Forms Related to Pesticides
Following is a compilation of forms relating to pesticides management.
Applicator/Technician
- Applicator/Technician Renewal/Recertification Application (PDF, 1.40 MB) - Required document to renew or recertify a certified applicator or a technician.
- Applicator/Technician Certification Exam Registration (PDF, 44.8 KB) - This document must be submitted to the regional DEC office where you are interested in testing.
- Address Change Form (PDF, 73.3 KB)
- NYSDMV form for Request for Photo Image (PDF, 154 KB) - Enables individuals without a NYS Department of Motor Vehicle identification card to have their photo captured free of charge for use on their pesticide certification ID.
- Pesticide Application Record Keeping Form for Private Applicators (PDF, 108 KB)
- Voluntary Surrender Applicator/Technician Certification (PDF, 21.4 KB) - Used to formally end pesticide certification and its requirements.
- Application and Instructions for Reciprocity (PDF, 129KB) - Form for out-of-state individuals applying for NYS pesticide certification through reciprocity.
Usage/Sales Annual Report
- Applicator/Technician Pesticide Annual Report 44-15-26 (PDF, 141 KB) - All applicators and technicians are required to submit annually by February 1.
- List of Commercial Applicators and Technicians 44-15-26A (PDF, 25.8 KB) - Enables businesses to report multiple applicators and/or technicians under their employment.
- Report Restricted Pesticide Sales 44-15-25 (PDF, 122 KB) - Commercial Permit holders are required to submit their restricted use pesticide sales by February 1.
- Report Pesticide Sales to Certified Private Applicators 44-15-27 (PDF, 119 KB) - Commercial Permitees are required to report their pesticide sales to private applicators by February 1.
Pesticide Product Registration
- Pesticide Registration Application (PDF, 104 KB)
- Product Information Form (PDF, 165 KB)
- Amended Labeling Application (PDF, 89 KB)
Business/Agency Registration
- Pesticide Business Registration Application (PDF, 161 KB) - For businesses that wish to apply pesticides commercially or on public properties.
- Pesticide Agency Registration Application (PDF, 115 KB) - For agencies that wish to apply pesticides commercially or on public properties.
- Commercial Permit Application (PDF, 67.9 KB) - For businesses that wish to sell pesticide products.
Training Sponsors/Instructors
- Pesticide Training Course Application in PDF (91 KB)
Pesticide Training Course Application in Microsoft Word (45 KB) - Pesticide Training Instructor Application in PDF (74 KB)
Pesticide Training Instructor Application in Microsoft Word (42 KB)
Aquatic Permit Applications
Agricultural Purchase Permit Application
- Agricultural Purchase Permit Application (PDF, 104 KB) - A permit is required to purchase restricted use pesticides for agricultural use.
