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P-42.1, r. 1 - Regulation respecting prevention of disease in potatoes
Schedule
Disposition versions
SCHEDULE 4
(s. 5)
APPLICATION FOR AUTHORIZATION TO PLANT SEED POTATOES WHICH ARE NOT OF THE GRADE REQUIRED IN PROTECTED ZONES
______________________________________________________________________________
Name of producer: _____________________________________
Address: _____________________________________
_____________________________________
Variety of potato: _____________________________________
Grade: _____________________________________
Seed certificate
No: _____________________________________
_____________________________________
Date: _____________________________________
Signature of producer: _____________________________________
______________________________________________________________________________
______________________________________________________________________________
For office use
Granted Refused
Authorization: _____________________________________
Comments: _____________________________________
_____________________________________
_____________________________________
_____________________________________
Date: _____________________________________
Signature of inspector: _____________________________________
______________________________________________________________________________
