Forms

Titles of Regulations: 2VAC5-670. Regulations Governing Pesticide Product Registration, Handling, Storage, and Disposal under Authority of the Virginia Pesticide Control Act.

2VAC5-675. Regulations Governing Pesticide Fees Charged by the Department of Agriculture and Consumer Services.

2VAC5-680. Regulations Governing Licensing of Pesticide Businesses Operating under Authority of the Virginia Pesticide Control Act.

2VAC5-685. Regulations Governing Pesticide Applicator Certification under Authority of Virginia Pesticide Control Act.

Contact Information: Liza Fleeson Trossbach, Program Manager, Office of Pesticide Services, Department of Agriculture and Consumer Services, P.O. Box 1163, Richmond, VA 23218, telephone (804) 371-6559, or email liza.fleeson@vdacs.virginia.gov.

FORMS (2VAC5-670)

Application for New Pesticide Product Registration, VDACS 07208 (rev. 9/2014)

Application for New Pesticide Product Registration/Additional Information and Instructions, VDACS-07208 (rev. 7/2019)

FORMS (2VAC5-675)

Application for New Pesticide Product Registration/Additional Information and Instructions, VDACS-07208 (rev. 7/2017)

Application for Virginia Pesticide Business License to sell, distribute, store, apply, or recommend pesticides for use, VDACS-07209 (rev. 7/2017)

Application for Reciprocal Pesticide Applicator Certificate/Commercial Pesticide Applicator Categories, VDACS-07210 (rev. 7/2017)

Commercial Pesticide Applicator Certification Application/Eligibility Requirements for Commercial Applicator Certification, VDACS-07211 (rev. 7/2017)

Pesticide Registered Technician Application/General Training Requirements for Registered Technicians, VDACS-07212-A (rev. 7/2018)

Pesticide Registered Technician Request for Authorization to Take Pesticide Applicator Examination, VDACS-07212-B (eff. 7/2018)

Commercial Pesticide Applicator Request for Authorization to Take Pesticide Applicator Examination/Commercial Pesticide Applicator Categories, VDACS-07218 (rev. 7/2017)

Application for New Pesticide Product Registration/Additional Information and Instructions, VDACS-07208 (rev. 7/2019)

Application for Virginia Pesticide Business License to sell, distribute, store, apply, or recommend pesticides for use, VDACS-07209 (rev. 7/2019)

Application for Reciprocal Pesticide Applicator Certificate/Commercial Pesticide Applicator Categories, VDACS-07210 (rev. 7/2019)

Commercial Pesticide Applicator Certification Application/Eligibility Requirements for Commercial Applicator Certification, VDACS-07211 (rev. 7/2019)

Pesticide Registered Technician Application/General Training Requirements for Registered Technicians, VDACS-07212A (rev. 7/2019)

Pesticide Registered Technician Request for Authorization to Take Pesticide Applicator Examination, VDACS-07212B (rev. 7/2019)

Commercial Pesticide Applicator Request for Authorization to Take Pesticide Applicator Examination/Commercial Pesticide Applicator Categories, VDACS-07218 (rev. 7/2019)

FORMS (2VAC5-680)

Application for Virginia Pesticide Business License, Form VDACS-07209 (rev. 9/06).

Application for Virginia Pesticide Business License to sell, distribute, store, apply, or recommend pesticides for use, VDACS-07209 (rev. 7/2019)

Certificate of Insurance, Form VDACS-07214 (rev. 4/96).

Request to take the Virginia Pesticide Business License Examination (rev. 1/09)

Request to take the Virginia Pesticide Business License Examination (rev. 7/2019)

FORMS (2VAC5-685)

Commercial Pesticide Applicator Certification Application - A, Form VDACS-07211 (rev. 9/2016)

Commercial Pesticide Applicator Request for Authorization to Take Pesticide Applicator Examination - B, Form VDACS-07218 (rev. 9/2016)

Commercial Pesticide Applicator Certification Application - A, Form VDACS-07211 (rev. 7/2019)

Commercial Pesticide Applicator Request for Authorization to Take Pesticide Applicator Examination - B, Form VDACS-07218 (rev. 7/2019)

Commercial Pesticide Applicator Certification Exam bubble answer sheet, 2003

Private Pesticide Applicator Certification Exam bubble answer sheet, 2003

Private Pesticide Applicator Request for Authorization to Take Pesticide Applicator Examination at Department of Motor Vehicles Customer Service Center (eff. 1/2009)

Power of Attorney (rev. 9/2016)

Proof of Additional Category Specific Training for Registered Technicians (rev. 8/2016)

Application for Reciprocal Pesticide Applicator Certificate, Form VDACS-07210 (rev. 9/2016)

Pesticide Registered Technician Application Form - RT-A, Form VDACS-07212-A (rev. 9/2016)

Pesticide Registered Technician Request for Authorization to Take Pesticide Applicator Examination – RT-B, Form VDACS-07212-B (eff. 9/2016)

Application for Reciprocal Pesticide Applicator Certificate, Form VDACS-07210 (rev. 7/2019)

Pesticide Registered Technician Application Form - RT-A, Form VDACS-07212-A (rev. 7/2019)

Pesticide Registered Technician Request for Authorization to Take Pesticide Applicator Examination – RT-B, Form VDACS-07212-B (rev. 7/2019)