MDA Forms

The MDA has hundreds of forms related to its programs and activities. As a service to our stakeholders, we make these forms available on our web site. If you don't see the form you are looking for on this site, please contact MDA.Info@state.mn.us.

Agricultural Liming Material

• Application for License and Inspection Fee Exemption Relating to Distribution of By-Product (PDF: 114 KB / 1 page)
• License Application (PDF: 44 KB / 1 page)

Anhydrous Ammonia

• Equipment Inspection Checklist - Combination of MN/DOT, MDA, MN State Patrol Regulations (PDF: 107 KB / 4 pages)
• Driver's Vehicle Inspection Report (PDF: 79 KB / 1 page)
• Storage Facility Inspection Checklist (PDF: 103 KB / 2 pages)
• Storage Permit Application - New Facility (PDF: 117 KB / 2 pages)
• Storage Permit Application - Substantial Alteration (PDF: 118 KB / 2 pages)

Apiary

• Application for Apiary Inspection (PDF: 100 KB / 1 page)

Chemigation

• Chemigation Permit Application (PDF: 113 KB / 2 pages) 
• Substantial Alteration Chemigation Permit Application (PDF: 86 KB / 1 page)

Commercial Feed

• Annual Inspection Fee Form (Tonnage Tax) (PDF: 20 KB / 2 pages)
• Animal Feed, Application for Certificate of Free Sale for (PDF: 97 KB / 1 page)
• Pet Food Listing (dog or cat food) (PDF: 31 KB / 2 pages)
• Specialty Pet Food Listing (pet food other than dog or cat) (PDF: 33 KB / 2 pages)

Dairy & Food

• Dairy Permit Inspection Request (PDF: 185 KB / 1 page) 
• Dairy Permit Update Request (PDF: 166 KB / 1 page)
• Documentation Checklist (PDF: 111 KB / 1 page) 
• E. coli Checklist for Regulatory Requirements (PDF: 141 KB / 3 pages)
• Egg Grading & Sales for Small Producers Exempt from Licensing Poultry Slaughter & Sales Direct to Consumers Exemption (PDF: 169 KB / 1 page) 
• Farm Water Sample Result Record (PDF: 192 KB / 1 page) 
• HACCP Form 1 - Basic Compliance Checklist (PDF: 132 KB / 2 pages)
• HACCP Form 2 - Ongoing Requirements Checklist (PDF: 136 KB / 1 page)
• HACCP Form 3 - Records Requirements Checklist (PDF: 145 KB / 1 page)
• Hunter Harvested Venison Donation Program - Charitable Organization Registration (PDF: 272 KB / 2 pages)
• Hunter Harvested Venison Donation Program - Processor Training Registration Form (PDF: 147 KB / 1 page)
• Hunter Harvested Venison Processor Registration Form (PDF: 172 KB / 1 page)
• Letter of Intent (PDF: 120 KB / 1 page) 
• Listeria Checklist for Regulatory Requirements (PDF: 143 KB / 2 pages)
• Milk Handling Equipment & Facility Construction Review Application (PDF: 148 KB / 2 pages) 
• Plan Review Application (PDF: 80 KB / 6 pages)
• SSOP Form 1 - Basic Compliance Checklist (PDF: 139 KB / 2 pages)
• SSOP Form 2 - Ongoing Requirements Checklist (PDF: 132 KB / 1 page)

Data Requests & Information Access

• Certification of Identity (PDF: 9 KB / 1 page)
• Data Request Form (PDF: 19 KB / 1 page)

Environment

• ACRRA Application for Reimbursement (PDF: 229 KB / 12 pages)
• ACRRA Application for Reimbursement (MS Word Version)
• Agricultural Voluntary Investigation and Cleanup (AgVIC) Application (PDF: 89 KB / 4 pages) 
• Guidelines for Developing and Maintaining an Incident Response Plan - short form
• Guidelines for Developing and Maintaining an Incident Response Plan (PDF: 712 KB / 24 pages) - long form

Exporting

• Processed Product Certificate (PDF: 143 KB / 1 page)

Farm

• Aggie Bond Beginning Farmer Loan Application (PDF: 40 KB / 8 pages)
• Agricultural Improvement Loan Application (PDF: 119 KB / 6 pages) 
• Annual Report by Permanent Resident Aliens and E-2 Investments Visa Holders  (PDF: 134 KB / 1 page)
• Basic Farm Loan Application (PDF: 168 KB / 6 pages) 
• Corporate Farm Application (PDF: 476 KB / 11 pages)
• Initial Report of Agricultural Land Purchases by Permanent Resident Aliens & E-2 Investments Visa Holders (PDF: 132 KB / 1 page)
• Livestock Expansion Loan Application (PDF: 119 KB / 6 pages) 
• Report of Agricultural Land Holdings Non-Resident Aliens - Grandfathered In (PDF: 119 KB / 2 pages)
• Restructure II Loan Application (PDF: 168 KB / 6 pages) 
• Seller Assisted Loan Application (PDF: 168 KB / 6 pages) 
• Sustainable Agriculture Loan Program Application (PDF: 490 KB / 11 pages) 
• Value-Added Stock Loan Application (PDF: 132 KB / 4 pages)
• Wind Company's Annual Report (PDF: 136 KB / 1 page)

