Sale Certificate Format Form – Fill Out and Use This PDF

		DEPARTMENT of AGRICULTURE
	JEREMIAH W. (JAY)	STATE OF MISSOURI	DR. JON
		JEFFERSON CITY
	NIXON		HAGLER

Serving, promoting and protecting the agricultural producers, processors

and consumers of Missouri’s food, fuel and fiber products.

Date

CERTIFICATE o f FREE SALE

TO W H OM IT MAY CON CERN :

Th e u n d er sign ed , of th e Missou r i Depar tm en t of Agr icu ltu r e, State of Missou r i, Un ited States of

Am er ica, cer tifies th at ( c o m p a n y n a m e ) h ead qu ar ter ed in (c ity	a n d s ta te – U S A) with a
m an u factu r in g facility located at ( lo c a tio n – c ity a n d s ta te – U S A) ,	is a fir m kn own to u s.

Th eir m an u factu r ed pr od u ct(s), ( p ro d u c t n a m e ) , ( b rie f d e s c rip tio n o f p ro d u c t) , is/ ar e available for fr ee sale in th e State of Missou r i an d d istr ibu ted gen er ally th r ou gh ou t th e Un ited States. To th e best of m y kn owled ge, th er e is n o pr oh ibition again st expor t of th is/ th ese pr od u ct(s) in to th e cou n tr y of ( n a m e o f c o u n try) .

As a m atter of policy, th e Missou r i Depar tm en t of Agr icu ltu r e, wh ile assistin g an d pr om otin g sales, d oes n ot en d or se an y par ticu lar pr od u cts.

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N a m e

In te rn a tio n a l Ma rke tin g S p e c ia lis t Ag B u s in e s s D e ve lo p m e n t D ivis io n

Su bscr ibed an d swor n befor e m e th is _ _ _ _ day of _ _ _ _ _ _ , 2 0 _ _ .

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N o ta ry P u b lic – S ta te o f Mis s o u ri

Division of Agriculture Business Development

GEORGE WASHINGTON CARVER STATE OFFICE BUILDING

Ph. (573) 751-4762 • 1616 Missouri Boulevard • P.O. Box 630 • Jefferson City, MO 65102-0630 • FAX (573) 751-2868 • www.mda.mo.gov