Pesticide Report for Pesticide-Producing and Device-Producing Establishments (EPA Form 3540-16)

Pesticide Establishment Application, Notification of Registration, and Pesticide Production Reports for Pesticide-Producing and Device-Producing Establishments (Renewal)

Documents and Forms

Document Name Document Type
Form 3540-16 Pesticide Report for Pesticide-Producing and Device-Producing Establishments (EPA Form 3540-16) Form
Form 3540-16 Instructions (Example - Reporting Year 2022).pdf www.epa.gov/compliance/epa-form-3540-16-pesticide-report-pesticide-producing-and-device-producing Instruction
Form 3540-16 Instructions (Example - Reporting Year 2022).pdf www.epa.gov/compliance/epa-form-3540-16-pesticide-report-pesticide-producing-and-device-producing Instruction
3540-16 Pesticide Reports for Pesticide-Producing and Device-Pro Form 3540-16 (Example - Reporting Year 2022).pdf www.epa.gov/compliance/epa-form-3540-16-pesticide-report-pesticide-producing-and-device-producing Form
3540-16 Pesticide Reports for Pesticide-Producing and Device-Pro Form 3540-16 (Example - Reporting Year 2022).pdf www.epa.gov/compliance/epa-form-3540-16-pesticide-report-pesticide-producing-and-device-producing Form

Information Collection (IC) Details

IC Title:	Pesticide Report for Pesticide-Producing and Device-Producing Establishments (EPA Form 3540-16)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Mandatory

CFR Citation: 40 CFR 167

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	3540-16	Pesticide Reports for Pesticide-Producing and Device-Producing Establishments	Form 3540-16 (Example - Reporting Year 2022).pdf	https://www.epa.gov/compliance/epa-form-3540-16-pesticide-report-pesticide-producing-and-device-producing	Yes	Yes	Fillable Fileable Signable
Instruction			Form 3540-16 Instructions (Example - Reporting Year 2022).pdf	https://www.epa.gov/compliance/epa-form-3540-16-pesticide-report-pesticide-producing-and-device-producing	Yes	Yes	Printable Only

Line of Business: Environmental Management

Subfunction: Environmental Monitoring and Forecasting

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 20,607	Number of Respondents for Small Entity: 4,121

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

Percentage of Respondents Reporting Electronically: 92 %

	Approved	Change Due to Adjustment in Agency Estimate	Previously Approved
Annual Number of Responses for this IC	20,607	5,544	15,063
Annual IC Time Burden (Hours)	31,103	4,887	26,216
Annual IC Cost Burden (Dollars)	0	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.