Form Ag 0064 PDF Details

Form Ag 0064 is a form that is used to report the sale or other disposition of an agricultural commodity. The form must be filed by the buyer and seller within fifteen days of the sale or other disposition. The information on Form Ag 0064 can be used to help determine the taxable value of agricultural commodities. This form is important for ensuring that taxes are paid on any sales or dispositions of agricultural commodities.

QuestionAnswer
Form NameForm Ag 0064
Form Length1 pages
Fillable?No
Fillable fields0
Avg. time to fill out15 sec
Other namesdealapplication apply for livestock dealer license in tennessee form

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TENNESSEE DEPARTMENT OF AGRICULTURE

DIVISION OF CONSUMER & INDUSTRY SERVICES – ANIMAL HEALTH

P. O. Box 40627, Nashville, Tennessee 37204

Phone: 615/837-5120, Fax 615/837-5250

Animal.health@tn.gov

APPLICATION FOR TENNESSEE LIVESTOCK DEALER LICENSE

Person* to Whom License is to be Issued: _________________________________________________________________

(Must be an individual, corporation, limited liability company, partnership, or other duly formed and recognized legal entity.) Email Address;____________________________________________________________________________

Mailing Address:______________________________________________________________________________

Street, Route or P.O. Box

____________________________________________________________________________________________

City

State

Zip Code

County

Phone Numbers:______________________________________________________________________________

Business

Home

Cellular

 

Address where business records are located: _______________________________________________________

Street, Route or P.O. Box

____________________________________________________________________________________________

CityStateZip Code County

LIST NAMES OF BUSINESS PARTNERS and/or CORPORATION OFFICERS: _________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

LIVESTOCK THAT IS BOUGHT, RECEIVED OR ASSEMBLED FOR RESALE (Check all that apply):

Cattle _____ Calves _____ Horses _____ Mules _____ Poultry _____ Swine _____ Sheep _____ Goats _____

and Alternate Livestock (please list) ______________________________________________________________

THE FOLLOWING MUST BE ENCLOSED BEFORE A LICENSE WILL BE ISSUED:

(1). Annual fee of $25.00, made payable to the Tennessee Dept. of Agriculture and sent to the address at top of form.

(2) Proof the applicant has met bonding requirements of 9 C.F.R. 201.

I HEREBY CERTIFY THAT THE INFORMATION SUBMITTED IN THIS APPLICATION IS CORRECT TO THE BEST OF MY KNOWLEDGE.

_________________________________________________

____________________________________________

Name and Title of Applicant

(Please Print)

Signature of Applicant

Date

Licenses are valid from July 1 through June 30

AG-0064 (Rev. 11/13)

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