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Lbs x DESCRIBE YOUR EXPERIENCE IN THE USE OF THE SCALE INDICATED ABOVE ARS 41-2093 requires a Deputy Public Weighmaster to have a valid Deputy Public Weighmaster license. ARIZONA DEPARTMENT OF WEIGHTS AND MEASURES 4425 W Olive Avenue Suite 134 Glendale AZ 85302-3844 Phoenix Metro assistance 602 771-4935 Outside Phx Metro 1-800-277-6675 FAX 623-939-8586 DEPUTY PUBLIC WEIGHMASTER APPLICATION LICENSE FEE no charge PLEASE PRINT BIRTH DATE APPLICANT NAME Must be at least 18 years old PUBLIC WEIGHMASTER LICENSE BUSINESS NAME PHONE CITY BUSINESS ADDRESS FAX ZIP PHYSICAL LOCATION SCALE OWNER INFORMATION if different from business name above SCALE OWNER NAME SCALE TYPE check one DECK/PLATFORM SIZE BMF VEHICLE SCALE ADDRESS OTHER CAPACITY. In addition applicants must pass a written examination before they can perform Deputy Public Weighmaster duties. This is to certify that I have full knowledge of Title 41 Chapter 15 and Arizona Administrative Code Title 20 chapter 2 as it relates to Weighmaster licensing and duties and any other Department regulations relating to Weighmaster and will upon licensure operate in accordance with said laws rules and regulations. In addition applicants must pass a written examination before they can perform Deputy Public Weighmaster duties. This is to certify that I have full knowledge of Title 41 Chapter 15 and Arizona Administrative Code Title 20 chapter 2 as it relates to Weighmaster licensing and duties and any other Department regulations relating to Weighmaster and will upon licensure operate in accordance with said laws rules and regulations.

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