The California DPR 035 form is an application used to amend pesticide product registrations. This form allows applicants to request changes such as adding new crops, uses, or pests to an existing product label. Ensure you fill out the form accurately and completely by clicking the button below.
The California DPR 035 form is a crucial document for those looking to amend pesticide product registrations. This form serves as the official application to request changes to existing pesticide products, ensuring compliance with state regulations. It requires detailed information about the applicant, including the firm name, mailing address, and authorized representative's contact details. Additionally, the form asks for specific product information, such as the product brand name and U.S. EPA registration number. Applicants must specify the type of amendment they are seeking, which could range from adding a new crop or use to reducing precautionary statements on the label. It is essential to note that certain minor amendments do not require this application form. Completing the DPR 035 form accurately is vital, as incomplete submissions will not be processed. A cover letter detailing the requested changes, along with the necessary fees and product labeling, must accompany the application. Timely and accurate submissions can significantly expedite the amendment process, allowing for quicker compliance and market access.
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 canote-request@pestreg.cdpr.ca.gov 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>.
Completing the California DPR 035 form is a critical step in the amendment process for pesticide products. After filling out the form, applicants will need to submit it along with supporting documents and a fee. This ensures that the application is processed efficiently.
Once completed, ensure that all necessary documents are attached, including a cover letter and the amendment application fee. Then, mail the application to the appropriate address for processing.
What is the purpose of the California DPR 035 form?
The California DPR 035 form is designed for individuals or companies seeking to amend a pesticide product registration. This form allows applicants to request changes such as adding new crops, uses, or pests to their product labels. It ensures that all necessary information is provided to the Department of Pesticide Regulation (DPR) for review. Completing this form accurately is crucial, as it helps maintain compliance with state regulations regarding pesticide use and safety.
What information is required on the DPR 035 form?
When filling out the DPR 035 form, applicants need to provide several key pieces of information. This includes the firm name, mailing address, and the name of an authorized representative who can answer questions about the application. Additionally, the form requires details about the product, such as its brand name and U.S. EPA registration number. Applicants must also specify the type of amendment action they are requesting, which could involve adding new uses or modifying existing label information. Ensuring that all sections are complete and accurate is essential for the application to be processed without delays.
Is there a fee associated with submitting the DPR 035 form?
Yes, there is a fee for submitting the DPR 035 form. An amendment application fee of $100.00 is required for actions that must be supported by scientific data. This fee applies regardless of whether the DPR ultimately reviews the data provided. It is important to include this fee with the application, as failure to do so may result in delays or rejection of the request. Payment should be made via check or money order, payable to the Department of Pesticide Regulation.
How should I submit the completed DPR 035 form?
Once the DPR 035 form is completed, it should be mailed to the appropriate address provided in the instructions. For general correspondence, applicants can send it to the Pesticide Registration Branch at P.O. Box 4015, Sacramento, California. If using a package delivery service like FedEx, the form should be sent to 1001 I Street, Sacramento, California. It is advisable to keep a photocopy of the completed application for your records. Ensuring that the application is sent to the correct address will help facilitate a smoother review process.
Filling out the California DPR 035 form can be straightforward, but many people make common mistakes that can delay the process. One frequent error is failing to provide the correct Firm Name. This name must match exactly with what is on file with the U.S. EPA. If there are any discrepancies, it could lead to rejection of the application.
Another mistake is not updating the Mailing Address if it has changed. It’s important to check the box indicating an updated address. If this step is overlooked, important correspondence may be sent to the wrong location, causing unnecessary delays.
Many applicants forget to include the Name of Authorized Representative. This person should be able to answer questions about the application. If the representative is an agent, a letter of authorization from the firm is required. Omitting this can lead to confusion and further complications.
Providing an incorrect Product Brand Name is another common error. The name must be exactly as it appears on the label. Any variations, including the use of symbols, can result in the application being rejected.
Some applicants neglect to enter the U.S. EPA Registration Number when required. This number is essential unless the product is exempt from registration. Failure to include it could lead to significant delays in processing the application.
When indicating the Type of California Amendment Action Requested, applicants sometimes fail to provide enough detail. It’s crucial to specify the action clearly and attach a cover letter if necessary. Lack of clarity can result in the application being returned for more information.
Another frequent oversight is not signing the form. The Signature of Authorized Representative is required, along with the printed name and title. An unsigned application will not be processed.
Applicants often forget to include the required amendment application fee of $100. This fee applies to all amendments needing scientific data. Without payment, the application will be considered incomplete.
Inadequate copies of the product labeling can also be an issue. It is necessary to submit six copies, and typescript labeling may be used if final printed labels are not yet available. Not providing enough copies can lead to delays in processing.
Lastly, many people overlook the need for a cover letter. This letter should describe the type of amendment action requested and what is being submitted. Without it, the application may not provide enough context for the reviewers, leading to confusion and potential rejection.
The California DPR 035 form is an essential document for those seeking to amend pesticide product registrations. However, several other forms and documents often accompany this application to ensure compliance with state regulations. Below is a list of these related documents, each with a brief description.
These documents collectively facilitate the amendment process and help ensure that all necessary information is provided to the DPR. Properly preparing and submitting these forms can significantly streamline the registration amendment process.
When filling out the California DPR 035 form, it is essential to follow specific guidelines to ensure your application is processed smoothly. Below is a list of things you should and shouldn't do.
Following these guidelines will help ensure that your application is complete and can be processed in a timely manner. If you have questions, do not hesitate to reach out for assistance.
Understanding the California DPR 035 form can be challenging. Here are ten common misconceptions about this important application form, along with clarifications to help you navigate the process more easily.
By understanding these misconceptions, applicants can better prepare their submissions and navigate the amendment process more effectively.
Key Takeaways for Filling Out and Using the California DPR 035 Form: