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FARM CERTIFICATION APPLICATION - Oregon

Oregon DEPARTMENT OF TRANSPORTATION COMMERCE AND COMPLIANCE DIVISION 455 AIRPORT ROAD SE BUILDING A SALEM OR 97301 PH (503) 378-5203 FAX (503) 378-5765 FARM CERTIFICATION APPLICATIONDATE RECEIVEDTELEPHONE NUMBERNAME OF FARM (IF APPLICABLE)NAME OF FARMER (PRINT)COUNTY/COUNTIESUSDOT NUMBERFEIN OR TINFARM ADDRESSCITYSTATEZIPMAILING ADDRESS (IF DIFFERENT)FARM NUMBER1. OWN2. RENT/LEASENAMETELEPHONEADDRESSCITYSTZIP CODEAGENCY USE ONLYFORM 735-9670 (1-23) VEHICLES TO BE REGISTERED UNDER FARM CERTIFICATIONPLATE NUMBERYEARMAKEBODY STYLEVEHICLE IDENTIFICATION NUMBERREGISTRATION WEIGHTAXLE COUNTI certify the information above and on any attachments is true and correct and all information given is made under the penalty for false CERTIFICATION (ORS ).

NOTE: Commercial feedlots, horse boarding facilities, timber and lumber operations are not classified as farming operations and are not eligible for farm registration. LIST COMMODITIES PRODUCED ANNUALLY BY WEIGHT LIST LIVESTOCK PRODUCED ANNUALLY BY …

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