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Century Farm Program

Century Farm Application

Office of Farmland Preservation

FY 2015 Local PDR Fiscal Certification Form – 11/14/2014 Deadline
FY 2015 Local PDR Program Certification Form – 11/14/2014 Deadline

Division of Animal and Food Industry Services

Agricultural Animal Seizure Report (PDF 21KB)
Animal Custody Record
(PDF 28KB)
Animal Facility Inspection Form – Pound Regulations (PDF 54KB)
Animal Health Laboratory Submission Form (PDF 16KB)
Animal Record (PDF 34KB)
Application for Livestock/Poultry Dealer Registration (PDF 16KB)
Canine Care Workshop Registration Form
Dangerous Dog Registration Form
Dangerous Dog Renewal Form
Dangerous Dog Secondary Owner Information Form
Equine Event Report
(PDF 34KB)
Equine Event Denied Entry Report (PDF 34KB)
Humane Investigator Investigation Report (PDF 23KB)
Humane Investigator Quarterly Report (PDF 20KB)
Poultry Service Request Form & Fees (PDF 17KB)
2003 Statewide Summary Report — Reporting Rescue Groups (PDF 96KB)
2003 Statewide Summary Report — Reporting Cities (PDF 98KB)
2003 Statewide Summary Report — Reporting Counties (PDF 96KB)
2003 Statewide Summary Report — Reporting Humane Societies (PDF 87KB)
2003 Statewide Summary Report — All Reporting Entities (PDF 96KB)

Foodborne Illness Complaint Form
General Complaint Form

Home Operations:
Food Processing Application

Food Service Vendor

Meat & Poultry Services
Application for Permit of Exemption (PDF 5KB)
Application for Permit of Poultry Exemption (PDF 8KB)
Application for State Meat and Poultry Inspection (PDF 11KB)
Application/Approval for Voluntary Reimbursable Inspection Service (PDF 13KB)

Division of Consumer Protection

Charitable Gaming

Charitable Solicitation
Virginia Exemption Application for Charitable or Civic Organization (Form 100)
Registration Statement for a Charitable Organization (Form 102)
Professional Fundraising Registration (Form 103)
Professional Solicitor Registration (Form 104)
Professional Solicitor Bond Template (Form 105)
Solicitation Notice (Form 120)
Consent to Solicit (Form 121)
Professional Solicitor’s Final Accounting Report Late Fees (Form 130)
Schedule A – Accounting For All Ticket Sales, Including Solicitation for Donated Tickets (Form 131)
Commitment for Receipt of Donated Tickets (Form 132)
Virginia Solicitation of Contributions Law
Rules Governing the Solicitation of Contributions
Unified Registration Statement: This form may be utilized by charitable organizations soliciting in multiple states.
Charitable Solicitation Complaint Form

Credit Services Business
Credit Services Business Registration Form (OCRP-71)
Credit Services Business Bond
Template (OCRP-74)
Credit Services Business Irrevocable Letter of Credit
Template (OCRP-73)
Virginia Credit Services Businesses Act
OCRP Regulatory Programs Complaint Form

Extended Service Contract
Extended Service Contract Provider/Obligor Application for Registration (OCRP-61)
Extended Service Contract Letter of Credit Template (OCRP-63)
Extended Service Contract Provider/Obligor Bond Template (OCRP-64)
Virginia Extended Services Contract Providers Act

OCRP Regulatory Programs Complaint Form

Health Clubs
Health Club Registration Form (OCA-31)
Health Club Bond Template (OCA-34)
Health Club Letter of Credit Template (OCA-33)
Health Club Act
Health Club Contract Requirements
OCRP Regulatory Programs Complaint Form

Membership Campgrounds
Application for the Registration of Membership Camping Operator (OCRP-51)
Membership Campground Letter of Credit Template (OCRP-53)
Membership Camping Operator's Bond Template (OCRP-54)
Virginia Membership Campground Act
OCRP Regulatory Programs Complaint Form

