Application for Registration of Pesticide-Producing and Device-Producing Establishments ((EPA Form 3540-8)

OMB Control No. 2070-0078
Expires on 1/31/2020

United States Environmental Protection Agency

Instructions for Completing EPA Form
3540-8 Application for Registration of
a Pesticide-Producing and DeviceProducing 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 also 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 the 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.
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Who Must Submit this Form
•

Any establishment 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

A facility where only custom blending activities take place is not considered a pesticide-producing
establishment and therefore does not need to be registered. Please see the Pesticide
Establishment Registration and Reporting FAQ for more information.
https://compliancegov.zendesk.com/hc/en-us/categories/201457388

Optional Electronic Registration (New Domestic Establishments Only)
EPA has created an optional electronic reporting system for pesticide establishments using the Section
Seven Tracking System (SSTS). Once registered pesticide establishments will be able to use EPA’s Central
Data Exchange (CDX) to quickly register new establishments (EPA Form 3540-8) and/or submit Annual
Pesticide Production Reports (EPA Form 3540-16).
To sign up for electronic reporting, go to: https://www.epa.gov/compliance/electronic-reportingpesticide-establishments.

General Instructions
•

Read all instructions before completing this form.

•

Registering an establishment is only required once.

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•

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://www2.epa.gov/compliance/epaform-3540-8-application-registration-pesticide-producing-and-device-producing.

•

You must obtain an EPA Company Number from EPA’s Office of Pesticides Programs (OPP)
before submitting this application. Please see http://www2.epa.gov/pesticideregistration/pesticide-registration-manual-how-obtain-company-number-and-register-official
for information on obtaining an EPA Company Number.

•

Once you have obtained the EPA company number, then you must submit an EPA Form 3540-8
(Application for Registration of Pesticide-Producing and Device-Producing Establishment) to the
applicable EPA office where your company Headquarters office is located to obtain the EPA
establishment registration number. For assistance in completing the Form, please contact the
pesticide establishment coordinator in your area. (See Page 7).
https://www.epa.gov/compliance/pesticide-establishment-registration-and-reporting-contacts

•

If you need additional information about your responsibilities as a pesticide or device producing
establishment, please see Pesticide Establishment—Registration and Reporting Questions at:
https://compliancegov.zendesk.com/hc/en-us/categories/201457388

•

Regulations regarding books and records of pesticide and device production and distribution can
found at 40 CFR Part 169.

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 9—Site Address: Please provide the physical address of the company headquarters
office of the producing establishment.

•

Items 10 to 15—Mailing Address: Please provide the mailing address where EPA can contact you
about your registered establishments. For foreign establishments, if identical to above, write
SAME. Note: This address may be different than the address you used to obtain your company
number.

NOTE

Country Codes for Foreign Pesticide Establishments are available at:
http://www2.epa.gov/compliance/country-codes-foreign-pesticide-establishments

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Item 16—Phone Number: Please enter the telephone number, including country code, EPA
should use to contact you about your pesticide establishments.

•

Item 17—eMail: Please enter your email address (optional).

Authorized Agent (if applicable)
•

Item 18—Authorized Agent Name: If you are the designated authorized agent and you are
submitting an application on behalf of the company (including foreign) indicated in Item 1, provide
your name, address, etc. [See 40 CFR Part 152.50(3)]

•

An authorized agent must include a copy of the “letter of agent” (LOA) on company letterhead,
signed and dated by the authorized foreign company official. The letter statement must be
translated into English, especially the name, title, email address and telephone number of the
authorized foreign company official.

NOTE

If a foreign company official changes or 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).
In addition, all companies should send a copy of the letter to the Office of Pesticides Programs. It
may be fax to 703-305-7670. https://www.epa.gov/pesticide-registration/pesticide-registrationmanual-how-report-changes-company-name-or-address

•

Items 19— Authorized Agent Organization: As the designated authorized agent, provide your
company name.

•

Items 20 to 23—Mailing Address: Please provide the mailing address where EPA can contact you
on behalf of the company and/or establishment.

