Electronic Forms Index

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By Division/Program

Animal Health and Food Safety Services Division (AHFSS) Forms

Form NumberForm Name
ACP-73-001 Animal Care Program Complaint Form
ACP-73-002 Distributor Registration Application
ACP-73-003 Certification Application
ACP-73-004 Certifying Agent Accreditation Application
AHB-76-024-AApplication to Register Equine Event
AHB-76-025Saleyard Assessment Report
AHB-76-027Official Form For Declaration Of Drugs Administered
AHB-76-050Application for License as Commercial Blood Bank for Animals
AHB-76-051Application for Registration of of Commercial Blood Bank Products
AHB-76-068-AApplication For License To Feed Garbage To Swine
AHB-76-070-AApplication for Renewal of License to Feed Garbage to Swine
AHB-76-074Pasture to Pasture Permit for a Beef Breeding Herd
AHB-76-074-AOne-time Event Permit
AHB-76-196-WLocation Number Request for Traceability Framework
AHB-76-199Official Bovine Trichomonosis Test Report Form
AHB-76-199-AOfficial Bovine Trichomonosis Test Report Continuation Form (for more than 1 page)
AHB-76-201Approved Tagging Site Agreement
AHB-76-203Report of Heifers Spayed after Arrival
AHB-76-206Certificate of Independent Review and Completion of Trich Sample Collection and Evaluation Training
AHB-76-208Working Horse Permit Application
AHB-76-210Report of Official Ear Tags Distributed or Applied
AHB-76-211Laboratory Certification Program Application
AHB-76-212Hatchery Premises Enhanced Biosecurity Plan Template
AHB-76-213Equine Medication Monitoring Program Order Form
AHB-76-214Public Complaint Form
AHB-76-215California Feed Mill Premises Biosecurity Plan Template
AHB-76-216California Poultry Farm Premises Biosecurity Plan Template
AHB-76-217California Broiler Farm Premises Enhanced Biosecurity Plan Template
AHB-76-218California Poultry Slaughter Premises Enhanced Biosecurity Plan Template
AHB-76-219California Animal Response Emergency System (Cares) Local Government Emergency Animal Shelter Assessment Form
AHB-76-220California Dairy Farm Premises Enhanced Biosecurity Plan Template
AHB-76-221Premises Specific Enhanced Biosecurity Plan
AHB-76-222California Dairy Processor Premises Enhanced Biosecurity Plan Template
AHB-76-223CDFA Highly Pathogenic Avian Influenza (HPAI) in Livestock Monitored Herd Agreement
LID-74-002Application for Livestock Brand
LID-74-010-AApplication for Dairy Exemption Number
LID-74-036-YBill of Sale or Consignment Slip
LID-74-037Feedlot Registration Form
LID-74-089Application for Annual Cattle Transportation Permit
LID-74-097Application for Annual Out-of-State Permit
MDFS-72-222Label Review Submission Form
MDFS-72-230Examination Application for Registered Dairy Inspector Certification
MDFS-72-244Application for a Milk Products Plant License
MDFS-72-244aApplication For A Frozen Milk Products Plant License
MDFS-72-244bApplication for a semifrozen (Soft-Serve) Milk Products Plant License
MDFS-72-245Application For A Limited Frozen Manufacturing Permit
MDFS-72-254Application for License to Manufacture Products Resembling Milk Products
MDFS-72-259Application for Registration/Renewal of a Product Resembling a Milk Product
MDFS-72-266-AVitamin Permit Application
MDFS-72-271Application for Certificate of Free Sale and Sanitary Origin
MPES-79-001-AUSDA Exempt Meat & Poultry Establishment Registration
MPES-79-001-BUSDA Exempt Poultry Establishment Registration
MPES-79-002-AApplication to Operate a Custom Livestock Slaughterhouse
MPES-79-002-BApplication to Operate a Meat Processing Establishment
MPES-79-003-AApplication to Operate a Poultry Plant
MPES-79-004-AApplication to Operate a Pet Food Establishment
MPES-79-005-ADead Animal Hauler License Application
MPES-79-006-AApplication to Operate a Collection Center
MPES-79-007-AApplication to Operate a Rendering Plant
MPES-79-008-ALivestock Meat Inspector License Application
MPES-79-009-APoultry Meat Inspector License Application
MPES-79-010-AProcessing Inspector License Application
MPES-79-012-A(1)Personal Use - Inedible Kitchen Grease Transporter Registration Application
MPES-79-012-A(2)Commercial Use - Inedible Kitchen Grease Transporter Registration Application
MPES-79-015Driver / Vehicle Information For Renderer's
MPES-79-015-ARegistration Of Transporters Of Uncooked Parts or Products of Animals Not Intended for Use as Human Food
MPES-79-016-AInedible Permit Application
MPES-79-018Application for Permit to Remove Inedible Material From Rendering Plant
MPES-79-020Driver – Vehicle Information For Collection Centers
MPES-79-021-AApplication for Livestock Producer Registration
MPES-79-021-BApplication for Mobile Slaughter Operation
MPES-79-025Request For Survey For State Meat and Poultry Inspection
MPES-79-025-ARequest For Survey For State Licensed Rendering Facility
MPES-79-038Meat, Poultry and Egg Safety Branch - Schedule Of Operations
MPES-79-038ASchedule of Operations Pet Food
MPES-79-039Meat, Poultry and Egg Safety Branch - General Facility Notes
MPES-79-060Daily Report Of Poultry, Rabbits, and Ratites Inspected
MPES-79-061Monthly Summary – Poultry, Rabbits And Ratites Slaughtered, Inspected & Processed
MPES-79-070Meat, Poultry and Egg Safety Branch - Daily And Monthly Processing Report
MPES-79-071Monthly Report – Processing Operations at State Inspected Meat and Poultry Official Establishments
MPES-79-073Monthly summary - Livestock Slaughtered and Inspected
MPES-79-080Label and Formulation Approval
MPES-79-086Meat, Poultry and Egg Safety Branch - Smokehouse Chart
MPES-79-121Permit Request To Dispose Of Carcass(es) at a Landfill
MPES-79-124IKG Manifest Instructions and Receiving Facility Information
MPES-79-125Manifest - Inedible Kitchen Grease Transport Generator Information
MPES-517-004-AEgg Handler and Producer Registration Form
MPES-517-004-BEgg Handler and Producer Registration Renewal Form
MPES-517-016Egg Mill Fee Exemption Statement
MPES-517-029-AIn-State Egg Mill Fee Assessment Report
MPES-517-029-BOut-of-State Egg Mill Fee Assessment Report
MPES-517-030Egg Mill Fee Advance Payment/Adjustment Statement
MPES-518-001Shell Egg Food Safety (SEFS) Pre-Audit Questionnaire