Prepaid Legal Service Plan Sellers
Initial Registration
Renewal Registration
Virginia Prepaid Legal Services Plan Act
OCRP Regulatory Programs Complaint Form

Transporters of Waste Kitchen Grease
Online Registration

Travel Clubs
Application for Registration Travel Clubs (OCA-21)
Travel Club Bond Template (OCA-24)
Irrevocable Letter of Credit Travel Clubs Template (OCA-26)
Travel Club Fidelity Bond Template (OCA 25)
Virginia Travel Club Act
Additional Travel Club Registration Guidelines (OCA-23)
OCRP Regulatory Programs Complaint Form

Pesticide Services
Application for New Pesticide Product Registration (PDF 10KB)
Application for Reciprocal Pesticide Applicator Certificate (PDF 51KB)
Application for Virginia Pesticide Business License (PDF 12KB)
Certificate of Insurance (PDF 10KB)
Change of Information Form (PDF 75KB)
Commercial A Pesticide Applicator Certification Application (PDF 35KB)
Commercial Application Instructions (PDF)
Commercial B Pesticide Applicator Request for Authorization to Take Pesticide Applicator Examination (PDF 50KB)
Pesticide Registered Technician Application
Pesticide Disposal Registration Form (PDF)
Power of Attorney (PDF 67KB)
Private Pesticide Applicator Request for Authorization to Take Pesticide Applicator Examination at Department of Motor Vehicles Customer Service Center (PDF 11KB)
Proof of Additional Category Specific Training for Registered Technicians (PDF 19KB)
Registered Technician Instructions (PDF)
Request to take the Virginia Pesticide Business License Examination (PDF 49KB)
Responsibilities of Commercial Pesticide Applicators and Registered Technicians in Virginia
Training Manual Order Form
Virginia Pesticide Discontinuance Policy
Virginia Pesticide News
Worker Protection Standard, Training Verification Program, State - Training Provider Agreement (PDF 8KB)

Plant Industry Services
Permit Application (PDF 11KB)
Virginia Ginseng Management Program (PDF 8KB)
Virginia Plants and Plant Product Inspection Law and Quarantine Requirements
Registration Packet for Agricultural Products Dealer
Registration Packet for Commercial Feed Licenses and Product Registration (PDF 28KB)
Registration Packet for Virginia Fertilizer License and Product Registration (PDF 121KB)
Registration Packet for Virginia Lime License and Product Registration (PDF107KB)
Registration Packet for Virginia Seed License and Product Registration (PDF 137KB)
Virginia Fertilizer/Lime Contractor — Applicator Permit (PDF 13KB)

Weights and Measures
Application for the Registration of Motor Fuels (PDF 8KB)
Application for Weights and Measures Service Agency Certification — Taxi Companies (PDF 26KB)
Application for Weights and Measures Service Agency Certification (PDF 28KB)
Application for Weights and Measures Service Technician Certification and Registration for Technician Training (PDF 28KB)
Motor Fuel Price Gouging Complaint Form (PDF 30KB)
Registration Packet for Commission Merchants

Registration Packet for Cotton Handlers
Virginia Petroleum Products Retail Locations (PDF 7KB)
Virginia Public Weighmaster Law and Application (PDF 135KB)

Division of Marketing

Livestock Marketing
Services Beef Breeding Cattle Clearing House Questionnaire (PDF 9KB)
Sheep Clearing House Questionnaire (PDF 7KB)
Goat Clearing House Request (PDF 5KB)

Market News Service
Hay Clearing House Request Form
Market News Publications Request Form

Virginia Grown Guide - Application for Participation Form
Virginia Grown Point-of-Sale Materials (PDF 4KB)
Organic Cost Share Application, Info sheet and W-9 form

Fruit, Vegetable & Peanut Marketing Services
Fruit and Vegetable Programs Request for Inspection, Reinspection or Appeal Inspection (PDF 9KB)

Employment Application
State Employment Application
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