APPLICATION FOR AGRICULTURAL/VEGETABLE SEED PERMIT

July 1, 2011 to June 30, 2012

Iowa Laboratory Facilityi 2230 S. Ankeny Boulevardi Ankeny, Iowa 50023i 515-725-1470i

The Iowa Department of Agriculture and Land Stewardship is an equal opportunity employer and provider

2 of 2 pages 3-16-2011 update

Business Name

Contact Person

Address

City/State/Zip

Telephone/Fax

Email

Check appropriate responses below:

Type of Seed Sold in Iowa Type of Business

____ Corn ____ Corporation

____ Soybeans ____ Cooperative

____ Small Grains ____ Partnership

____ Forage/Grasses ____ Individual

____ Lawn Other (Specify) ______

____ Vegetable

____ Other (Specify) ______

Brand, branch and/or subsidiary names: Please list o a separate piece of paper, location and other information for branch, or other facilities where your company holds substantial quantities of labeled seed in Iowa. If there is none, please write ‘none.’

Bond Requirement: You may need to provide a bond. To determine that, please answer the questions below. (See Chapter 199.16, Code of Iowa). If your responses are Yes, No, Yes; then you are required to post a bond and need to contact our office.

Do you contract with any Iowa growers to have them grow any of the seed you sell? Yes No

If yes, answer the following:

a. Do you furnish seed stock to the grower at no cost? Yes No

b. Do you contract to buy back the seed they produce at higher than market prices? Yes No

Fee Schedule: All New (First-Time) Permits are $10.00. For all renewal permits, see the next page for the Seed Permit Fee Schedule based on Gross Annual Sales in Iowa.

FEE enclosed, based on company GROSS ANNUAL SALES (last 12 months) in Iowa:

SIGNATURE OF APPLICANT: DATE:

Make checks payable to: Iowa Department of Agriculture and Land Stewardship, or IDALS

Iowa Laboratory Facilityi 2230 S. Ankeny Boulevardi Ankeny, Iowa 50023i 515-725-1470i

The Iowa Department of Agriculture and Land Stewardship is an equal opportunity employer and provider

2 of 2 pages 3-16-2011 update

Seed Permit Fee Schedule

This complete schedule is developed in accordance with the Agricultural Seeds Act, Section 199.15, Chapter 199, Code of Iowa, to aid in determining the correct fee amounts for permits to sell seed in Iowa.

Note: All new, first time permits are $10.00. For renewal permits the gross annual sale of seeds, under the permit holder’s label, in Iowa only, is used to calculate the fee amount from the schedule below.

If gross sales in Iowa (past 12 mo) is more than / …but not over / Fee Amount / If gross sales in Iowa (past 12 mo) is more than / …but not over / Fee Amount
$0.00 / $25,000.00 / $30.00 / 2,300,000.00 / 2,400,000.00 / 780.00
25,000.00 / 50,000.00 / $60.00 / 2,400,000.00 / 2,500,000.00 / 810.00
50,000.00 / 100,000.00 / $90.00 / 2,500,000.00 / 2,600,000.00 / 840.00
100,000.00 / 200,000.00 / $120.00 / 2,600,000.00 / 2,700,000.00 / 870.00
200,000.00 / 300,000.00 / $150.00 / 2,700,000.00 / 2,800,000.00 / 900.00
300,000.00 / 400,000.00 / $180.00 / 2,800,000.00 / 2,900,000.00 / 930.00
400,000.00 / 500,000.00 / $210.00 / 2,900,000.00 / 3,000,000.00 / 960.00
500,000.00 / 600,000.00 / $240.00 / 3,000,000.00 / 3,100,000.00 / 990.00
600,000.00 / 700,000.00 / $270.00 / 3,100,000.00 / 3,200,000.00 / 1,020.00
700,000.00 / 800,000.00 / $300.00 / 3,200,000.00 / 3,300,000.00 / 1,050.00
800,000.00 / 900,000.00 / $330.00 / 3,300,000.00 / 3,400,000.00 / 1,080.00
900,000.00 / 1,000,000.00 / $360.00 / 3,400,000.00 / 3,500,000.00 / 1,110.00
1,000,000.00 / 1,100,000.00 / $390.00 / 3,500,000.00 / 3,600,000.00 / 1,140.00
1,100,000.00 / 1,200,000.00 / $420.00 / 3,600,000.00 / 3,700,000.00 / 1,170.00
1,200,000.00 / 1,300,000.00 / $450.00 / 3,700,000.00 / 3,800,000.00 / 1,200.00
1,300,000.00 / 1,400,000.00 / $480.00 / 3,800,000.00 / 3,900,000.00 / 1,230.00
1,400,000.00 / 1,500,000.00 / $510.00 / 3,900,000.00 / 4,000,000.00 / 1,260.00
1,500,000.00 / 1,600,000.00 / $540.00 / 4,000,000.00 / 4,100,000.00 / 1,290.00
1,600,000.00 / 1,700,000.00 / $570.00 / 4,100,000.00 / 4,200,000.00 / 1,320.00
1,700,000.00 / 1,800,000.00 / $600.00 / 4,200,000.00 / 4,300,000.00 / 1,350.00
1,800,000.00 / 1,900,000.00 / $630.00 / 4,300,000.00 / 4,400,000.00 / 1,380.00
1,900,000.00 / 2,000,000.00 / $660.00 / 4,400,000.00 / 4,500,000.00 / 1,410.00
2,000,000.00 / 2,100,000.00 / $690.00 / 4,500,000.00 / 4,600,000.00 / 1,440.00
2,100,000.00 / 2,200,000.00 / $720.00 / 4,600,000.00 / 4,700,000.00 / 1,470.00
2,200,000.00 / 2,300,000.00 / $750.00 / 4,700,000.00 / or more / 1,500.00

Iowa Laboratory Facilityi 2230 S. Ankeny Boulevardi Ankeny, Iowa 50023i 515-725-1470i

The Iowa Department of Agriculture and Land Stewardship is an equal opportunity employer and provider