Citrus Pest and Disease Prevention Division Forms

Form NumberForm Name
CDF-005Citrus Pest & Disease Prevention Monthly Assessment Remittance
CDF-005ERemesa de Evaluación
CDF-005PCitrus Pest & Disease Prevention Prior Rate Monthly Assessment Remittance
CDF-005PERemesa de Evaluación de la Tarifa Anterior
CDF-014HLB Fruit Seller Mitigation Form
CDF-015 Asian Citrus Psillid-Free Declaration Form
CDF-016 Cooperative Asian Citrus Psyllid and Huanglongbing Quarantine Program Compliance Agreement
CDF-017 Exhibit: Citrus – H Harvester/ Farm Labor Contractor
CDF-018 Huanglongbing Pest Risk Mitigation Form

Division of Measurement Standards (DMS) Forms

Form NumberForm Name
DMS-40-100California Type Evaluation Program - Application for Evaluation of A Weighing or Measuring Device
DMS-41-016Measurement Standards - Complaint Report
DMS-41-016-A/WPetroleum Enforcement - Air/Water Complaint Form
DMS-41-020Petroleum Enforcement - Developmental Engine Fuel Variance Quarterly Report Form
DMS-41-054Petroleum Enforcement - Motor Oil Fee Return Form aka Motor Oil Fees Remittance Form
DMS-42-005Weighmaster License Application
DMS-42-035Weighmaster License Cancellation Form
DMS-42-040Measurement Standards - Common Tare Notice
DMS-44-062Service Agency Application - Weights and Measures
DMS-44-070Service Agency Cancellation Form
DMS-45-100Prospective Registered Service Agency Advisory Committee Member Questionnaire

