Application for Certified Farmers' Market Certificate

Certified Farmer's Markets

1220 N Street, Sacramento, CA 95814 • (916) 900-5030 • cfm@cdfa.ca.gov

Step 1 - Applicant / Market Information

Certified Producer(s) Local Government Agency Nonprofit Organization

* Name of Market Operator

* Agent for Service of Process

* Operator Mailing Address

* Operator City

* Operator ZIP

Operator Business Phone

Operator Cell Phone

Operator Fax Number

Operator Website

* Operator E-Mail Address

* Market Name

* Remittance Form Mailing Address

* Remittance City

* Remittance ZIP

* Market Manager Name

Manager Business Phone

Manager Cell Phone

Manager Fax Number

Market E-Mail Address

Market Location

Market City

Market ZIP

* County

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