•

Item 24—Phone Number: Please enter the telephone number EPA should use to contact you
about the pesticide company and/or establishments.

•

Item 25—Email: Please enter your email address.

Signature Certification
•

Items 26 and 27—Name and Title of Company Official 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 28 and 29—Signature of Company Official or Authorized Agent: The company official
and/or authorized agent listed in Item 26 must sign and date the application in order for it to be
processed. Note: If you are the authorized agent listed in Item 18—25, you must sign and date
the application in order for it to be processed.

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Establishment Information
NOTE

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NOTE

OMB Control No. 2070-0078
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Please complete Items 30 through 46 for each producing establishment you wish to register with EPA.
You may register establishments in multiple states on this form.

Item 30—Establishment Name: Please enter the name of the establishment being registered with
EPA.
Each establishment requesting to be registered must be operated by the company identified in Item 1.

•

Items 31 to 38—Site Address: Please provide the physical address, not a post office box or route
number, where your establishment is located.

•

Items 39 to 44—Mailing Address: Please provide the mailing address for the establishment if
different from the site address (if identical to above, write SAME).

•

Item 45—Phone Number: Please enter the phone number for the establishment. For foreign
establishments, please provide the country code.

•

Item 46—eMail: Please enter an email address EPA can use to contact the establishment.

Before You Submit Your Application:
•

Did you enter your company number received from the Office of Pesticides Programs? (Item 2)

•

Did you remember to sign your application? (Item 26) If you submit your application through
email you must still print and sign the form with a “wetink signature”, then scan the form and
email as a PDF.

•

If you are designating an Authorized Agent, is the letter attached? (See note at Item 18)

•

Did you include all the Authorized Agent information? (Item 18—25)

•

Are you sending your establishment applications to the correct Regional or Headquarters contact?
(See Page 7)

•

If you are changing or electing an Authorized Agent for your Company and/or Establishment, did
you also notify the Office of Pesticide Programs? (See note at Item 18)

•

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

•

Please proofread your application before submittal. Errors in your application will delay the
process.

•

Be sure to include all pages when you submit your EPA Form 3540-8.
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FOR FOREIGN COMPANIES- Please make certain that the foreign company who is registering the
potential pesticide-producing establishment wholly owns and/or operates the facility that is
being registered on the application (EPA Form 3540-8).

•

Where Should I Send my Completed Application?
•

Domestic producers should submit the application to the EPA Regional Office where your
company headquarters is located either by mail or email as a PDF. If you submit your application
through email you must still print and sign the form with a “wetink signature”, then scan the
form and email as a PDF (See Page 7)

•

Foreign producers should submit the application to the EPA office in Washington, DC either by
mail or email as a PDF. If the authorized agent is listed, EPA will send the notification to the
authorized agent. (See Page 7)

What Happens after I File this Application?
•

Upon receipt of the completed application, EPA will assign a unique number to each establishment
registered and notify the company or authorized agent of the registration(s).

•

You must submit an initial report on EPA Form 3540-16 (Pesticide Report for Pesticide-Producing and
Device-Producing Establishments) (http://www2.epa.gov/compliance/epa-form-3540-16-pesticidereport-pesticide-producing-and-device-producing-establishments) to 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. You may also submit
initial and annual reports electronically, go to: https://www.epa.gov/compliance/electronicreporting-pesticide-establishments

•

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. If you wish to terminate your establishment registration, please send a
letter to EPA using your company letterhead with the request. 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 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, which can be mailed or emailed as a PDF to
your EPA Pesticide Establishment Coordinator. If you inform us using 3540-8, please specify what
information has changed: https://www.epa.gov/compliance/epa-form-3540-8-application-registrationpesticide-producing-and-device-producing

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Where to Submit Applications

OMB Control No. 2070-0078
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DOMESTIC PRODUCERS:

Submit applications to the following EPA Regional Office where
your company headquarters is located.

