Affidavit of Kansas Producer Regarding Required Production Levels Pursuant to
Subsection (a) of K.S.A. 41-355
Applicant for Initial and Renewal License
STATE OF KANSAS )
) SS:
COUNTY OF ______________________ )
The undersigned, a duly authorized representative of the Kansas Producer indicated
below, being of lawful age and being first duly sworn, on his/her oath states that said
Kansas Producer is applying for an initial license or renewing an existing license.
Initial license, applicant has:
100 vines of sound, ripe grapes
1,000 pounds of other sound, ripe fruits or berries or 100 pounds of honey as
required by subsection (a) of K.S.A. 41-355.
Renewing existing license, applicant has:
__________ vines of sound, ripe grapes
__________ pounds of other sound ripe fruits or berries or ________ pounds of honey.
If renewing an existing license and producer has less than 100 vines of sound, ripe grapes,
1,000 pounds of other sound, ripe fruits or berries or 100 pounds of honey, then said
producer must attach to this affidavit a detailed plan as to how it intends to come into
compliance and request approval of said plan from the Director.
Further affiant sayeth not.
____________________________________
Signature of affiant
____________________________________
Typed or printed name of affiant
ABC-284
