MONTANA DEPARTMENT OF AGRICULTURE
Agricultural Sciences Division
PO Box 200201 – Helena, MT 59620-0201
REGISTRATION FORM for
COMMERCIAL FERTILIZERS, SPECIALTY FERTILIZERS and SOIL AMENDMENTS
For year ending December 31, 20
Print or Type:
BUSINESS NAME ___________________________________________________________________________________________________
BUSINESS LOCATION ______________________________________________________________________________________________
Street Address City State Zip
MAILING ADDRESS _________________________________________________________________________________________________
Address City State Zip
TELEPHONE _____________________________ FAX ______________________________ E-mail _____________________________
Source of Primary Plant
Product Commercial Fertilizer Grade OR Name of Micro Nutrients
Brand Name Type * Food Element
Product and Grade (Please list)
Nitrogen P2O5 K2O
* C - Commercial fertilizer, S - Specialty fertilizer, A - Soil Amendment
Application is made for the registration of:
commercial fertilizer(s) at $30.00 each = $ (31002)
specialty fertilizer(s) at $45.00 each = $ (31002)
soil amendment(s) at $20.00 each = $ (31002)
$ TOTAL FEES
Please print name and title, sign and date:
CONTACT PERSON_______________________________ TITLE ________________________________
SIGNATURE______________________________________ DATE _______________________________
M:\ASD\CSB\F&F\Forms\05FERT Reg web-form.doc (Revised 07/2007)
for COMMERCIAL FERTILIZERS, SPECIALTY FERTILIZERS and SOIL AMENDMENTS
Each brand and grade of fertilizer and each soil amendment, except un-manipulated animal
and vegetable manures, must be registered by or on behalf of the manufacturer before
distribution in Montana.
All requirements for registering must be completed and in the Helena office before a
registration can be processed. Allow up to three weeks for processing. Incomplete forms
will be returned for completion. For the annual re-registration of products, a pre-printed
form will be mailed to each firm prior to the registration deadline.
1. Record the business name as it appears on the product label or invoice and complete
the contact information.
2. Complete the brand name, type of product, grade of fertilizer or name specialty fertilizer
and grade or the name of soil amendment, source of each primary plant food element and
micronutrients (if applicable) for each product.
3. Provide a label (PDF format on CD) for each new product and for product labels that have
been revised since the last registration.
4. Complete and return the Supplemental Registration form for waste derived products if
5. Date and sign the application form(s).
6. Remittance should be made by check or money order payable to the Montana Department of
Agriculture and sent to the address indicated at the top of the registration form.
7. For questions concerning this form, call Lynn Jones, Licensing Section Supervisor, at
(406) 444-5400 or Andy Gray, Fertilizer Program Coordinator, at (406) 444-3730, or by e-
mail at email@example.com.
8. Copies of this form can be found at www.agr.mt.gov
COMMERCIAL FERTILIZER – “includes any substance containing one or more recognized
plant nutrients which is used for its plant nutrient content and which is designed for use or
claimed to have value in promoting plant growth, yield, or quality of the crop.”
SOIL AMENDMENT – “means any material not included under commercial fertilizer or those
products subject to the Federal Insecticide, Fungicide, and Rodenticide Act, as amended,
which is added to the soil or to plants for the purposes of influencing the growth, yield, or
quality of the crop, soil flora or fauna, or other soil characteristics.”
SPECIALTY FERTILIZER – “is a commercial fertilizer (dry or liquid) distributed primarily for
non-farm use, such as home gardens, lawns, shrubbery, flowers, golf courses, municipal
parks, cemeteries, greenhouses, and nurseries and includes commercial fertilizers used for
research or experimental purposes.”
M:\ASD\CSB\F&F\Forms\05FERT Reg web-form.doc Revised 11/05