The Virginia Department of Agriculture and Consumer Services Forms ABOUT VDACS ANIMALS CONSERVATION & ENVIRONMENTAL EDUCATION FOOD, FOOD SAFETY & CONSUMER PROTECTION INSPECTION & GRADING SERVICES LOCALITIES MARKETING & ECONOMIC DEVELOPMENT MARKETS & FINANCE PESTICIDES PLANT, PEST, FEED, FERTILIZER & SEED SERVICES/FORMS SERVICES/FORMS Animal Health Animal Custody Record Animal Custody Record Online Reporting System—User Login Animal Custody Record Online Reporting System—Public Report Search Animal Care Complaint Form Animal Health Laboratory Fee Schedule Animal Health Laboratory Submission Form Agricultural Animal Seizure Report Application for Livestock Dealer Registration Application for Poultry Dealer Registration Dangerous Dog Registration Form Dangerous Dog Renewal Form Dangerous Dog Secondary Owner Information Form Virginia Dangerous Dog Registry Equine Event Report Equine Event Denied Entry Report Poultry Service Request Form & Fees Charitable Gaming Bingo Managers & Callers Online Bingo Manager & Bingo Caller Registration System Bingo Manager Certificate of Registration Application – Form 402 (pdf) Bingo Manager Certificate of Registration Application – Form 402 (xlsx) Bingo Caller Certificate of Registration Application – Form 401 (pdf) Bingo Caller Certificate of Registration Application – Form 401 (xlsx) Bingo Manager Training Material Bingo Caller Training Material List of Registered Bingo Caller List of Registered Bingo Manager Organization Licensing Tips for using the interactive Excel Bingo/Raffle Applications Bingo/Raffle/Texas Hold’em Poker Tournament Application - New Applicant (pdf) Bingo/Raffle/Texas Hold’em Poker Tournament Application - Renewal Applicant (pdf) Permit Amendment (pdf) Gaming Personnel Information Update (pdf) Report of Game Termination, Revised (pdf) Landlord & Texas Hold’em Poker Tournament Operator Registering Landlord Registration Application (pdf) Operator Registration Application (pdf) Supplier Licensing Charitable Gaming Supplier Permit Application – Form 301 (Revised 02/26/18) Certification of Non-Permit Holder – Form 303 (Revised 07/15/21) Certification of Non-Charitable Gaming/Gambling – Form 304 (Revised 05/09/25) Annual Supplier Sales and Transactions Report - Form 302 (Revised 09/09/25) (pdf) Annual Supplier Sales and Transactions Report - Form 302 (Revised 09/09/25) (xlsx) Instructions (Revised 07/30/13) Supplier Transaction Reporting Format (xlsx) Manufacturer of Electronic Pull-Tab System Licensing Currently Registered Manufacturers of Electronic Pull-Tab System Manufacturer of Electronic Pull-Tab System Permit Application – Form 305 (Revised 10/12) Manufacturer of Electronic Pull-Tab System Permit Application – Personal Information Form – Form 305-A (Revised 10/12) Manufacturer of Electronic Pull-Tab System Permit Renewal Application – Form 306 (Revised 10/13) Manufacturer of Electronic Pull-Tab System Permit Renewal Application – Personal Information Form – Form 306-A (Revised 10/13) Game Management Forms and Complaints Form 103 - Bingo Session Reconciliation Summary (Revised 10/24/2022) - Required (pdf) Form 103 - Bingo Session Reconciliation Summary (Revised 10/24/2022) - Required (xlsx) Form 103 - Instructions (Revised 10/24/2022) Form 104-A - Admission Sales Reconciliation - Paper (Revised 03/23/23) - Required (pdf) Form 104-A - Admission Sales Reconciliation - Paper (Revised 03/23/23) - Required (xlsx) Form 104-A - Instructions (Revised 03/23/23) Form 104-B - Floor Sales Reconciliation - Paper (Revised 12/19/14) (pdf) Form 104-B - Floor Sales Reconciliation - Paper (Revised 12/19/14) (xlsx) Form 104-B - Instructions (Revised 12/19/14) Form 104-C - Decision Bingo Reconciliation (Revised 08/14/13) - Required (pdf) Form 104-C - Decision Bingo Reconciliation (Revised 08/14/13) - Required (xlsx) Form 104-C - Instructions (Revised 07/30/13) Form 104-D - Raffle/Treasure Chest Sales Reconciliation - Bingo Session (Revised 03/23/23) - Required (pdf) Form 104-D - Raffle/Treasure Chest Sales Reconciliation - Bingo Session (Revised 03/23/23) - Required (xlsx) Form 105 - Instant Bingo/Seal Cards/Pull-Tabs Reconciliation (10/24/2022) - Required (pdf) Form 105 - Instant Bingo/Seal Cards/Pull-Tabs Reconciliation (10/24/2022) - Required (xlsx) Form 105 - Instructions (Revised 10/24/2022) Form 105-A - Instant Bingo/Seal Cards/Pull-Tabs Reconciliation Continuation (Revised 08/05/13) - Required (pdf) Form 105-A - Instant Bingo/Seal Cards/Pull-Tabs Reconciliation Continuation (Revised 08/05/13) - Required (xlsx) Form 105-A - Instructions (Revised 08/02/13) Form 106-A - Storeroom Inventory Issue - Paper (Revised 08/01/13) - Optional (pdf) Form 106-A - Storeroom