Division of Marketing Services / Fairs & Expositions Forms

Form NumberForm Name
ASB-GC-001 Grape Crush and Purchase Inquiry 2023 Crop
ASB-GC-0022023 Assessment Report - Final
ASB-GC-003-EZGrape Crush Inquiry 2023 EZ
ASB-GC-003-MOGGrape Crush Inquiry 2023 MOG
ASB-GC-003-RegularGrape Crush Inquiry 2023
ASB-GC-0042023 Crop Grape Crush Excel Certification Form
ASB-GC-0052023 No Crush Purchase
ASB-GC-007Pierce's Disease Assessment - Supplement
ASB-GC-008Data Page - Supplement
MEB-28-003Market Enforcement Branch - Application for License
MEB-28-004Market Enforcement Branch - Application for Agent's License
MEB-28-006Commission Merchant/Broker Charges
MEB-28-012Market Enforcement Branch - Verified Complaint
MEB-28-005Corporate Officer Designation
MFEB-STOP-001Statement of Operations
MKT01Request for Conciliation
MPB-205-030Milk Handler's Bond
MPB-205-031-AMilk Handler's License Application - Renewing Processor
MPB-205-031-CMilk Handler's License Application - New Processor
MPB-210-006Production Base and Pool Quota Transfer Application
MPB-210-125California Milk Advisory Board (CMAB) Assessment Report

Farmer Equity Program Forms

Form NumberForm Name
FEP-1.1California Underserved & Small Producer Grant Program Invoice
FEP-1.6Beginning Farmer/Farmworker Training & Workforce Development Technical Review Application

Pierce's Disease Control Program (PDCD) Forms

Form NumberForm Name
PDCP-7.100 Origin Bulk Citrus Compliance Agreement
PDCP-7.101 Destination Bulk Citrus Compliance Agreement
PDCP-7.102 ATP Nursery Compliance Agreement
PDCP-7.103 Nursery Compliance Agreement
PDCP-7.104 Broker Nursery Compliance Agreement
PDCP-7.105 Distribution Center/Nursery Compliance Agreement
PDCP-7.106 Exhibit #X1 Program Management Practices for Aerial Spray Treatments
PDCP-7.107 Exhibit #X2 Program Management Practices for Ground/Foliar Spray and Soil Treatments
PDCP-7.108 Exhibit #X3 Program Management Practices for Hazardous Materials Spills

Plant Health and Pest Prevention Services Division (PHPPS) Forms

Form NumberForm Name
PHPPS-63-002Curly Top Virus Control Program
PHPPS 64-003 Prospective Voting Member Appointment Questionnaire
PHPPS-64-004Application for the Registration and Certification of Deciduous Fruit and Nut Trees
PHPPS-64-005Application for Certification of Strawberry Plants
PHPPS-64-017Application for the Certification of Avocado Nursery Stock
PHPPS-64-019Application for the Registration of Avocado Trees and Increase Blocks
PHPPS-64-029Application for License to Sell Nursery Stock
PHPPS-64-030Application for Certification of Seed Garlic
PHPPS-64-031Fee Exempt License to Sell Nursery Stock
PHPPS-64-055Application for the Registration of Grapevines
PHPPS-64-057Report Number 7 - Nursery Inspection Report
PHPPS-64-060Application for the Registration and Certification of Pome Fruit Trees
PHPPS-64-085Annual Nursery Stock Nematode Certification Agreement
PHPPS-65-020Pest and Damage Record
PHPPS-65-057Application for Registration and/or Testing of Citrus Trees
PHPPS-66-026Application and Permit to Move and Use Live Insect Pests or Insects or Noxious Weeds
PHPPS-66-045Application and Permit to Move and Use Plant Quarantine Commodities
PHPPS-66-045-AApplication for a Permit to Import Seed Sweet Potatoes for Planting or Propagation
PHPPS-66-085Application for Phytosanitary Field Inspection of Seed
PHPPS-68-004Application for Authorization to Sell Seed
PHPPS-68-005California Seed Advisory Board Prospective Member Appointment Questionnaire
PHPPS-69-001IH Registration Application Packet Growers
PHPPS-69-002IH Application Packet Breeders
PHPPS-69-003IH Amendment App - Contact, Business, KP
PHPPS-69-004IH Amendment App - Site, Cultivar, Plan
PHPPS-69-005Industrial Hemp Application for Testing Approval
PHPPS-69-008IH Sample Analysis Request Form
PHPPS-69-010IH Destruction Plan
PHPPS-69-011IH Destruction Report
PHPPS-69-012IH Application for Established Agricultural Research Institutions
PHPPS-69-013Industrial Hemp Advisory Board Prospective Member Appointment Questionnaire
PHPPS-BEAPP001Application for Apiary Serial Number Brand for Bee Equipment
PHPPS-BEBOS001Bill of Sale Apiary Equipment
PHPPS-BECOD001Apiary Certificate of Destruction
PHPPS-BEE-03Hold Order for Diseased Apiary
PHPPS-BEE-04Notice to Abate Nuisance: Neglected or Abandoned Bee Hives or Appliances Containg Comb Exposed to Robbing by Bees

