FarmNameRegistry

Please fill the required fields below in accordance with Title 43, Chapter 25, Tennessee Code Annotated.

Contact Information

First Name*

Last Name*

Address Line 1*

Address Line 2

City*

State*

Zip*

Phone*

Email*

Certificate Selection - Please choose the type of certificate you would like to recieve.*

Farm Information

I hereby make application for registration of the following farm name of my farm located in the following county.

Owner Name as it should appear on Certificate*

Farm Name*

County*

Farm Address is the Same As Mailing Address

Address Line 1*

Address Line 2

City*

Zip*

I understand that if there is another farm in my county registered under a like name on the records of the Tennessee Department of Agriculture, that I will be so advised and may select another name and submit it to the department.

The name of my farm is or will be posted in a clearly visible place at the following address.

The name of my farm is or will be posted in a clearly visible place at (place of posting)*

It will be at or near a public highway (name of road)*

Signature

Use your mouse or finger to draw your signature above

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Tennessee Department of Agriculture,
Commissioner’s Office
Ellington Agricultural Center, Box 40627,
Nashville, TN 37204
Phone (615) 837-5103