SSCASouthern Seed

Certification

Association

Application for Certification

Submit an Application for each crop kind, variety and Certified class

Attach Form "A" for Contract growers

Applicant ______________________________________	Date _______________

Address	______________________________________	County _____________

______________________________________	Phone Day __________

Night ______________

Directions to Farm:

Mobile _____________

_______ Miles __________ From ___________________

N.E.S.W. Town	Hwy. No. ___________

Crop _______________________________________	Variety __________________________________________

Acres _ ________________ Seed Class Planted (B,F,R,C) _____________________ Class to Produce ______________

Seedstock Source _______________________________ Seedstock Lot No. ______________ Year Grown _____________

Previous Crops - 19 ____: __________ 19 ____: ___________ 19 ____: ____________ Planting Date ______________

Who Will Harvest This Seed? ____________________________ Who Will Condition This Seed? ____________________

I hereby apply for membership in the Southern Seed Certification Association for the current year and for inspection of the crop listed on this application. I understand and agree to abide by the Rules and Regulations of the SSCA relative to certification of the crop listed above. Also, I confirm that the entire acreage listed above was planted with seed represented by tags and purchase invoice submitted with this application.

FEES SUBMITTED (See Back)

Membership	$ _______________	* Planted an eligible class of certified seed on eligible land.

Acreage	$ _______________	* Thoroughly cleaned all equipment involved in planting.

Total	$ _______________	* Provided adequate isolation distance.

Make check payable to:

Southern Seed Certification Association, Inc.	________________________________________

P.O. Box 2619	Signature of Applicant

Auburn, AL 36831	_________________________________________

Phone (334)821-7400 (334)844-4995 Fax (334)844-4901)	Print Name

FOR INSPECTOR USE ONLY

Maturity Stage ____________________________	Date Inspected _______________ Class Approved ______________

Isolation _________________________________	Acres Approved _______________ Acres Rejected _______________

Roguing _________________________________	Estimated Yield ____________________________________________

Other Varieties ____________________________	Remarks __________________________________________________

Other Crops ______________________________	__________________________________________________________

Weeds __________________________________	__________________________________________________________

__________________________________________________________

Applicant ________________________________	Inspector __________________________________________________

INSPECTION FEES

CROP	Acreage Fee

(Per acre)

Cotton ………………………………………………………………...	$ 1.50

Peanut ………………………………………………………………….	1.50

Soybeans ……………………………………………………………….	1.50

Small Grain ………………………………………………………………	1.50

Fescue, Ryegrass, Vetch, Clover …………………………………………	1.50

Bermuda, Lespedeza ………………………………………………………	1.50

Sorghums, Millet ………………………………………………………….	3.50

Cantaloupe, Watermelon, Cowpeas, Okra ………………………………….	5.00

Sweet Potatoes ………………………………………………………………	10.00

Any portion of an acre will be charged as one acre on all crops.

LATE APPLICATIONS. Late applications will be accepted if filed within 15 days after deadline, however, there will be a $10.00 penalty fee per application in addition to the fees listed above. If inspection has been completed in your area prior to receipt of your application, a late fee to include all expenses will be charged in addition to the fees, above, provided the inspector's itinerary can accommodate your request prior to harvest.

MEMBERSHIP - $50.00 per year

CONDITIONING PLANT INSPECTION FEE - $50.00 per inspection

COST OF TAGS – $0.50

FINAL DATE FOR FILING APPLICATIONS

CROP	DATE

Bahiagrass, Clover, Fescue, Ryegrass, Small Grains and Vetch ..........................	April 1

Peanus and Cowpeas ..........................................................................................	June 15

Cotton, Sorghum and Lespedeza ........................................................................	July 1

Soybeans, Millets and Sweet Potatoes ...............................................................	August 1

Bermudagrasses ..........................................	a. New fields - 10 days prior to planting

b. Established fields - 30 days prior to lifting

Hybrid Corn ................................................	10 days after planting