EPA form 8570-5

Please Read All Instructions Before Completing this Form (Form must be typed)

Form Approved. OMB. No. 2070-0044

Paperwork Reduction Act Notice
The respondent paperwork burden for the Notice of Supplemental Distribution of a
Registered Pesticide Product is estimated to be approximately 15 minutes per response, including
time for reviewing the instructions; searching existing data sources, gathering and maintaining
the data needed, and completing and reviewing the information. Send any commentsregarding
the burden estimate or any other aspect ofthis collection of information, including suggestionsfor
reducing this burden to: Director, Collection Strategies Division, 1200 Pennsylvania Avenue,
N.W., Washington, DC 20460; and to: Office of Management and Budget, Paperwork Reduction
Act Project (2070-0044), Washington, DC 20503, marked “Attention: Desk Officer for EPA.”