North Carolina Department of Agriculture & Consumer Services
Standards Division
1050 Mail Service Center
Raleigh, North Carolina 27699-1050
(919) 707-3228
APPLICATION FOR NEW PUBLIC WEIGHMASTER LICENSE
IF FORM IS NOT FILLED OUT COMPLETELY, IT WILL BE RETURNED TO YOU TO BE COMPLETED.
DO NOT WRITE BELOW THIS LINE.
License Number
2/2016
*
Required Fields
*Name(Please Print) *County ______________________
*Business Name
*Business Mailing Address
*City, State, and Zip Code
Physical Address (if different than above)
City, State, and Zip Code
* Business Fax Number
If there is someone other than
yourself (preferably a manager, office clerk, owner, etc.) we can contact in case there is a
problem with your license, please list their name and number if different from above.
Contact Person
Phone Number
Upon receipt of a properly completed public weighmaster application and a check or money order payable to the North
Carolina Department of Agriculture & Consumer Services in the amount of $25.00, you will be issued a weighmaster seal
which should be stamped on every weight certificate you issue (tobacco weighmasters are permitted to use their signature
instead of the seal).
ALL PUBLIC WEIGHMASTER LICENSES EXPIRE ON JUNE 30 OF EACH YEAR
General statutes 81A-55 and 81A-61 state:
"Any public weighmaster who refuses to issue a certificate as prescribed by this Article, or who issues a certificate
giving false weight, or who misrepresents the weight to any person, or who otherwise violates any provisions of the
Article or the rules and regulations pursuant to this Article, may have his license revoked, suspended or terminated
by the Commissioner."
"When making a weight determination, a public weighmaster shall use a weighing device that is of a type suitable
for the weighing of the product to be weighed and that has been tested and approved for use by the Commissioner
within a period of 12 months immediately preceding the date of the weighing."
*Signature of Applicant Date
Phone Number
Business Email ___________________________________
If you already hold a Public Weighmaster license and need to renew, please call 919-707-3228 to obtain the appropriate form
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