Recordkeeping by Federally-Certified Commercial Applicators in Indian Country

Certification of Pesticide Applicators (Renewal)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 2070-0029 can be found here:

Documents and Forms

Document Name Document Type
Form 8500-17 Recordkeeping by Federally-Certified Commercial Applicators in Indian Country Form and Instruction
8500-17 Request for Pesticide Applicator Certification in Indian Form 8500-17 Fed-cert-plan.pdf Form and Instruction
8500-17-N Request for Pesticide Applicator Certification in Navajo Form 8500-17-N.pdf Form and Instruction
8500-17-N-Instr. Instructions for 8500-17-N Form 8500-17-N-instr.pdf Form and Instruction

Information Collection (IC) Details

IC Title:	Recordkeeping by Federally-Certified Commercial Applicators in Indian Country	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 40 CFR 171.11

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	8500-17	Request for Pesticide Applicator Certification in Indian Country	Form 8500-17 Fed-cert-plan.pdf	Yes	No	Fillable Printable
Form and Instruction	8500-17-N	Request for Pesticide Applicator Certification in Navajo	Form 8500-17-N.pdf	Yes	No	Fillable Printable
Form and Instruction	8500-17-N-Instr.	Instructions for 8500-17-N	Form 8500-17-N-instr.pdf	Yes	No	Fillable Printable

Line of Business: Environmental Management

Subfunction: Pollution Prevention and Control

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 940	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits

Percentage of Respondents Reporting Electronically: 0 %

	Requested	Previously Approved
Annual Number of Responses for this IC	940	940
Annual IC Time Burden (Hours)	2,914	2,914
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.