The California DPR 035 form is an essential document used for applying to amend a pesticide product's registration. This form allows applicants to request changes such as adding new crops, uses, or pests to their product labels, ensuring compliance with state regulations. Properly completing this form is crucial for maintaining the integrity and legality of pesticide products in California.
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The California DPR 035 form is a crucial document for those involved in the pesticide industry, specifically for those seeking to amend existing pesticide product registrations. This form serves as an application to modify various aspects of a pesticide product, ensuring compliance with state regulations. Key information required includes the firm name, mailing address, and details about the authorized representative. Additionally, applicants must provide the product brand name and the U.S. EPA registration number. The form also outlines the specific type of amendment being requested, which could range from adding a new crop or use site to modifying precautionary statements on the label. It is important to note that amendments requiring scientific data will incur a fee and necessitate thorough documentation. Incomplete submissions will not be processed, emphasizing the need for accuracy and attention to detail. Understanding the requirements and properly completing the DPR 035 form is essential for a smooth amendment process, allowing businesses to adapt to changing market needs and regulatory standards.
APPLICATION TO
AMEND PESTICIDE PRODUCT
DPR-035 (05/06)
Page 1 of 2
DPR USE ONLY:
Tr. ID#________________________________
Reg. No._______________________________
R.S. Assigned __________________________
Applicant Information
Important: Read all instructions before completing this form.
1.
Firm Name
2.
Mailing Address of Firm
Check box if updated address
City
State
Zip Code
3.
Street Address (if different from above) or Agent Address
4.
Name of Authorized Representative
5.
Telephone Number of Representative
6. Fax Number
7. E-mail Address
( )
Product Information
8.Product Brand Name (exactly as shown on label)
9.U.S. EPA Registration Number (or California Registration Number for Spray Adjuvants)
10.Type of California amendment action requested that must be supported by scientific data.
Addition of a crop. Addition of sites or uses. Addition of indoor use.
Adding the first agricultural use for the active ingredient. Adding pests or types of pests not already on the label. Reducing the signal word or the precautionary statements. Other (explain in cover letter).
NOTE: Minor amendments not requiring scientific data are not subject to the fee and do not require an application form.
I certify, under penalty of perjury, that all information submitted on this application to amend pesticide product is accurate and complete.
X_____________________________________ / _____________________________________________/ ____________________
Signature of Authorized Representative
Type or Print Name/Title
Date Signed
Mail completed application to:
For correspondence only: Department of Pesticide Regulation Pesticide Registration Branch P.O. Box 4015
Sacramento, California 95812-4015
For package deliveries, Fed Ex, etc: Department of Pesticide Regulation Pesticide Registration Branch
1001 I Street
Sacramento, California 95814-2828
RC# _______________________________
_______________________________
Fee$ ______________________________
RC Date ___________________________
Date Received ______________________
OK by _____________________________
Date Licensed____________________
Returned __________________________
________________________________
Instructions for
DEPARTMENT OF PESTICIDE REGULATION
PESTICIDE REGISTRATION BRANCH (916) 445-4400
Page 2 of 2
INCOMPLETE FORMS WILL NOT BE PROCESSED.
If any section does not apply to your product, please mark it N/A. A separate application form must be completed for each amendment for each product brand name. If you need further assistance, contact the Pesticide Registration Branch at (916) 445-4400.
PRODUCT INFORMATION
1.Firm Name: This must be the same as on file with U.S. EPA.
2.Firm Mailing Address: Correspondence, licenses, notices, etc. will be sent to this address.
4.Name of Authorized Representative: The person who is authorized to answer any questions about your application for registration. Generally, this is the person who prepares the application. If the person is an agent, a letter from the firm authorizing
the agent to act on their behalf is required.
7.E-mail address: In accordance with California Notice to Registrants 2005-4, supplying DPR with this information will automatically enroll the applicant (firm or agent) into the automatic notification program. Applicants that do not wish to receive these automatic email updates must specify this in their cover letter or on the application form.
8.Product Brand Name: This must be EXACTLY the same as the brand name registered (or, if applicable, received) by U.S. EPA and the same as on the product labeling. The product brand name cannot be the same as another product, within the same company, with a different formulation. Do not include symbols used in place of words that are part of the brand name (e.g. @, TM, *, (R), etc.).
