Save time and money by submitting annual reports electronically.

EPA Form 3540-16 Pesticide Report for Pesticide-Producing and Device-Producing Establishments (Fillable)(11 pp, 1 MB, December 2016)  (ZIP)

EPA Form 3540-16 Pesticide Report for Pesticide-Producing and Device-Producing Establishments (Printable)(11 pp, 173 K, December 2016)  (ZIP)

You must print, sign and date the form. Submit reports to the pesticide establishment coordinator where your company headquarters is located.

You must use Adobe Acrobat version 9.1 or higher to complete the form. Please read the instructions carefully to complete and submit the form

Note: EPA will not accept any copies, faxes or emails of establishment initial or annual reports (EPA Form 3540-16)