Virginia Department of Agriculture and Consumer Services
Office of Plant Industry Services - Permit Application Form
Select Permit Type
*
Ginseng Dealer
Nursery Stock Dealer
Nursery Operation
Name of Business or Individual Dealer
*
Physical Address
Street Address
*
City
*
State
*
Zip Code
*
Mailing Address (if different than Physical Address)
Street Address
City
State
Zip Code
Contact Person (Last name, First name)
*
City or County of Business Location
*
Phone Number
*
Alternate Phone Number
Fax Number
Email Address
*
Nursery Operation Information
Total Amount of Acreage
*
Agreement and Signature
"The below named party makes application for this permit and agrees to comply with all laws, rules and regulations applicable thereto."
Digital Signature
*
Date
*
Submit Application