North Dakota Department of Agriculture

Feed Manufacturers New License Application

Enter the following information about the North Dakota Feed Manufacturers License Applicant:

Company Name: *
Contact Name:

Street Address
Address 1: *
Address 2:
City: * State: * Zip: * -

Mailing Address         Same as Street Address
Address 1:
Address 2:
City: State: Zip: -

Miscellaneous Company Information
Phone: *
Fax:
Email address: *
County:

Commercial Feed Manufacturer Information
Is this a Licensed FDA Medicated Feed Mill?:
Does this Facility Manufacture Medicated Feeds?:
Does this Facility Sell at Retail?