Inventory Issue - Paper (Revised 08/01/13) - Optional (xlsx) Form 106-A - Instructions (Revised 08/01/13) Form 106-B - Storeroom Inventory Issue - Instant Bingo/Seal Cards/Pull-Tabs (Revised 08/01/13) - Optional (pdf) Form 106-B - Storeroom Inventory Issue - Instant Bingo/Seal Cards/Pull-Tabs (Revised 08/01/13) - Optional (xlsx) Form 106-B - Instructions (Revised 08/01/13) Form 107 - List of Bingo Workers Form (Revised 08/01/13) (pdf) Form 107 - List of Bingo Workers Form (Revised 08/01/13) (xlsx) Form 107 - Instructions (Revised 08/01/13) Form 108 - Prize Receipt Form (Revised 08/01/13) (pdf and xlsx) Form 108 - Prize Receipt Form (Revised 08/01/13) (pdf and xlsx) Form 108 - Instructions (Revised 08/01/13) Form 109-A - Storeroom Inventory - Paper (Revised 08/01/13) - Required (pdf) Form 109-A - Storeroom Inventory - Paper (Revised 08/01/13) - Required (xlsx) Form 109-A - Instructions (Revised 07/30/13) Form 109-B - Storeroom Inventory Form - Instant Bingo/Seal Cards/Pull-Tabs (Revised 08/01/13) - Required (pdf) Form 109-B - Storeroom Inventory Form - Instant Bingo/Seal Cards/Pull-Tabs (Revised 08/01/13) - Required (xlsx) Form 109-B - Instructions (Revised 08/01/13) Form 110 – Raffle Sales Reconciliation Form – Stand Alone Raffle (Revised 08/01/13) (pdf) Form 110 – Raffle Sales Reconciliation Form – Stand Alone Raffle (Revised 02/26/18) (xlsx) Form 110 – Instructions (08/01/13) Form 111 - Instant Bingo/Seal Cards/Pull-Tabs Reconciliation Form (Non-Bingo) (Revised 5/24) (pdf) Form 111 - Instant Bingo/Seal Cards/Pull-Tabs Reconciliation Form (Non-Bingo) (Revised 5/24) (xlsx) Form 111 - Instructions (Revised 08/05/24) Form 111-A - Instant Bingo/Seal Cards/Pull-Tabs Reconciliation Continuation Form (Non-Bingo) (Revised 5/24) (pdf) Form 111-A - Instant Bingo/Seal Cards/Pull-Tabs Reconciliation Continuation Form (Non-Bingo) (Revised 5/24) (xlsx) Form 111-A - Instructions (Revised 08/05/24) Form 111-B – Instant Bingo/Seal Cards/Pull-Tabs Reconciliation Continuation Form (Non-Bingo) (Revised 5/24) (pdf) Form 111-B – Instant Bingo/Seal Cards/Pull-Tabs Reconciliation Continuation Form (Non-Bingo) (Revised 5/24) (xlsx) Form 111-B - Instructions (Revised 08/05/24) Form 112 - Destruction of Unused Charitable Gaming Supplies (Revised 05/24) (pdf) Complaint Poster (Revised 11/21/17) (pdf) Form 114 - King of Clubs/Queen of Hearts/Raffle Sales Reconciliation – Social Quarters (Revised 5/18/23) - Required (xlsx) Form 114 – King of Clubs/Queen of Hearts/Raffle Sales Reconciliation – Social Quarters (Revised 5/18/23) - Required (pdf) Form 115 – Electronic Gaming/Pull-Tab Deposit Reconciliation (Revised 3/25) - Required (xlsx) Form 115 – Electronic Gaming/Pull-Tab Deposit Reconciliation (Revised 3/25) - Required (pdf) Form 115 – Instructions (Revised 3/25) Form 117 – Texas Hold’em Poker Tournament Reconciliation Summary (Revised 5/24) – Required (pdf) Form 117 – Texas Hold’em Poker Tournament Reconciliation Summary (Revised 5/24) – Required (xlsx) Form 117 - Instructions (Revised 08/05/24) Charitable Solicitation Virginia Exemption Application for Charitable or Civic Organization: (Form 100) Registration Statement for a Charitable Organization: (Form 102) Professional Fundraising Registration: (Form 103) Professional Solicitor Registration: (Form 104) Professional Solicitor Bond Template: (Form 105) Solicitation Notice: (Form 120) Consent to Solicit: (Form 121) Professional Solicitor’s Final Accounting Report Late Fees: (Form 130) Virginia Solicitation of Contributions Law Rules Governing the Solicitation of Contributions Unified Registration Statement: This form may be utilized by charitable organizations soliciting in multiple states. Charitable Solicitation Complaint Form Credit Services Business Credit Services Business Registration Form (OCRP-71 Credit Services Business Bond: Template (OCRP-74) Credit Services Business Irrevocable Letter of Credit: Template (OCRP-73 Virginia Credit Services Businesses Act OCRP Regulatory Programs Complaint Form Extended Service Contract Extended Service Contract Provider/Obligor Application for Registration (OCRP-61) Virginia Extended Services Contract Providers Act OCRP Regulatory Programs Complaint Form Fantasy Contests Complaint Form Form 501 - Fantasy Contest Operator Registration Application Form 501-A – Personal Information Form Feed, Fertilizer & Seed CFA Certification Online Application Commercial Animal Feed Purchasing Report Commercial Animal Feed Statement of Agreement Commercial Animal Feed Tonnage Reporting and Payment Agreements Instructions Fertilizer Tonnage Reporting System Fertilizer Tonnage County Codes (FIPS) Fertilizer Tonnage Template Fertilizer Tonnage: UFTRS