Illinois Crop Improvement Association, Inc. | Forms

After filling in the appropriate fields below, print this page for your records before clicking the "submit" button.

<return to Forms	OECD Certificate Order Form
*Company
*Email
*Location
*Variety
*Crop
*Class
Not Finally Certified (Gray tag)
*Number of bags/containers shipped
*Total net weight of seed shipped	lbs.
*Grade
*Lot #
*Reference # from OECD tags
*Destination of seed
Additional Billing and Shipping Information
	* Required Fields If you have questions, please contact: ICIA Tags & Records Attn: Diane Campbell Phone 217-359-4053 ext 22 Fax 217-359-4075 e-mail: dcampbell@ilcrop.com Revised January 3, 2007