Electronic Forms Index

California has adopted the Uniform Electronic Transactions Act (California Civil Code § 1633.1-1633.17), which establishes the legal validity of e-Signatures and contracts in a manner similar to the federal law, Electronic Signatures in Global and National Commerce Act.

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By Division/Program

Animal Health and Food Safety Services Division (AHFSS) Forms

Form NumberForm Name
AHB-76-024-AApplication to Register Equine Event
AHB-76-025Saleyard Assessment Report
AHB-76-026Report Of Heifer Calves Vaccinated - Brucellosis
AHB-76-027Official Form For Declaration Of Drugs Administered
AHB-76-033Permit For Movement Of Animals, Animal Products, Vehicles, Farm Equipment, Farm Products Or Other Materials That Are Subject To A Quarantine
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-76-080Equine Medication Monitoring Program Record of Sample Collection
AHB-76-080-BNotification of Selection for Blood Collection
AHB-76-122Garbage Cooking Record
AHB-76-169Retattooing Brucellosis Vaccinates
AHB-76-196-WLocation Number Request for Traceability Framework
AHB-76-197Application for Designated Pen Status
AHB-76-197-AInspection Report for Designated Pens
AHB-76-198-ATerminal Feedlot Inspection Report
AHB-76-199Official Bovine Trichomonosis Test Report Form
AHB-76-201Approved Tagging Site Agreement
AHB-76-203Report of Heifers Spayed after Arrival
AHB-76-204Application for Designation as an Approved Feedlot
AHB-76-204-AApproved Feedlot Inspection Report
AHB-76-206Certificate of Independent Review and Completion of Trich Sample Collection and Evaluation Training
AHB-76-207Request Form – Interstate Entry Permit
AHB-76-208Working Horse Permit Application
AHB-76-210Report of Official Ear Tags Distributed or Applied
AHB-77-010Certificate of Veterinary Inspection (for Large Animals)
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
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-79-013Permit To Ship Inedible Product For Pet Food To California
MPES-79-014Application And Permit To Obtain Specimens From Official Meat Inspection Establishment
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-79-017Application and Permit To Ship Sealed Inedible Product for Pet Food
MPES-79-018Application for Permit to Remove Inedible Material From Rendering Plant
MPES-79-019-AApplication to operate an Inedible Kitchen Grease Rendering Plant
MPES-79-020Driver – Vehicle Information For Collection Centers
MPES-79-025Request For Survey For State Meat and Poultry Inspection
MPES-79-025-ARequest For Survey For State Licensed Rendering Facility
MPES-79-029Meat, Poultry and Egg Safety Branch - Sewage Disposal Approval
MPES-79-037Meat, Poultry and Egg Safety Branch - Survey For Inspection
MPES-79-038Meat, Poultry and Egg Safety Branch - Schedule Of Operations
MPES-79-039Meat, Poultry and Egg Safety Branch - General Facility Notes
MPES-79-041Imported Poultry Product Reinspection
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-79-072-ADaily Livestock Slaughter Report (Cattle)
MPES-79-072-BDaily Livestock Slaughter Report (Other Species)
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-79-125Meat, Poultry and Egg Safety Branch - Witness Statement Form
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-005PCitrus Pest & Disease Prevention Prior Rate Monthly Assessment Remittance
CPDPC-003Citrus Pest and Disease Prevention-New Customer Sheet

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-42-040Measurement Standards - Common Tare Notice
DMS-42-005Weighmaster License Application
DMS-42-035Weighmaster License Cancellation Form
DMS-44-062Service Agency Application - Weights and Measures
DMS-44-070Service Agency Cancellation Form

Division of Marketing Services / Fairs & Expositions Forms

Form NumberForm Name
MEB-28-003Market Enforcement Branch - Application for License
MEB-28-003-EZMarket Enforcement Branch - Application for License (Cash Buyer/Dealer)
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-0012020 Statement of Operations
MKT01Request for Conciliation

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-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-64-060Application for the Registration and Certification of Pome Fruit Trees
PHPPS-64-085Annual Nursery Stock Nematode Certification Agreement
PHPPS-65-057Application for Registration and/or Testing of Citrus Trees
PHPPS-66-008Warning - Quarantine Inspection
PHPPS-66-008-AWarning Shipment Under Gypsy Moth Quarantine
PHPPS-66-012Feed grain and Seed screenings Mill Inspection/Approval
PHPPS-66-026Application and Permit to Move and Use Live Insect Pests or Insects or Noxious Weeds
PHPPS-66-045-AApplication for a Permit to Import Seed Sweet Potatoes for Planting or Propagation
PHPPS-66-071Pest Exclusion - Notice of Rejection
PHPPS-66-079Certificate of Quarantine Compliance
PHPPS-66-085Application for Phytosanitary Field Inspection of Seed
PHPPS-66-086Certification of Phytosanitary Field Inspection of Seed
PHPPS-66-094Plant Health and Pest Prevention Services - Notice of Violation
PHPPS-66-102Warning Hold Inspection - Plant Material
PHPPS-66-105Approved Laboratory Agreement and Permit Agreement
PHPPS-66-112Phytosanitary Certificate for Reexport
PHPPS-66-130Notice to Hold Commodities on Premises
PHPPS-68-004Application for Authorization to Sell Seed
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-69-006IH Planting Report
PHPPS-69-007Preharvest Report
PHPPS-69-008IH Sample Analysis Request Form
PHPPS-69-009IH Harvest Report
PHPPS-69-010IH Destruction Plan
PHPPS-69-011IH Destruction Report
PHPPS-BEAPP001Application for Apiary Serial Number Brand for Bee Equipment
PHPPS-BEBOS001Bill of Sale Apiary Equipment
PHPPS-BECOD001Apiary Certificate of Destruction
PHPPS-BEE-02Certificate of Apiary Inspection
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-513-002Commercial Feed License Application
IS-513-009Notice of Warning - Compliance Chart
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-513-038Livestock Drugs Registration Application
IS-513-040Restricted Livestock Drug License Application
IS-513-123Inspector Call Report
IS-CFM-120Certified Farmers' Market Advisory Committee - Prospective Member Appointment Questionnaire
IS-Cit-120California Citrus Committee Prospective Member Appointment Questionnaire
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-0011Organic Input Material Registration Renewal
IS-OIM-0013Organic Input Material Formula Sheet
IS-OIM-0030Organic Input Material Fee Schedule
IS-OIM-0031Organic Input Material Registration Update Form
IS-OIM-0035Organic Input Material Registration Process
IS-ORG 120Organic Products Advisory Committee - Prospective Member Appointment Questionnaire
IS-STZ 101Inspection Services -Complaint Form
IS-STZ-102Standardization/CA Citrus Registration Form
IS-STZ-120Inspection Services - Standardization Advisory Committee Prospective Member Appointment Questionnaire

Office of Grants Administration

Form NumberForm Name
OGA-1.1.3Grant Reviewer Conflict of Interest
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-1.2.6Check Booklet Return 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-1.4.1Pet Lover's Grant Cover Sheet
OGA-1.4.2Pet Lover's Grant Proposal & Budget Narrative
OGA-1.5.1CalAgPlate Grant Proposal Cover Page
OGA-1.5.2CalAgPlate Grant Proposal & Budget Narrative
OGA- Crop Block Grant Program - Outcome Measures
OGA- Crop Block Grant Program - Concept Proposal Budget
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-2.1.4Line Item Shift Request