Missouri Egg License Application

Please DO NOT include any personal, confidential, and/or sensitive information in your responses on this form (e.g. social security number, credit card information, health information, account number, etc.).

Application Type

selection required

Please select application type.*

New Application

Renew

License Type Information

choose at least one option

Retailer...(R1)-Farmer's Markets/Roadside Stands Only...$25.00

Retailer...(R2)...$25.00

Dealer...(D1) ...$40.00

Dealer...(D4)...$50.00

Processor...(P1)...$60.00

Processor...(P3)...$75.00

Processor...(P4)...$100.00

Total Due
$

The 2026 license year begins on June 30, 2025,
and expires July 1, 2026.

Owner Information

Prefix

required

Last Name *

First Name *

Middle Initial

Suffix

Business Name*

Address 1*

Address 2

City*

State*

County*

required

Zip Code *

Ext. - * x X

Primary Phone*

* x

Phone Type * Ext.

E-mail Address

* x

Confirm E-mail Address

x email and confirm email do not match

Missouri Tax ID #*

Owner Contact Option(s)

Check one or both* choose at least one option

Receive license, renewal and correspondence by mail

Receive license, renewal and correspondence by email

Location Information

Same Information as Above

Prefix

Last Name *

First Name *

Middle Initial

Suffix

Business Name*

Address 1*

Address 2

City*

State*

County*

* *

Zip Code *

Ext. - * x X

Primary Phone*

* x

Phone Type * Ext.

E-mail Address

* x

Confirm E-mail Address

x email and confirm email do not match

Upload No Tax-Due Statement

If you are applying for a Retailer Egg License you must upload your no tax-due statement.
Without this statement, your egg license will not be issued.

If you only sell at Farmer’s Markets or Roadside Stands, and do not make annual sales of
$25,000 or more from the sale of “farm products” check this box to be exempt from
supplying the no tax-due statement.

Upload Name
JPEG , JPG , PDF

Signature

I certify this information is correct you must agree to the terms

Legal Name* legal name required

Date 05/29/2025

Confirmation Message

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