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)
• Example of a Confidential Statement of Formula EPA Form 8570-4 - basic formulation (pdf)
• Example of a Confidential Statement of Formula EPA Form 8570-4 - 100% repack (pdf)
• Example of a Notice of Supplemental Distributor Registration EPA Form 8570-5 (pdf)
• Example of an Application for Experimental Use Permit EPA Form 8570-17 (pdf)
• Example of an Application for Notification of State Registration [24(c)] EPA Form 8570-25 (pdf)
• Example of a Formulator's Exemption Statement EPA Form 8570-27 (pdf)
• Example of a Certification with Respect to Data Citation EPA Form 8570-34 - Cite-All Method (pdf)
• Example of Certification with Respect to Data Citation EPA Form 8570-34 - Selective Method (pdf)
• Example of Certification with Respect to Data Citation EPA Form 8570-34 - Selective Method, cite-all option (pdf)
• Example of Data Matrix EPA Form 8570-35 - Cite-All Method (pdf)
• Example of Data Matrix EPA Form 8570-35 - Selective Method (pdf)
• Example of Data Matrix EPA Form 8570-35 - Selective with Generic Data Method (pdf)
• Example of Summary of the Physical/Chemical Properties EPA Form 8570-36 (pdf)
• Example of Self-Certification Statement for Physical/Chemical Properties EPA Form 8570-37 (pdf)