Inspection Services Division (PHPPS) Forms

Form NumberForm Name
IS-51-022Application for Experimental Permit for Nonstandard Container/Pack
IS-51-022-RRenewal Request for Experimental Permit
IS-51-023 Melon and Vegetable Adjoining State Movement Permit
IS-51-034Controlled Atmosphere Registration Application for Apples
IS-51-047Application/Certificate for Certified Farmers' Market
IS-51-049-MApplication for Certified Producer's Certificate
IS-51-049-MSSupplemental Certified Producer's Certificate
IS-51-055-CStandardization and California Citrus Program Remittance Form
IS-51-064Certified Farmers' Market Remittance Form
IS-51-067Tomato Handler Registration
IS-51-070Community Supported Agriculture - Producer Registration and Remittance Form
IS-513-008 Feed and Livestock Drugs Notice of Warning
IS-513-015Fertilizing Materials Mill Assessment Form
IS-513-020Fertilizing Materials License Application
IS-513-023Conventional Fertilizing Material Label Registration Application
IS-513-024Conventional Fertilizing Material Registration Update Form
IS-513-026 (OIM-0049)Organic Input Material Label Registration Application
IS-513-037Notification Of Drug Treated Livestock
IS-513-040Restricted Livestock Drug License Application
IS-513-074Certificate of Movement of Cottonseed Products
IS-513-117Restricted Livestock Drug License Renewal Notice
IS-513-118Fertilizing Materials License Renewal Notice
IS-513-120Voluntary Disposal of Quarantined Material - Feed
IS-513-121Voluntary Disposal of Quarantined Material - Fertilizer
IS-513-121bRequest to Authorize Disposal of Quarantined Material
IS-513-130 Feed and Livestock Drugs Inspector Call Report
IS-AVO-120California Avocado Inspection Committee - Prospective Member Appointment Questionnaire
IS-AVO-121Avocado Inspection Program Monthly Remittance Form
IS-CFM-120Certified Farmers' Market Advisory Committee - Prospective Member Appointment Questionnaire
IS-Cit-120California Citrus Committee Prospective Member Appointment Questionnaire
IS-Comp-101Inspection Services -Complaint Form
IS-F2F-001Personnel Time Report Template Option 1
IS-F2F-002Personnel Time Report Template Option 2
IS-F2F-003Travel Expense Claim Template
IS-F2F-004Advance Payment Request Template
IS-F2F-005Invoicing Template Track 1
IS-F2F-006Invoicing Template Track 2
IS-F2F-007Mileage Reimbursement Report Template
IS-F2F-008Procurement Metrics Worksheet
IS-F2F-009Invoice Template GusNIP
IS-F2F-010Invoice Template Refrigeration
IS-F2F-011Invoice Template GusCRR
IS-F2F-012Budget Revision Request Template Track 1
IS-F2F-013Budget Revision Request TemplateTrack 2
IS-F2F-014SOW Revision Request Template Track 1
IS-F2F-015SOW Revision Request Template Track 2
IS-F2F-016Personnel Time Report Template Option 3
IS-F2F-018Farm-to-School Incubator Grant Budget Worksheet
IS-F2F-019Farm-to-School Incubator Grant Project Work Plan
IS-F2F-020Farm-to-School Incubator Grant Letter of Intent Template
IS-F2F-021Farm-to-School Incubator Grant Additional Data Organizational Worksheet
IS-F2F-022Prospective Member Appointment Questionnaire
IS-F2F-023Expense Summary Track 1
