Business Location Name: Enter the name of the business.
Street Address: Enter the address for the business. Do not use a rural route or a post office box address.
City: Enter the city for the business address.
State: Enter the state for the business address.
Zip Code: Enter the zipcode for the business address.
County: Select the county in which the business address is located.
Province: If the business is located in a country other than the United States, enter the province name.
Country: Select the country in which the business is located.
Postal Code: If the business is located in a country other than the United States, enter the postal code.
Physical Location or Directions: Provide directions to locate the place where business is conducted and/or products are grown or raised for sale.