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 Adobe Reader to view 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)