IS-F2F-024Expense Summary Track 2
IS-F2F-025Expense Summary Track 3
IS-F2F-026Expense Summary Track 4
IS-F2F-027Procurement Metrics Worksheet: Track 1
IS-F2F-028Budget Revision Request Track 1
IS-F2F-029Budget Revision Request Track 2
IS-F2F-030Budget Revision Request Track 3
IS-F2F-031Budget Revision Request Track 4
IS-F2F-032Scope of Work Revision Request Track 1
IS-F2F-033Scope of Work Revision Request Track 2
IS-F2F-034Scope of Work Revision Request Track 3
IS-F2F-035Scope of Work Revision Request Track 4
IS-F2F-036Procurement Metrics Worksheet: Track 3
IS-F2F-037Farm to School Sales Worksheet
IS-F2F-038Equipment Inventory Record
IS-F2F-039Land Purchase Reporting Template
IS-FIAB-001Fertilizer Inspection Advisory Board Prospective Member Appointment Questionnaire
IS-FIAB-002Feed Inspection Advisory Board Prospective Member Appointment Questionnaire
IS-FREP-001Fertilizer Inspection Advisory Board Technical Advisory Subcommittee Prospective Member Application Packet
IS-FREP-002Irrigation and Nitrogen Management Training Program, Application for Live or In-Person Continuing Education Units
IS-FREP-003Irrigation and Nitrogen Management Training Program, Application for Self-Study Continuing Education Units
IS-OCal-001Certifying Agent Accreditation Application
IS-OCal-002Certifying Agent Accreditation Affirmation
IS-OCal-003Certifying Agent Registration Application
IS-OCal-004Certifying Agent Registration Affirmation
IS-OCal-007Registration Renewal Fee Payment Remittance Form
IS-OCal-008 Accreditation and Registration Fee Remittance Form
IS-OIM-0002Organic Input Material Agreement
IS-OIM-0010Organic Input Material Method & Ingredient Declaration
IS-OIM-0011IS-OIM-0011 OIM Registration Renewal Form – 2 page
IS-OIM-0011IS-OIM-0011 OIM Registration Renewal Form – 3 page
IS-OIM-0011IS-OIM-0011 OIM Registration Renewal Form – 4 page
IS-OIM-0011IS-OIM-0011 OIM Registration Renewal Form – 5 page
IS-OIM-0013IS-OIM-0013 OIM Formula Sheet – 1 page
IS-OIM-0013IS-OIM-0013 OIM Formula Sheet – 2 page
IS-OIM-0013IS-OIM-0013 OIM Formula Sheet – 3 page
IS-OIM-0013IS-OIM-0013 OIM Formula Sheet – 4 page
IS-OIM-0031Organic Input Material Registration Update Form
IS-OIM-0035Organic Input Material Registration Process
IS-ORG 100-CSSCertification, Site, Commodity and Sales Form
IS-ORG 100-CAGross Sales & Operation Information Form
IS-ORG 100-RFOrganic Registration Form
IS-ORG 106Federal Organic Certification & State Registration Cost Share Application
IS-ORG 120Organic Products Advisory Committee - Prospective Member Appointment Questionnaire
IS-SPI-120Shipping Point Inspection Advisory Committee - Prospective Member Appointment Questionnaire
IS-STZ-102Standardization/CA Citrus Registration Form
IS-STZ-120Inspection Services - Standardization Advisory Committee Prospective Member Appointment Questionnaire
PSP-001 Questionnaire for Produce Farms

Office of Civil Rights

Form NumberForm Name
SO-129Violence/Threat/Bullying Incident Report
SO-201Discrimination and Harassment Complaint Form
SO-215Language Access Complaint Form
SO-242Religious Accommodation Request Form

