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($$   1  Level 1Level 2Level 3Level 4Level 5&0 d dkZ&Draw Object <<=8C HKKKK !  _HHHH/d/ __SSCA  SouthernSeed H   $ $H$H$Certification  $ $ $ $Association H$H$ $ $      P    ApplicationforCertification @  @  h  SubmitanApplicationforeachcropkind,varietyandCertifiedclass @`  @  @  @h  @! hh 0 AttachForm AforContractgrowers     lf 8($`~1  `E8H 1 ttIp  l HpHpH$H$ @ Applicant______________________________________0  Date_______________0@$$L  p$ Address0  ______________________________________0p$County_____________| 4 p$   ______________________________________0  PhoneDay__________ d p$      P    0 X 0XpX$Night______________ p$ DirectionstoFarm: P     X    t,       P    0 X 0XpX$Mobile_____________  p$ _______Miles__________From___________________  ^hԀN.E.S.W#h^6#.^hԀTown#h^# X 0  Hwy.No.___________< p$ pp8pQpp8pAm)MH dtEMH0 A     P     X  H$H$HpHpCrop_______________________________________0  Variety__________________________________________$$ Acres_________________SeedClassPlanted(B,F,R,C)_____________________ClasstoProduce______________     P     X     SeedstockSource_______________________________SeedstockLotNo.______________YearGrown_____________PreviousCrops19____:__________19____:___________19____:____________PlantingDate______________     P    WhoWillHarvestThisSeed?____________________________WhoWillConditionThisSeed?____________________B Am)MF dEMF0 A     P     X   IherebyapplyformembershipintheSouthernSeedCertificationAssociationforthecurrentyearandforinspectionofthecroplistedonthisapplication.IunderstandandagreetoabidebytheRulesandRegulationsoftheSSCArelativetocertificationofthecroplistedabove.Also,Iconfirmthattheentireacreagelistedabovewasplantedwithseedrepresentedbytagsandpurchaseinvoicesubmittedwiththisapplication.FEESSUBMITTED(SeeBack)̀0  Membership0P $$$_______________0XP $P $0X$X$*Plantedaneligibleclassofcertifiedseedoneligibleland.\($$   Acreage0  0P $$$_______________0XP $P $0X$X$*Thoroughlycleanedallequipmentinvolvedinplanting.t*$$   Total0  0P $$$_______________0XP $P $0X$X$*Providedadequateisolationdistance.,$$      P     X      `     Makecheckpayableto:SouthernSeedCertificationAssociation,Inc.0  ________________________________________!/$$ P.O.Box2619   P     X   SignatureofApplicant "0 Auburn,AL368310 0 $ $0X$$_________________________________________#\ 1X$X$ Phone(334)8217400(334)8444995Fax(334)8444901)^h0  #h^#ԀPrintNamex$0!2$$      P     X Y  Am)Jt% dEJt%0 A @  @ FORINSPECTORUSEONLY @X  @  @  @`  @  @  @h  @!  @$  @  @   &"4      P     X      `   MaturityStage____________________________0 X DateInspected_______________ClassApproved______________8'#6X$X$ Isolation_________________________________0 X AcresApproved_______________AcresRejected_______________@($8X$X$ Roguing_________________________________0 X EstimatedYield____________________________________________H)&:X$X$ OtherVarieties____________________________0 X Remarks__________________________________________________P*'<X$X$ OtherCrops______________________________0 X __________________________________________________________X+(>X$X$ Weeds__________________________________0 X __________________________________________________________`,)@X$X$      P     X __________________________________________________________Applicant________________________________0 X Inspector__________________________________________________p.(+DX$X$  x/0,F Ї!hh&  ?+ 4 <DL!X?  X  ?+4 4 <DL!X? X      INSPECTIONFEES] EԌ  Ќ X   X4X X      ,ӹ X 'tCROP    P     X     򀀀0 ` 0`$`$0$$AcreageFee$$  `     P     X      ` 0  0$$(Peracre)$$  h  Cotton888888888888888888888888... `   0  $񀀀1.50 $$   Peanut8888888888888888888888888. `   0  񀀀1.50 $$ Soybeans888888888888888888888888. `   0  񀀀1.50  $$ SmallGrain888888888888888888888888  0  񀀀1.50 $$ Fescue,Ryegrass,Vetch,Clover8888888888888888  0  񀀀1.50 $$ Bermuda,Lespedeza888888888888888888888  0  񀀀1.50 $$ Sorghums,Millet8888888888888888888888.  0  񀀀3.50 $$ Cantaloupe,Watermelon,Cowpeas,Okra8888888888888.  0  񀀀5.00$ $$ SweetPotatoes888888888888888888888888  0  񀀀10.00, $$ !XVX!h  X  ?+ 4 <DL!X? #!hX!XV)'#Anyportionofanacrewillbechargedasoneacreonallcrops.     LATEAPPLICATIONS.Lateapplicationswillbeacceptediffiledwithin15daysafterdeadline,however,therewillbea$10.00penaltyfeeperapplicationinadditiontothefeeslistedabove.Ifinspectionhasbeencompletedinyourareapriortoreceiptofyourapplication,alatefeetoincludeallexpenseswillbechargedinadditiontothefees,above,providedtheinspectorsitinerarycanaccommodateyourrequestpriortoharvest.!XVX!h "' Am) xdEH]0H!A *) X'         P #!hX!XV)#MEMBERSHIP 󀄀$50.00peryear :-  CONDITIONINGPLANTINSPECTIONFEE 󀄀$50.00perinspection B/  COSTOFTAGS !$0.50!XVX!h J1 Am) xdEH0H!A R 3      P  *    & `        a,  #!hX!XVj+#FINALDATEFORFILINGAPPLICATIONS a,, ,Ԍ 8 Ќ                CROP0  0P $$0 P $P $0 $ $0X$$0X$X$0$$0`$$0`$`$0$$ DATE !<$$   Bahiagrass,Clover,Fescue,Ryegrass,SmallGrainsandVetch..........................0  April1$ @$$   PeanusandCowpeas..........................................................................................0  June15%!B$$   Cotton,SorghumandLespedeza........................................................................0  July1&"D$$   Soybeans,MilletsandSweetPotatoes...............................................................0  0$$August1'#F$$   Bermudagrasses..........................................0  a.Newfields10dayspriortoplanting&($H$$      P     X   b.Establishedfields30dayspriortolifting  HybridCorn................................................0  10daysafterplanting 6*&L$$ !XVX!h'` U, ?+ 4 <DL!X?#h!hU##hXXVW2#