Pesticide Forms

PESTICIDE APPLICATIONS

Application for License of Pesticides and Non-Chemical Pest Control Devices – Use this form for new product licensing including products whose name or formulation has changed. Submit one application along with a copy of the Confidential Statement of Formula, the EPA Stamped approved label, the final printed label and a payment of $330.00 for each product.  See “Instructions for Form P-2” for additional requirements.

Application for License Renewal of Pesticides – Use this form for requesting pesticide license renewal. Submit one renewal application along with a payment of $330.00 for each product license being renewed. Submit one copy of any revised labels. If revisions involve a change in the product name or formulation, submit a Form P-2 for licensing as a new product.

For discontinued products, licenses must be maintained for three years following written notification to the Pesticides Branch; or until there is no remaining stocks in the channels of trade.  See “Instructions for Form P-1” for additional requirements.

Electronic Submissions – While P-2 and P-1 forms (reflecting an original signature), and payment of licensing fees must be submitted via regular mail, electronic submission of supporting documents is preferred.  We ask that documents be in pdf format and without any security to allow insertion of our licensing stamp.  A copy of the license certificate, label and receipt for payment will then be e-mailed back to you.  Even if not making electronic submissions, please be sure to include the e-mail address of the responsible party on the P-2 and P-1 forms.

Electronic submissions may be sent to the following e-mail address: hdoapestreg@hawaii.gov

Experimental Use Permit (EUP) Application – Complete this form for conducting trials involving the evaluation of pesticides to determine the scope and limitations of its usefulness and the effect of its use on humans and the environment.  (See Administrative Rules, Section 4-66-45 through 4-66-51 for specific EUP requirements)

Restricted Use Pesticide (RUP) Sales Record Form – For use by RUP dealers.  (Not for hydrated lime sales.)

APPLICATORS AND RUP DEALER REPRESENTATIVE CERTIFICATION / RECERTIFICATION

Examinations are normally administered once a week.  Contact your district pesticide branch office (indicated on the application) to schedule an examination date.  Examination fees are as follows:

$25.00 per examination

$50.00 per initial certification card issued

$25.00 per replacement card

Form P-18.1   Application for Certification / Recertification of Private Applicators

Form P-17.1   Application for Certification / Recertification of Commercial Applicators

Form P-28-1   Application For RUP Dealer Representative License 

Form P-28-2   Application For RUP Dealer Representative License Renewal

(Last updated February 15, 2011)

 

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