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

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

Pesticides Registration Manual Home Page

  • Example of an Application for Registration/Amendment EPA Form 8570-1 (pdf) (228.81 KB)
  • Example of a Confidential Statement of Formula EPA Form 8570-4 - basic formulation (pdf) (150.36 KB)
  • Example of a Confidential Statement of Formula EPA Form 8570-4 - 100% repack (pdf) (149.36 KB)
  • Example of a Notice of Supplemental Distributor Registration EPA Form 8570-5 (pdf) (81.8 KB)
  • Example of an Application for Experimental Use Permit EPA Form 8570-17 (pdf) (95.53 KB)
  • Example of an Application for Notification of State Registration [24(c)] EPA Form 8570-25 (pdf) (147.99 KB)
  • Example of a Formulator's Exemption Statement EPA Form 8570-27 (pdf) (32.03 KB)
  • Example of a Certification with Respect to Data Citation EPA Form 8570-34 - Cite-All Method (pdf) (34.12 KB)
  • Example of Certification with Respect to Data Citation EPA Form 8570-34 - Selective Method (pdf) (36.08 KB)
  • Example of Certification with Respect to Data Citation EPA Form 8570-34 - Selective Method, cite-all option (pdf) (36.15 KB)
  • Example of Data Matrix EPA Form 8570-35 - Cite-All Method (pdf) (69.91 KB)
  • Example of Data Matrix EPA Form 8570-35 - Selective Method (pdf) (69.81 KB)
  • Example of Data Matrix EPA Form 8570-35 - Selective with Generic Data Method (pdf) (86.24 KB)
  • Example of Summary of the Physical/Chemical Properties EPA Form 8570-36 (pdf) (200.09 KB)
  • Example of Self-Certification Statement for Physical/Chemical Properties EPA Form 8570-37 (pdf) (38 KB)
  • Pesticide Registration Home
  • About Pesticide Registration
  • Electronic Submission of Applications
  • Pesticide Registration Manual
  • Fees and Waivers
  • Registration Information by Type of Pesticide
  • — Antimicrobial Registration
  • — Biopesticide Registration
  • — Conventional Registration
  • — Inert Ingredient Regulation
  • Requirements and Guidance
  • — Data
  • — Forms
  • — Labeling
Contact Us to ask a question, provide feedback, or report a problem.
Last updated on February 9, 2022
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