United States Environmental Protection Agency

Instructions for Completing EPA Form 3540-8

Application for Registration of

Pesticide-Producing and Device-Producing Establishment

Purpose of Form

This form is used to register establishments that produce pesticides,
devices and active ingredients within the United States and that import
into the United States.

Information submitted by respondents is used to issue establishment
registration numbers.  EPA uses this information to identify producing
establishments and ensure that pesticides or devices produced in the
United States or imported into the United States are in compliance with
Federal Insecticide, Fungicide and Rodenticide Act (FIFRA). 

Authority to Request Information

FIFRA section 7 (7 USC section 136e) requires any person producing any
pesticide, device or active ingredient used in producing a pesticide in
the United States or imported into the United States to be registered
with the Agency.  (Hereinafter “producing establishment.”)  The
owner of a producing establishment must register as required by 40 CFR
Part 167.  The information must be submitted on the Application for
Registering a Pesticide-Producing and Device-Producing Establishments
(EPA Form 3540-8). 

EPA requires information contained in this application to identify the
person(s) legally responsible for pesticides, devices or substances to
be used as an active ingredient of a pesticide.  EPA must ensure that
pesticides, devices and active ingredients are manufactured in a way
that protects human health and the environment as required by FIFRA. 

The public reporting and recordkeeping burden for this collection of
information is estimated to average 18 minutes per response.  Send
comments on the Agency's need for this information, the accuracy of the
provided burden estimates, and any suggested methods for minimizing
respondent burden, including through the use of automated collection
techniques to the Director, Collection Strategies Division, U.S.
Environmental Protection Agency (2822T), 1200 Pennsylvania Ave., NW,
Washington, DC 20460.  Include the OMB control number in any
correspondence.  Do not send the completed 3540-8 form to the above
address.

Who Must Submit this Form

Any establishment (Hyperlink to 40 CFR Part 167.3  SEQ CHAPTER \h \r 1 )
must register if it produces, packages, repackages, labels or relabels a
pesticide, device or substances used as an active ingredient of a
pesticide.  Registration must occur before production or distribution
takes place.  .

Any establishment where a substance is produced, packaged, repackaged,
labeled or relabeled must register with EPA if the producer intends that
substance to be used as an active ingredient of a pesticide.  If the
producer has actual or constructive knowledge that the substance will be
used by any person as an active ingredient of a pesticide, it must
register with EPA before production or distribution takes place. 

Any domestic establishment producing a pesticide, device, active
ingredient or any unregistered pesticide for export must register before
production or distribution takes place.

Any foreign establishment producing a pesticide, device or active
ingredient for import into the United States must register before
production or distribution takes place.

Any establishment, either foreign or domestic, that produces a pesticide
or device for use under a section 5 of FIFRA—Experimental Use Permit,
section 18 of FIFRA—Emergency Exemption or section 24(c) of
FIFRA—Special Local Need registrations must register before production
or distribution takes place.

NOTE	Custom blenders are exempt from the establishment registration
requirement.  Please see the   SEQ CHAPTER \h \r 1 Pesticide
Establishment Registration and Reporting Questions for more information.
 (http://www.epa.gov/compliance/resources/faqs/monitoring/fifra/estab-bl
end.html) 



General Instructions

Read all instructions before completing this form.

Print in ink or type when completing the form.  If you would like to
complete this form electronically, an interactive PDF version is
available at: 
http://www.epa.gov/compliance/monitoring/programs/fifra/establishments.h
tml.

You must obtain an EPA Company Number from EPA’s Office of Pesticides
Programs (OPP) before submitting this application.  Information on
obtaining an EPA Company Number is available at      (OPP’s URL)     .

  SEQ CHAPTER \h \r 1 Submit a copy of the letter from OPP (Assignment
of New EPA Company Number) and the completed EPA Form 3540-8 to the
correct EPA Regional or Headquarters contact where your company
headquarters is located.  (See Attachment 1).

If you need additional information about your responsibilities as a
pesticide or device producing establishment, please see Pesticide
Establishment—Registration and Reporting Questions at: 
http://www.epa.gov/compliance/resources/faqs/monitoring/fifra/establishq
anda.html.

If after reading these instructions, you have further questions about
completing the EPA Form 3540-8, please contact the applicable EPA
Regional or Headquarters contact.  (See Attachment 1).

Regulations regarding books and records of pesticide and device
production and distribution can found at 40 CFR Part 169 (Hyperlink  SEQ
CHAPTER \h \r 1 ).

How to Complete the Application Form

	Company Information

Item 1—Company Name:  Provide the legal name of your company as given
to the Office of Pesticide Programs (OPP).

Item 2—EPA Company Number:  Provide your EPA FIFRA Company Number as
assigned by OPP.  

Item 3—Company Name (doing business as):  If you operate your company
under a different name than that listed in Item 1 (i.e., doing business
as), please list it here.  For foreign establishments, the phrase
“trading as” is equivalent to “doing business as.”

Items 4 to 7—Site Address:  Please provide the physical address of the
company headquarters office of the producing establishment.  For foreign
establishments, zip code is equivalent to postal code, post code or
postcode.

Items 8 to 11—Mailing Address:  Please provide the mailing address
where EPA can contact you about your registered establishments.  For
foreign establishments, zip code is equivalent to postal code, post code
or postcode.  Note:  This address may be different than the address you
used to obtain your company number.

NOTE	Country codes are listed on Attachment 3 of these instructions or
are available at:

http://www.epa.gov/compliance/resources/publications/monitoring/fifra/fg
nestablishments.html



Item 12—Phone Number:  Please enter the telephone number, including
country code, EPA should use to contact you about your pesticide
establishments.

