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Get FARM CERTIFICATION APPLICATION - Odot State Or

FARM NO. DATE RECEIVED FARM CERTIFICATION APPLICATION Before completing, see instructions on back. If more space is required, attach a separate sheet. NAME OF FARM (IF APPLICABLE) PRINTED NAME OF FARMER COUNTY/COUNTIES TELEPHONE NUMBER USDOT NUMBER ( FARM ADDRESS CITY ) STATE ZIP CODE MAILING ADDRESS (If different) LIST THE TOTAL ACRES YOU: 1. OWN 2. RENT/LEASE . LIST THE NAME, PHONE NUMBER AND ADDRESS OF THE PERSON(S) YOU LEASE/RENT PROPERTY FROM NAME TELEPHONE NUMBER ADDRES.

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