Wyoming Secretary of State
State Capitol Building, Room 110 200 West 24th Street Cheyenne, WY 82002-0020 Ph. 307.777.7311 Fax 307.777.5339 Email: [email protected]
For Office Use Only
Wyoming Secretary of State Central Filing System
Business Name: _________________________________________________________________________________ Contact Person: ______________________________________ Phone: _____________________________________ Address: _______________________________________________________________________________________ ______________________________________________________________________________________________ Social Security or EIN Number: ____________________________________________________________________
Farm Product Registration Renewal Fees
Livestock P.C. 3 ½ in. Diskette Crop P.C. 3 ½ in. Diskette Livestock & Crop P.C. 3 ½ in. Diskette Livestock CD Report Crop CD Report Livestock & Crop CD Report Livestock CD Raw Data Crop CD Raw Data Livestock & Crop Raw Data Complete this portion only if you want a specific product or county lists: Product Name ____________ ____________ ____________ Product Code ___________ ___________ ___________ County Code __________ __________ __________ $50.00 $50.00 $50.00 $50.00 $50.00 $50.00 $50.00 $50.00 $50.00
Date: _______________________________________ Signature: __________________________________________
BuyerRegistration 3/10/2009