Pesticide Registration

Pesticide Registration Manual: Chapter 20 - Forms and How to Obtain Them

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Forms and How to Obtain Them

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 also are available 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 (thornton.eleanor@epa.gov)

For guidance in selecting the appropriate form contact one of OPP's product registration contacts.

Information on completing and submitting registration forms.

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EPA 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 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 Confidential Statement of Formula
8570-5 Notice of Supplemental Distribution of a Registered Pesticide Product
8570-17 Application for an Experimental Use Permit
8570-25 Application for/Notification of State Registration of a Pesticide To Meet a Special Local Need
8570-27 Formulator's Exemption Statement
8570-28 Certification of Compliance with Data Gap Procedures
8570-32 Certification of Attempt to Enter into an Agreement with other Registrants for Development of Data
8570-34 Certification with Respect to Citations of Data (as referenced in PR Notice 98-5)
8570-35 Data Matrix (as referenced in PR Notice 98-5)
8570-36 Summary of the Physical/Chemical Properties (as referenced in PR Notice 98-1)
8570-37 Self-Certification Statement for the Physical/Chemical Properties (as referenced in PR Notice 98-1)

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 Notice of Arrival of Pesticides or Devices
3540-8 Application for Registration of Pesticide-Producing Establishments and Instructions for Application
3540-16 Pesticide Report for Pesticide-Producing and Device-Producing Establishments and Instructions for Report

Pesticide Forms Overview Table

The Table lists which forms are needed for a registration, a label amendment, a formulation amendment and an Experimental Use Permit.

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