Item 13—Ownership Code:  Please enter the appropriate ownership code:

01—Individual 

02—Partnership 

03—Cooperative Association 

04—Corporation 

05—Other

Item 14—eMail:  Please enter your eMail address (optional).

Item 15—  SEQ CHAPTER \h \r 1 State or Country of Incorporation (if
incorporated):  Please enter the appropriate   SEQ CHAPTER \h \r 1
two-letter state abbreviation or three-letter foreign country
abbreviation where the company is incorporated.  (See Attachments 2 and
3)

	Authorized Agent (For Foreign Companies Only) (if applicable).

Item 16—Authorized Agent:  If you are the designated authorized agent
and you are submitting an application for the foreign company indicated
in Item 1, provide your name, address, etc.  [See 40 CFR Part
152.50(3)].

NOTE	  SEQ CHAPTER \h \r 1 If a foreign company official elects an
Authorized Agent to represent their company, they must specify the
designation on their company letterhead (translated into English). 
Provide the authorized agent’s company name, mailing address and
telephone number details in the letter.  Attach the letter to the
application request (EPA Form 3540-8).



Items 17— Authorized Agent Organization Name:  As the designated
authorized agent, provide your company name.

Items 18 to 21—Mailing Address:  Please provide the mailing address
where EPA can contact you on behalf of the foreign company. 

Item 22—Phone Number:  Please enter the telephone number EPA should
use to contact you about the pesticide establishments.

Item 23—eMail:  Please enter your eMail address (optional).

Signature Certification

Items 24 and 25—Name and Title of Company Official and/or Authorized
Agent:  Please enter the name and title of the person who is responsible
for the establishment to the requirements of FIFRA section 7.  Note:  If
you are the authorized agent submitting this application, please enter
your name and title. 

Items 26 and 27—Signature of Company Official and/or Authorized Agent:
 The company official and/or authorized agent listed in Item 24 must
sign and date the application in order for it to be processed.  Note: 
If you are the authorized agent listed in Item 16—23, you must sign
and date the application in order for it to be processed.

Establishment Information

NOTE	Please complete Items 28 through 34 for each producing
establishment you wish to register with EPA.  You may register
establishments in multiple states on this form.  



Item 28—Establishment Name:  Please enter the name of the
establishment being registered with EPA. 

NOTE	Each establishment registered must be owned and operated by the
company identified in Item 1.



Items 29 to 32—Site Address:  Please provide the physical address, not
a post office box or route number, where your establishment is located. 
For foreign establishments, zip code is equivalent to postal code, post
code or postcode.

Items 33 to 36—Mailing Address:  Please provide the mailing address
for the establishment if different from the site address (if identical
to above, write SAME).

Item 37—Phone Number:  Please enter the phone number for the
establishment.  For foreign establishments, please provide the country
code.

Item 38—eMail:  Please enter an eMail address EPA can use to contact
the establishment (optional).

  SEQ CHAPTER \h \r 1 Before You Submit Your Application:

Did you enter your company number received from the Office of Pesticides
Programs?

Did you remember to sign your application?

Did you include your company Ownership code?

If you are designating an authorized agent, is the letter attached?

Did you include all the Authorized Agent information?

Are you sending your establishment applications to the correct Regional
or Headquarters contact?  (See Attachment 1)

If you are changing or electing an Authorized Agent for your Company,
did you also notify the Office of Pesticide Programs as required?

If more than one page is used to list establishments, please complete
the statement, "This is page ___ of ___."

  SEQ CHAPTER \h \r 1 Please proofread your application before
submittal.  Errors in your application will delay the process.

Where Should I Send my Completed Application?

Domestic producers should submit the application to the EPA Regional
Office where your company headquarters is located (Item 6).  (See
Attachment 1). 

Foreign producers should submit the application to the EPA office in
Washington, DC (Item 6).  If the authorized agent is listed, EPA will
send the notification to the authorized agent (Item 16).  (See
Attachment 1).

What Happens after I File this Application?

Upon receipt of the completed application, EPA will assign a unique
number to each establishment listed and notify the company of the
registration. 

You must submit an initial report on EPA Form 3540-16 (Pesticide Report
for Pesticide-Producing and Device-Producing Establishments)
(http://www.epa.gov/compliance/monitoring/programs/fifra/establishments.
html) to   SEQ CHAPTER \h \r 1 EPA within 30 days after receipt of
notification of establishment registration.  Failure to file the initial
report is an unlawful act and may result in termination of the
establishment’s registration or a civil penalty assessment.  In
addition to the initial report, an annual report is due to EPA by March
1 of every year.

Each producing establishment must place its assigned EPA establishment
number on the immediate container or label of each pesticide, device or
active ingredient produced. 

Your registration will remain effective as long as you file an annual
production report (EPA Form 3540-16) with the Agency.  You may contact
EPA on your letterhead requesting that your establishment registration
be terminated.  Failure to report annually as required may result in
termination of your establishment’s registration or a civil penalty
assessment (40 CFR Part 167).

When Should   SEQ CHAPTER \h \r 1 my Company or Establishment
Information be Revised?

If any information changes after you file your application, you must
report to EPA those changes in writing on company letterhead or on EPA
Form 3540-8 within 30 days.  If you inform us using 3540-8, please
specify what information has changed. 
(http://www.epa.gov/compliance/monitoring/programs/fifra/establishments.
html). 

Attachments

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