Form 8570-32

United States Environmental Protection Agency
Washington, D.C. 20460
CE RT IFICAT ION OF ATT EM PT TO ENTE R IN TO AN
AGREEMENT WITH REGISTRANTS FOR
DEVELOPMENT OF DATA

OMB Control No.
2070-0174
Expiration Date
12/31/2025

Paperwork Reduction Act Notice: This collection of information is approved by OMB under the Paperwork Reduction Act, 44
U.S.C. 3501 et. seq. OMB Control No. 2070-0174. Responses to this collection of information are mandatory 40 CFR 158. An
agency may not conduct or sponsor, an a person is not required to respond to, a collection of information unless it displays a
currently valid OMB control number. The public reporting and record keeping burden for this collection of information is estimated
15 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 to the Regulatory Support Division Director, U.S.
Environmental Protection Agency (2821T), 1200 Pennsylvania Ave., NW, Washington, D.C. 20460. Include the OMB control
number in any correspondence. Do not send the completed form to this address.

Please fill in blanks below

Company Name

Company Number

Chemical Name

EPA Chemical Number

I Certify that:
My company is willing to develop and submit the data required by EPA under the authority of the Federal Insecticide,
Rodenticide and Fungicide Act (FIFRA), if necessary. However, my company would prefer to enter into an agreement
with one or more registrants to develop jointly or share in the cost of developing data.
My firm has offered in writing to enter into such an agreement. That offer was irrevocable and included an offer to be
bound by arbitration under section 3(c)(2)(B)(iii) of FIFRA if final agreement on all terms could not be reached
otherwise. This offer was m ade to the following firm (s) on the following date(s):
Name of Firm(s)

Date of Offer

Certification:
I certify that I am duly authorized to represent the company name above, and that the statements that I have made on
this form and all attachments therein are true, accurate and complete. I acknowledge that any knowingly false or
misleading statement may be punishable by fine or imprisonment or both under applicable law.
Signature of Company’s Authorized Representative

Name and Title (Please Print or Type)

EPA Form 8570-32

Date