Fertilizer Codes Fertilizer, Soil Amendment, Horticultual Growing Medium Purchasing Report Fertilizer, Soil Amendment, Horticultural Growing Medium Statement Of Agreement Fertilizer, Soil Amendment, Horticultural Growing Medium Tonnage Reporting and Payment Agreements Instructions Industrial Co-Products Guidance License Packet for Agricultural Products Dealer License and Product Registration Packet for Commercial Feed License and Product Registration Packet for Fertilizer License and Product Registration Packet for Lime License and Product Registration Packet for Seed Turf Fertilizer Reporting Tool Virginia Fertilizer/Lime Contractor — Applicator Permit Food Commercial Kitchen Food Processing Application Home Food Processing Application Wild Mushroom Harvester Application Wild Mushroom Retail Sales Application Fruit, Vegetable & Peanut Marketing Services Fruit and Vegetable Programs Request for Inspection, Reinspection or Appeal Inspection Health Clubs Health Club Registration Form (OCA-31) Health Club Bond Template (OCA-34) Health Club Letter of Credit Template (OCA-33) Health Club Act OCRP Regulatory Programs Complaint Form Home Operations Home Food Processing Application Home Service Contracts Home Service Contract Provider Registration Application (Form 801) Home Service Contract Provider Bond Form (Form 802) Home Service Contract Provider Line of Credit Form (Form 803) OCRP Regulatory Programs Complaint Form Market News Service Hay Clearing House Request Form Market News Publications Request Form Meat & Poultry Services Application for Permit of Exemption Application for Permit of Poultry Exemption Application/Approval for Voluntary Reimbursable Inspection Service Membership Campgrounds Application for the Registration of Membership Camping Operator (OCRP-51) Membership Campground Letter of Credit Template (OCRP-53) Membership Camping Operator's Bond Template (OCRP-54) Virginia Membership Campground Act OCRP Regulatory Programs Complaint Form Payment Portal Payment Portal Pesticide Services Application for New Pesticide Product Registration Application for Reciprocal Pesticide Applicator Certificate Application for Virginia Pesticide Business License Applicator Change of Information Business Change of Information Business License Application Instructions Certificate of Insurance Complete Business License Packet Complete Commercial Pesticide Applicator Packet Complete Registered Technician Packet Commercial A Pesticide Applicator Certification Application Commercial Application Instructions Commercial B Pesticide Applicator Request for Authorization to Take Pesticide Applicator Examination Pesticide Registered Technician A Application Pesticide Registered Technician B Application Pesticide Disposal Registration Form Power of Attorney Private Pesticide Applicator Testing Application Proof of Additional Category Specific Training for Registered Technicians Registered Technician Instructions Request to take the Virginia Pesticide Business License Examination Responsibilities of Commercial Pesticide Applicators and Registered Technicians in Virginia Training Manual Order Form Virginia Pesticide Discontinuance Policy Plant Industry Services Permit Application Virginia Pollinator Beekeeper Form Virginia Ginseng Management Program Virginia Plants and Plant Product Inspection Law and Quarantine Requirements Prepaid Legal Service Plan Sellers Online Registration Application Virginia Prepaid Legal Services Plan Act OCRP Regulatory Programs Complaint Form Transporters of Waste Kitchen Grease Online Registration Promotional Virginia’s Finest Program Application Travel Clubs Application for Registration Travel Clubs (OCRP-21) Travel Club Bond Template (OCRP-24) Irrevocable Letter of Credit Travel Clubs Template (OCRP-26) Travel Club Fidelity Bond Template (OCRP-25) Virginia Travel Club Act Additional Travel Club Registration Guidelines (OCRP-23) OCRP Regulatory Programs Complaint Form Weights & Measures Application for the Registration of Motor Fuels Application for Weights and Measures Service Agency Certification — Taxi Companies Application for Weights and Measures Service Agency Certification Application for Weights and Measures Service Technician Certification Motor Fuel Price Gouging Complaint Form Registration Packet for Commission Merchants Registration Packet for Cotton Handlers Registration Packet for Service Agency and Service Technician Virginia Public Weighmaster Law and Application Weights and Measures Service Agency Change of Information Form Weights and Measures Service Technician Change of Information Form parent","#menu-name"); document.getElementsByClassName("panel-heading")[0].innerHTML = "