Forms Related To Pesticides
Following is a compilation of forms relating to pesticides management.
Online Forms
Several pesticide forms are now available using DEC's online form tool, nForm. Users must have an NY.gov account to use nForm. Instructions on creating an account can be found here. nForm requires the use of one of the following browsers: Chrome, FireFox, or Microsoft Edge. The following forms are available online:
- Pesticide Applicator and Technician Renewal - Form for renewing/recertifying an applicator/technician
- Pesticide Certification Exam Registration - Registration form to sit for the Pesticide Certification Exam
- Request a Replacement Certification Identification Card or Update Contact Information - Form for changing an applicator's contact information and for requesting a replacement card
- Pesticide Business or Agency Registration Application - For applying for a new business or agency registration or renewing an existing registration
- Commerical Permit Application - For applying for a new commercial permit to sell or distribute restricted use pesticides or renew an existing permit
Printable Forms
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)
- Recordkeeping Example (PDF - 27 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.
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.
- Business Registration Address Change Form (PDF, 56 KB)
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.
Contact for this Page
DMM, Bureau of Pesticides Management
625 Broadway
Albany, NY 12233-7254
Phone: 518-402-8748
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