food Forms

• Pet Food Registration Instructions
• Pet Food 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

Product Registration Packages and Foms:

•  Fertilizer Registration Package
  
  
  • SF01 - Application for License to Manufacture/Distribute Fertilizers
    
    
  • SF02 - Application for Fertilizer Product Registration
    
    
•  Lime Registration Package
  
  
• SF03 - Application for Lime/Landplaster Product Registration
  
  
• Soil Additive Registration Package
  
  
  • SF05 - Soil Additive Registration Form
    
    
• Seed Registration Package
  
  
  • SF04 - Application For New Seed Dealer’s License

Seed Testing Laboratory:

• Seed Sample Submission Form for Homeowners (PDF Version) 
• Seed Sample Submission Form for Homeowners - (MS Excel Version) 

Seed Pathology Program:

• Endophyte Testing Form

Seed Complaint Arbitration:

• How To File a Seed Performance Complaint
  
  
• Seed Performance Complaint (01/07/06)
  
  
• SF07 - Request For Arbitration by North Carolina Seed Board
  
  
• Seed Arbitration Grower Data Form
  
  
• Seed Arbitration Initial Inspection Form(01/10/06)
  
  
• Seed Arbitration Labeler Data Form
  
  
• Seed Arbitration Grower Loss Data Form

Apiary Services Program:

• 2012 Apiary Registration Form

Boll Weevil Program:

• 2009 Cotton Acreage Change Form
  
  
• 2009 Cotton Acreage Late Reporting Form

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

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 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.
• *License Application  (Original issuance, transfer or change of address) Before apply for an structural license you must first complete the licensing application proccess above.

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

• Application for Registered Technician's Card
  The fee for a new or to renew a Registered Technician card is $40.00
  

• 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

Veterinary Division Forms

• Rendering & or Collectors Application Form

Animal Health Program

• Poultry Section
  • Pen-Raised Quail License Application
    
    
  • Poultry Dealer License Application Form
    
    
  • Poultry Dealer License Application Form
    
    
• Livestock Section

• Livestock Brand Packet
  
  
• Livestock Dealer Application

Animal Welfare Program

• New Facility and Renewal Application:
• Facility Application & Program of Veterinary Care (PDF)