Get Application-word.doc. Wednesday, May 8, 2002 - In

Filling out the Application-word.doc is essential for registering as a commercial dog breeder or broker in Indiana. This guide provides clear, step-by-step instructions to assist you in completing the application accurately and efficiently.

Follow the steps to successfully complete your application online.

1. Press the ‘Get Form’ button to access the application form and proceed to open it in your chosen editor.
2. Identify the type of registration you are applying for. Check the appropriate box for 'Commercial Dog Breeder' or 'Commercial Dog Broker' based on your operation.
3. Indicate whether you are submitting a new registration or a renewal registration by checking the corresponding box.
4. Fill in your business's name, mailing address, city, state, and ZIP code accurately in the designated fields.
5. If your facility's physical address differs from the mailing address, provide the physical address, city, state, and ZIP code.
6. Select your type of ownership by checking the appropriate box: Individual, Partnership, Corporation, LLC, or Other.
7. Enter the name of the contact person, filling in last name, first name, and middle initial in the respective fields.
8. If the mailing address of the contact person is different, fill in the new address, city, state, and ZIP code accordingly.
9. Complete the contact person's telephone numbers (home, cell, work) and fax number, ensuring all numbers are correct.
10. Include the email address and website URL for your business, if applicable.
11. Indicate whether your business is licensed by the USDA/APHIS/AC by checking 'Yes' or 'No.'
12. If your answer is 'Yes,' provide your USDA certificate/license number, along with the effective and expiration dates.
13. Prepare your payment for the registration fee according to the type of registration. Attach the check or money order made out to the State of Indiana.
14. Complete the veterinarian information section, including the veterinarian's name, clinic/hospital name, telephone number, and address.
15. Have the registrant sign and date the application to certify the accuracy of the information provided.
16. Review all filled information for accuracy and completeness before saving the changes, downloading, printing, or sharing the form as needed.

Complete your application online today to ensure your business is registered properly.