Pesticide Registration Manual: Appendix D - Examples of Completed Forms | Pesticide Registration

Links providing EPA examples of completed forms about the pesticide registration process.

You may need a PDF reader to view some of the files on this page. See EPA’s About PDF page to learn more.

Example of an Application for Registration/Amendment EPA Form 8570-1 (PDF)(1 pg, 234 K)
Example of a Confidential Statement of Formula EPA Form 8570-4 - basic formulation (PDF)(1 pg, 154 K)
Example of a Confidential Statement of Formula EPA Form 8570-4 - 100% repack (PDF)(1 pg, 153 K)
Example of a Notice of Supplemental Distributor Registration EPA Form 8570-5 (PDF)(1 pg, 86 K)
Example of an Application for Experimental Use Permit EPA Form 8570-17 (PDF)(1 pg, 98 K)
Example of an Application for Notification of State Registration [24(c)] EPA Form 8570-25 (PDF)(1 pg, 152 K)
Example of a Formulator's Exemption Statement EPA Form 8570-27 (PDF)(1 pg, 33 K)
Example of a Certification with Respect to Data Citation EPA Form 8570-34 - Cite-All Method (PDF)(1 pg, 35 K)
Example of Certification with Respect to Data Citation EPA Form 8570-34 - Selective Method (PDF)(1 pg, 37 K)
Example of Certification with Respect to Data Citation EPA Form 8570-34 - Selective Method, cite-all option (PDF)(1 pg, 37 K)
Example of Data Matrix EPA Form 8570-35 - Cite-All Method (PDF)(6 pp, 72 K)
Example of Data Matrix EPA Form 8570-35 - Selective Method (PDF)(6 pp, 71 K)
Example of Data Matrix EPA Form 8570-35 - Selective with Generic Data Method (PDF)(8 pp, 88 K)
Example of Summary of the Physical/Chemical Properties EPA Form 8570-36 (PDF)(1 pg, 205 K)
Example of Self-Certification Statement for Physical/Chemical Properties EPA Form 8570-37 (PDF)(1 pg, 39 K)