9.U.S. EPA Registration Number: Required unless product is exempt from, or does not require, registration under the Federal Insecticide Fungicide and Rodenticide Act (FIFRA) such as spray adjuvant. For a spray adjuvant, the California Registration
Number is required.
10.Type of California Amendment Action Requested:
*Adding sites or uses:
*Adding a crop:
*Adding indoor use:
*Adding the first agricultural use for the active ingredient:
*Adding pests or types of pests not already on the label:
*Reducing the signal word or the precautionary statements:
*Other: Please attach a cover letter explaining the type of registration action requested.
An Amendment Application Package must include the following:
A cover letter describing the type of amendment action requested and what is being submitted to DPR.
A completed “Application to Amend Pesticide Product” form. Make sure your amendment form is complete and signed. Keep a photocopy for your records.
An amendment application fee of $100.00 is required. The fee applies to all amendment actions that must be supported by scientific data, regardless of whether DPR reviews the data. Make check or money order payable to “Department of Pesticide Regulation.” Six (6) copies of the product labeling. Typescript labeling may be submitted if printed labels are not yet available; printer's proofs or final printed labels are required prior to acceptance of the amendment. Copy of U.S. EPA - stamped accepted label, and one copy of the U.S. EPA Notice of Registration, if applicable.
One copy of the data required by California regulations (Title 3 CCR §6170).
If not submitting data, include in your cover letter a reference to specific data on file with DPR or identification of a pesticide product(s) previously approved by the Director that would be subject to some or all of the same data requirements as applicable to the applicant’s product. NOTE: Applicant’s that rely upon data owned by another
company may, pursuant to FAC §12811.5, have certain obligations to the data owner in specifically defined situations. For further information, please refer to <http://www.cdpr.ca.gov/docs/legbills/ab1011/ resource.htm>.
Information Available on the Internet
Information about the California laws and regulations governing pesticide registration, as well as Department notices, policies and procedures is available on the internet at <http://www.cdpr.ca.gov>. Information on currently registered products, registrants, telephone numbers for Department staff, and other information is also available at this site.
Persons interested in receiving notices specific to registration issues must subscribe to the e-mail list or access the “California Notices to Registrants” web page found on the Departments’ website.
To subscribe to “California Notices to Registrants” for e-mail delivery, visit the E-List page at <http://www.cdpr.ca.gov/docs/listserv/listdesc.htm>, and click on the subscribe link under the list name. An alternate method of subscribing is to send an e-mail to [email protected] and put the word “subscribe” in the subject line. You will receive an e-mail, welcoming you to the list. To access new and historical notices via the Internet, see <http://www.cdpr.ca.gov/docs/canot/camenu.htm>.
After gathering all necessary information, you are ready to fill out the California DPR-035 form. This form is crucial for amending pesticide product registrations in California. Follow the steps below to ensure your application is complete and accurate.
Once you have completed the form, be sure to gather all required attachments and fees. Mail your application to the appropriate address provided in the instructions, ensuring that all components are included for processing. Keeping a copy of your submission for your records is also advisable.
The California DPR 035 form is an application used to amend a pesticide product registration. It is specifically designed for changes that require scientific data, such as adding new uses or crops to an existing pesticide label. This form must be completed accurately to ensure proper processing by the Department of Pesticide Regulation (DPR).
Any firm or individual seeking to amend a registered pesticide product in California must complete the DPR 035 form. This includes manufacturers or their authorized representatives who want to make changes to product labeling or registration details.
The form requires various details, including:
It is crucial that all information is accurate and complete to avoid delays in processing.
Amendments can include:
Yes, there is a fee of $100. This fee applies to all amendment actions that require scientific data. The payment should be made via check or money order payable to the "Department of Pesticide Regulation."
Incomplete forms will not be processed. It is essential to review the application thoroughly and ensure all applicable sections are filled out. If a section does not apply, mark it as N/A.
Completed applications should be mailed to the Department of Pesticide Regulation. For correspondence, use the P.O. Box address. For package deliveries, use the physical address listed on the form. Ensure that you keep a photocopy for your records.
