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Pesticide Registration Manual: Chapter 20 - Forms and How to Obtain Them
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In this chapter
The forms required to be submitted when applying for the registration of a pesticide product, experimental use permit, or distributor registration are listed below. A table at the end of this chapter describes the circumstances under which each of the forms should be submitted. Copies of these forms are available free of charge from:
U.S. Environmental Protection Agency
Registration Support Branch, Registration Division (7505P)
Attn: Registration Forms
Office of Pesticide Programs
1200 Pennsylvania Avenue, N.W.
Washington DC 20460
or e-mail: Eleanor Thornton (firstname.lastname@example.org)
Information on completing and submitting registration forms.
These forms are in PDF format, which allows them to be completed (filled out) on-screen, printed, and submitted to EPA.
|EPA Form No.||Title|
|8570-1 (PDF)||Application for Pesticide Registration/Amendment (Note: Do not be concerned that the Internet copy of this form may not have a red number in the upper right-hand corner. EPA will fill in this number upon receipt.)|
|8570-4 (PDF)||Confidential Statement of Formula|
|8570-5 (PDF)||Notice of Supplemental Distribution of a Registered Pesticide Product|
|8570-17 (PDF)||Application for an Experimental Use Permit|
|8570-25 (PDF)||Application for/Notification of State Registration of a Pesticide To Meet a Special Local Need|
|8570-27 (PDF)||Formulator's Exemption Statement|
|8570-28 (PDF)||Certification of Compliance with Data Gap Procedures|
|8570-32 (PDF)||Certification of Attempt to Enter into an Agreement with other Registrants for Development of Data|
|8570-34 (PDF)||Certification with Respect to Citations of Data (as referenced in PR Notice 98-5 (PDF)(10 pp, 87 K))|
|8570-35 (PDF)||Data Matrix (as referenced in PR Notice 98-5 (PDF)(10 pp, 87 K))|
|8570-36 (PDF)||Summary of the Physical/Chemical Properties (as referenced in PR Notice 98-1 (PDF))|
|8570-37 (PDF)||Self-Certification Statement for the Physical/Chemical Properties (as referenced in PR Notice 98-1 (PDF))|
The following forms may also be required in order to sell or distribute a pesticide product or device in the United States and can be obtained from the EPA Regional Office where your company headquarters is located or via links in the following list. Foreign establishments should contact the HQ EPA Office of Compliance. See Chapter 21 for listing of all addresses.
|EPA Form No.||Title|
|3540-1 (PDF)(2 pp, 208 K)||Notice of Arrival of Pesticides or Devices|
|3540-8 (PDF)(7 pp, 32 K)||Application for Registration of Pesticide-Producing Establishments and Instructions for Application|
|3540-16 (PDF)(8 pp, 376 K)||Pesticide Report for Pesticide-Producing and Device-Producing Establishments and Instructions for Report|
The Table lists which forms are needed for a registration, a label amendment, a formulation amendment and an Experimental Use Permit.