EPA Regional Offices

States/Terr.
Covered

EPA Regional Offices

U.S. EPA Region 1
Email as PDF: tham.kan@epa.gov
Kan Tham (3540-8)
Toxics and Pesticides Unit (OES 05-4)
5 Post Office Square, Suite 100
Boston, MA 02109-3912
Telephone: 617-918-1872

U.S. EPA Region 6
CT, MA
ME, NH
RI, VT

Email as PDF: ruple.chuck@epa.gov
Chuck Ruple (3540-8)
Pesticides Section (6MM-XP)
1445 Ross Avenue
Dallas, TX 75202-2733
Telephone: 214-665-6534

U.S. EPA Region 2
Email as PDF: Kramer.Michael@epa.gov

Email as PDF: boatman.brandon@epa.gov

U.S. EPA Region 8
DC, DE
MD, PA
VA, WV

Email as PDF: ross.carol@epa.gov
Carol Ann Ross (3540-8)
FIFRA Division (8ENF-AT-TP)
1595 Wynkoop
Denver, CO 80202
Telephone: 303-312-6018

U.S. EPA Region 4
Email as PDF: R4_Section_7_Team@epa.gov
Pesticide Reports Contact (3540-8)
Pesticides Section
Sam Nunn Atlanta Federal Center, 12th Floor
61 Forsyth Street, SW
Atlanta, GA 30303
Telephone: 404-562-9090

Pesticide Reports Contact (3540-8)
Pesticides & Toxics Compliance Section (LC-17J)
77 West Jackson Boulevard
Chicago, IL 60604
Telephone: 312-886-0270

CO, MT
ND, SD
UT, WY

U.S. EPA Region 9
AL, FL
GA, KY
MS, NC
SC, TN

Email as PDF: mcwhorter.scott@epa.gov
Scott McWhorter (3540-8)
FIFRA Section (ENF 3-3)
75 Hawthorne Street
San Francisco, CA 94105-3901
Telephone: 415-972-3584

U.S. EPA Region 5
Email: reg5pesticidereportscontact@epa.gov

IA, KS
MO, NE

Brandon Boatman (3540-8)
Pesticides Section (WWPD/TOPE/PEST)
11201 Renner Boulevard
Lenexa, KS 66219
Telephone: 913-551-7993

U.S. EPA Region 3
Christine Convery (3540-8)
Pesticides and Asbestos Programs Branch (3LC42)
1650 Arch Street
Philadelphia, PA 19103-2029
Telephone: 215-814-2249

AR, LA
NM, OK
TX

U.S. EPA Region 7
NJ, NY
PR, VI

Michael Kramer (3540-8)
Pesticides Team (MS-500)
2890 Woodbridge Avenue
Edison, NJ 08837-3679
Telephone: 732-321-6610
Email: R3_Pesticide_Establishments@epa.gov

States/Terr.
Covered

AZ, CA
GU, HI
MP, NV

U.S. EPA Region 10
IL, IN
MI, MN
OH, WI

Email as PDF: landry.andrew@epa.gov

AK, ID
OR, WA

Andrew Landry (3540-8)
Pesticides and Toxics Unit (OCE-101)
1200 Sixth Avenue, Suite 900
Seattle, WA 98101-1128
Telephone: 206-553-1504

FOREIGN PRODUCERS: Submit applications to the following EPA Washington, DC address:
Email as PDF: HQPesticideEstablishments@epa.gov
Email as PDF: HQPesticideEstablishments@epa.gov
U.S. Postal Service Mail Address
Foreign Pesticide Reports Contact (3540-8)
U.S. Environmental Protection Agency
Pesticides, Waste & Toxics Branch (2227A)
1200 Pennsylvania Avenue, NW Washington,
DC 20460-0001 USA
Telephone: 202-564-2084

Courier Delivery Address
Foreign Pesticide Reports Contact (3540-8)
U.S. Environmental Protection Agency
William J. Clinton Building—South
1200 Pennsylvania Avenue, NW, Room 7119B
Washington, DC 20004 USA

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