Renewal Application For License To Test And Repair Scales (Service-Repair Company) Form
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1RENEWAL APPLICATION FOR LICENSE TO TEST AND REPAIR
SCALES (SERVICE-REPAIR COMPANY)
No._______________
This will certify that information contained in the original application for license filed with
the Mississippi Department of Agriculture and Commerce has not changed in any way
since notarized application was filed.
Full Name of Applicant
Give Firm Name: If Corporation or Partnership, give exact title
Physical Address (No P. O. Boxes)
City
State
Zip
County
Telephone Number
Fax
Mailing Address
City
State
Zip
County
Current License Number
___________________________
________________________________
Date
Signature of Company Representative
________________________________
Title
Enclose with this form:
License fee of $100.00
List of Branch Offices covered
under this license
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Parent category: Legal