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Get South Dakota Commercial Aerial Applicator Form

APPLICATION (To be submitted with the P r i v a t e Pesticide Applicator License Application) Name: Address: First Middle Initial Street or Box Last City State Zip+4 Phone No. City State Zip+4 Phone No. Business Name or Employer: Address: Street or Box Email Address: 1. 2. 3. 4. 5. 6. 7. 8. 9. Federal Airman s Certification number: Rating: Agricultural Aircraft Operator s FAA Certificate number & Date issued: Will cover: (List each aircraft below) Make Model Year Federal.

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