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Affidavit Of Land Use History

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Affidavit Of Land Use History Powered By Docstoc
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                                       Prior Land Use Affidavit (PLUA)
This declaration is required for any new land added to an organic operation certified by MVOAI, or for applicants who have
rented or owned any of their land for less than three years prior to harvest of the crop. The landlord or previous owner must
complete and sign this form.

I,                          , the                                     (owner, manager, executor, etc.)
of the land herein identified as:

Legal Description –

Field Numbers, if applicable -

do hereby attest that the parcels of land described above were farmed by me or were under my control,
and that during this time, to the best of my knowledge, there were no herbicides, pesticides, fungicides,
fungicide treated seed, synthetic fertilizers or other substances prohibited as listed in §205.105 of US 7
CFR 205 USDA NOP Final Rule applied to this land during the last three years.

Furthermore, for the last three years, the activities on, and the inputs to, the above referenced parcel of
land have been as described below:
____________________________________________________________________________________
Year:         Crop:                                     Organic         Transitional       Conventional

Fertilizers and Pesticides used:

Other inputs used:
____________________________________________________________________________________
Year:          Crop:                      Organic      Transitional   Conventional

Fertilizers and Pesticides used:

Other inputs used:
____________________________________________________________________________________
Year:              Crop:                  Organic      Transitional   Conventional

Fertilizers and Pesticides used:

Other inputs used:
____________________________________________________________________________________
I do swear that the above is true, complete and correct to the best of my knowledge, and that no
prohibited inputs as described above have been used on this land other than those listed above.

Printed Name:                                                           Phone Number:
Address:

____________________________________                                    _____________________
Signature                                                               Date

                                        Prior Land Use Affidavit.doc Version 3.1

				
Jun Wang Jun Wang Dr
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