Yes, you can rely on data owned by another company, but you may have specific obligations to the data owner. It is advisable to refer to California regulations for more details on these obligations.
Additional information is available on the California Department of Pesticide Regulation's website. This includes details on laws, regulations, and notices related to pesticide registration. You can also subscribe to email notifications for updates.
If you have questions, you can contact the Pesticide Registration Branch at (916) 445-4400. They can provide assistance and clarification regarding the application process and requirements.
Failing to read all instructions before completing the form. This can lead to incomplete or incorrect submissions.
Not providing the Firm Name exactly as it appears on file with the U.S. EPA. Any discrepancies can cause delays.
Forgetting to check the box if the mailing address has been updated. This is important for receiving correspondence.
Neglecting to include the U.S. EPA Registration Number when required. This number is essential for processing the application.
Not specifying the type of California amendment action requested. Clear identification of the action is crucial for proper evaluation.
Omitting the Signature of Authorized Representative. Without a signature, the application cannot be processed.
Failing to attach a cover letter explaining the amendment action. This letter is necessary for context and clarity.
Not including the required amendment application fee of $100. Applications submitted without payment will not be processed.
Submitting fewer than six copies of the product labeling. All required copies must be included for review.
Forgetting to keep a photocopy of the completed application for personal records. This is important for future reference.
The California DPR 035 form is a vital document for those seeking to amend pesticide product registrations. Alongside this form, several other documents are often required to ensure a comprehensive application process. Below is a list of related forms and documents that can facilitate your submission and help clarify the requirements.
Submitting the California DPR 035 form along with these additional documents can streamline the amendment process for pesticide products. Each item serves a specific purpose, ensuring that your application is complete and meets all necessary requirements. Careful attention to detail in preparing these documents can significantly enhance the likelihood of a successful amendment approval.
The California DPR 035 form is quite similar to the Application for Pesticide Registration, which is another essential document in the pesticide approval process. Both forms require detailed information about the product, including its brand name and registration number. The application for pesticide registration also necessitates scientific data to support the claims made about the product's efficacy and safety. Just like the DPR 035, this application must be signed by an authorized representative, ensuring that the information provided is accurate and complete. Both documents help maintain regulatory standards for pesticides used in California, protecting both public health and the environment.
Another document that shares similarities with the DPR 035 form is the Pesticide Labeling Application. This application focuses specifically on the labels that accompany pesticide products. Much like the DPR 035, it requires the submission of product information, including the brand name and registration number. The labeling application ensures that all claims made on the product label are substantiated by scientific data. This is crucial for consumer safety, as labels provide essential information on how to use the pesticide correctly and safely. Both forms play a significant role in the regulatory framework governing pesticide products.
The Notice of Intent to Use Pesticides is yet another document that bears resemblance to the DPR 035 form. This notice is typically submitted by agricultural professionals who plan to apply pesticides in specific areas. Similar to the DPR 035, it requires detailed information about the pesticide being used, including its registration number and intended use sites. The primary purpose of this notice is to inform regulatory authorities and the public about pesticide applications, ensuring transparency and safety. Both documents emphasize the importance of responsible pesticide use and adherence to regulations.
Lastly, the Pesticide Incident Report shares common ground with the DPR 035 form. This report is filed when there is an adverse effect or incident related to pesticide use. Like the DPR 035, it requires specific information about the pesticide involved, including its brand name and registration number. The incident report aims to gather data on potential risks associated with pesticide products, which can lead to further regulatory actions or amendments to existing product registrations. Both documents highlight the ongoing need for monitoring and evaluation in the pesticide industry to safeguard public health and the environment.
When filling out the California DPR 035 form, there are important practices to follow to ensure your application is processed smoothly. Here are five things you should and shouldn't do:
Following these guidelines will help in submitting a complete and accurate application, minimizing the chances of delays or rejections.
Misconceptions about the California DPR 035 form can lead to confusion and delays in the amendment process. Here are four common misconceptions:
Understanding these points can help streamline the application process and ensure compliance with California regulations.
When working with the California DPR 035 form to amend a pesticide product, keep these key points in mind:
By keeping these takeaways in mind, you can navigate the application process more smoothly and ensure that your amendment request is handled efficiently.