Photo-montage of fruits and vegetables and farms

Application for Certified Producer's Certificate

Certified Farmer's Markets

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

Step 1 - Producer Information

* Issuing County

Certified Producer

Name

Email Address

Please note: An email address is required to modify or renew your certificate after submission.

DBA

Address

City

ZIP

Business Phone

Only those products listed below, and grown at the following production site(s) by the certified producer may be sold at a certified farmers' market.

Production Sites

Production Site 1

Production Site 2

Production Site 3

Production Site 4

Production Site 5

Production Site 6

Commodities

After completing this form, continue to Step 2 to add your commodities.

Storage Location / Months in Storage

Storage Location A

Storage Location B

Authorized County(ies)

Transporting products into another county for the purpose of selling at a certified farmers' market within that county is permitted only in the authorized counties listed on this certificate.

County #1

County #2

County #3

County #4

County #5

County #6

County #7

County #8

County #9

County #10

County #11

County #12

County #13

County #14

County #15

Name(s) of the Producer(s) that the Certificate Holder May Sell FOR #1

Sell-for Certificate Number #1

Sell-for Date Declared #1

Name(s) of the Producer(s) Authorized to SELL the Certificate Holder's Product #1

Sell-by Certificate Number #1

Sell-by Date Declared #1

Name(s) of the Producer(s) that the Certificate Holder May Sell FOR #2

Sell-for Certificate Number #2

Sell-for Date Declared #2

Name(s) of the Producer(s) Authorized to SELL the Certificate Holder's Product #2

Sell-by Certificate Number #2

Sell-by Date Declared #2

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