Fertilizer

• Bulk Pesticide/Fertilizer Storage Permit Application (PDF: 167 KB / 6 pages)
• Commercial Animal Waste Technician (CAWT) License Application (PDF: 88 KB / 1 page) 
• Fertilizer License Application (PDF: 29 KB / 1 page) 
• Pesticide/Fertilizer Inspection Request (PDF: 117 KB / 2 pages)
• Soil/Plant Amendment Product Registration Application (PDF: 70 KB / 1 page) 
• Specialty Fertilizer Product Registration Application (PDF: 89 KB / 1 page)

Insects/Invasive Pests

• Emerald Ash Borer Reporting Form (PDF: 63 KB / 1 page)

Livestock

• Compensation Claim for Crops Destroyed by Elk (PDF: 138 KB / 2 pages)
• Compensation Claim for Livestock Destroyed by Wolf (PDF: 290 KB / 2 pages) 
• Livestock Expansion Loan Program Application (PDF: 126 KB / 8 pages) 

Manure

• Commercial Animal Waste Technician (CAWT) License Application (PDF: 46 KB / 1 page) 

Minnesota Grown

• Minnesota Grown License and Minnesota Grown Directory Applications (PDF: 91 KB / 3 pages) 

Data Requests & Information Access

• Certification of Identity (PDF: 9 KB / 1 page)
• Data Request Form (PDF: 19 KB / 1 page)

Nursery / Greenhouse / Plant

• Nursery Certificate Application (PDF: 90 KB / 2 pages) 
• Plant Disease Laboratory Diagnostic Form (PDF: 126 KB / 1 page)
• Tree Care Company Registration Application (PDF: 85 KB / 1 page) 

Pesticide

• Bulk Pesticide/Fertilizer Storage Permit Application (PDF: 167 KB / 6 pages)
• Duplicate License (PDF: 27 KB / 1 page)
• Pesticide Applicator, Commercial/Noncommercial - New Application (PDF: 74 KB / 1 page) 
• Pesticide Dealer - New Application (PDF: 99 KB / 1 page)
• Pesticide/Fertilizer Inspection Request (PDF: 117 KB / 2 pages)
• Pesticide Product Registration Form (PDF: 88 KB / 1 page)
• Pesticide Product Registration Inspection (PDF: 98 KB / 1 page)
• Report of Sale of Restricted Use Pesticides to Certified Applicators (PDF: 21 KB / 2 pages)
• Structural Pesticide Applicator - New Application (PDF: 90 KB / 1 page) 
• Structural Pesticide Company - New Application (PDF: 92 KB / 1 page) 

Pesticide Application Records (Samples)

• Agricultural Pest Control — Animal (Category K) (PDF: 11 KB / 1 page)
• Anti-Microbial (Category I) (PDF: 11 KB / 1 page)
• Field Crop Pest Management, Aerial Application (Category C) (PDF: 18 KB / 1 page)
• Field Crop Pest Management, Ground Application (Category C) (PDF: 16 KB / 1 page)
• Food Processing (Category M) (PDF: 11 KB / 1 page)
• Forest Spraying Aerial Application (Category G) (PDF: 12 KB / 1 page)
• Forest Spraying Ground Application (Category G) (PDF: 11 KB / 1 page)
• Mosquito and Black Fly Control Aerial Application (Category L) (PDF: 87 KB / 1 page)
• Mosquito and Black Fly Control Ground Application (Category L) (PDF: 25 KB / 1 page)
• Noncommercial Aquatic (Category F) (PDF: 14 KB / 1 page)
• Noncommercial Structural (Category S) (PDF: 13 KB / 1 page)
• Pocket Gopher Control (Category P) (PDF: 12 KB / 1 page)
• Rights-of-Way Aerial Application (Category J) (PDF: 12 KB / 1 page)
• Rights-of-Way Ground Application (Category J) (PDF: 15 KB / 1 page)
• Seed Treatment (Category H) (PDF: 11 KB / 1 page)
• Sewer Root Control (Category R) (PDF: 11 KB / 1 page)
• Stored Grain and Fumigation, Excluding Fumigation (Category N) (PDF: 11 KB / 1 page)
• Stored Grain and Fumigation, Fumigation Only (Category N) (PDF: 13 KB / 1 page)
• Structural Pest Control Applicator, Excluding Fumigation (PDF: 13 KB / 1 page) 
• Structural Pest Control Applicator with Fumigator (Category N) (PDF: 13 KB / 1 page)
• Turf and Ornamentals — Indoor Application, Greenhouses and Indoor Plantscapes (Category E) (PDF: 12 KB / 1 page)
• Turf and Ornamentals — Outdoor Application (Category E) (PDF: 15 KB / 1 page)
• Wood Preservative, Field Treatments (Category Q) (PDF: 14 KB / 1 page)
• Wood Preservative, Treatment Plants (Category Q) (PDF: 12 KB / 1 page)

Seed

• Seed Brand Name Registration Application (PDF: 102 KB / 2 pages)
• Seed Permit Application (PDF: 102 KB / 2 pages)
• Seed Sample Submission - Fee Schedule and Login Sheet (PDF: 21 KB / 2 pages)

Wholesale Produce Dealer

• License Application (PDF: 113 KB / 2 pages) 
• Beneficiaries Notice of Intent to Preserve Trust Assets (PDF: 121 KB / 1 page) 
• Wholesale Produce Dealer Bond Claim Form - Claimant (PDF: 132 KB / 1 page)