Rev 2023-01

											FORM GW-16

REQUEST TO DISCONTINUE THE OPERATION OF A 
ARKANSAS PUBLIC GRAIN WAREHOUSE 
AND/OR BE EXEMPT FROM
THE ARKANSAS PUBLIC GRAIN WAREHOUSE LAW

__________________________
 DATE

I,________________________________________________________________,
	request to be released from the provision of the Arkansas Public Grain Warehouse Law.

By signing this request, I am stating that I have no obligations as a public grain
warehouseman to pay for and/or deliver stored grain to any person.

	Should I decide to continue my operation or begin storing grain at a future date, I will notify the Grain Warehouse Section of the Plant Industries Division, 30 days prior to the opening of my facility.

                                                                                                                                                          

									Signature/Title

                                                                   
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