Office of Environmental Farming & Innovation Forms

Form NumberForm Name
OEFI-001DDRDP Proof of Expenditures and Matching Funds
OEFI-002DDRDP Final Performance Report Template
OEFI-003DDRDP Quarterly Progress Report Template
OEFI-004AMMP Proof of Expenditures and Matching Funds
OEFI-005OEFI Project Modification Request Form
OEFI-0062019 CSA TA Quarterly Report Template
OEFI-007OEFI Programs Advance Payment Request Form
OEFI-008DDRDP Critical Project Review Report
OEFI-009OEFI Programs Invoice Template
OEFI-010Healthy Soils Demonstration Projects Progress Report
OEFI-011Healthy Soils Demonstration Annual Report Template
OEFI-012SWEEP Scope of Work Revision Form
OEFI-013Healthy Soils (HSP) Incentives Invoice Template
OEFI-015 HSP Demonstration Project Final Report
OEFI-016Time & Activity Report
OEFI-017HSP Demonstration Projects Outreach Attendance Tracker
OEFI-018HSP Demonstration Type A Project Data Report
OEFI-020Grant Beneficiary Letter of Commitment and Landowner Permission Letter

Office of Grants Administration Forms

Form NumberForm Name
OGA-1.1.2Technical Review Committee Application
OGA-1.1.2-ATechnical Review Committee Application Appendix A
OGA-1.1.3Grant Reviewer Conflict of Interest
OGA 1.1.4Grant Recipient Questionnaire
OGA-1.2.1Senior Farmers' Market Nutrition Program AAA Agreement
OGA-1.2.2Check Control Log
OGA-1.2.3Senior Farmers' Market Nutrition Program - Check Issuance Form
OGA-1.2.4Senior Participant Check Issuance Log
OGA-1.2.5Check Booklet Receipt Form
OGA-1.2.6Senior Farmers' Market Nutrition Program - Closeout Form
OGA-1.2.7Complaint Form
OGA-1.2.8Ineligible Participation Form
OGA-1.2.9Lost or Stolen Check Form
OGA-1.2.10Senior Farmers' Market Nutrition Program Proxy Form
OGA-1.2.11Senior Farmers' Market Nutrition Program Service Provider Agreement
OGA-1.2.12Senior Farmers’ Market Nutrition Program: Self-Certification
OGA-1.3.1Prevention Fund Grant Application
OGA-1.5.3Calagplate Review Criteria Form
OGA- Specialty Crop Block Grant Program - Additional Assistance Application
OGA- Crop Block Grant Program- Project Objectives and Work Plan
OGA- Crop Block Grant Program - Budget Narrative
OGA- Crop Block Grant Program - Cost Sharing
OGA- Crop Block Grant Program- Scope of Work Template
OGA- Crop Block Grant Program - Project Overview Template
OGA-1.7.1Specialty Crop Multi-State Program - Project Narrative
OGA-1.7.2Specialty Crop Multi-State Program - Outcome Measures
OGA-1.7.3Specialty Crop Multi-State Program - Budget Spreadsheet
OGA-1.7.4Specialty Crop Multi-State Program - Budget Narrative
OGA-1.10.1Contractor Status
OGA-2.1.1Advance Payment Request
OGA-2.1.1AAdvance Payment Request Supplement
OGA-2.1.1BAdvance Payment Request Liquidation
OGA-2.1.4Line Item Shift Request
OGA-2.1.5Expense Summary
OGA-2.1.6Equipment Inventory Record
OGA-2.4.1Pet Lover's Final Performance Report
OGA-2.5.1CalAgPlate- Final Performance Report
OGA-2.6.1Specialty Crop Block Grant Program - (2021 only) - Progress Report
OGA-2.6.2Specialty Crop Block Grant Program (2022-Present) – Progress Report
OGA-2.6.3Specialty Crop Block Grant Program (2020-2021) – Final Report
OGA-2.6.4Specialty Crop Block Grant Program (2022-Present) – Final Report
OGA-2.7.1Specialty Crop Multi-State Program (2019-2021) – Progress Report
OGA-2.7.2Specialty Crop Multi-State Program (2019-2021) – Final Report
OGA-2.7.3Specialty Crop Multi-State Program (2023-Present) – Progress Report
OGA-2.7.4Specialty Crop Multi-State Program (2023-Present) – Final Report
OGA-2.9.1Beginning Farmer and Farmworker Training and Workforce Development Grant Program – Progress Report
OGA-2.9.2Beginning Farmer and Farmworker Training and Workforce Development Grant Program – Final Report
OGA-2.11.1California Underserved and Small Producers Grant Program - Progress Report
OGA-2.11.1ACalifornia Underserved and Small Producer Program - Progress Report Appendix A, Drought Relief Grants