Forms Available on DPR’s Website
Note: Most of our forms are in PDF format. They can be downloaded and then read using the Acrobat Reader software installed in most computers and also available free from Adobe Systems. When using the free Reader software, you can download and save a blank form without any saved information. You can also fill out and print the form with your data. However, you cannot save a PDF form with information you typed into it unless you have purchased the full version of Adobe Acrobat software.
- Cal/EPA online customer service survey
- DPR feedback form if you have questions about our programs or suggestions on improving our services.
- Publication/video order form, PDF (86 kb) for mail or fax orders of printed publications and videos, most of which are not available online.
Licensing, permitting, use reporting, registration, mill assessment
- Licensing and certification - To apply for, renew, or makes changes to a professional license or certificate. Also continuing education, certificate of insurance, financial responsibility and other miscellaneous licensing forms.
- Permits are required in California for agricultural use of restricted pesticides. These permits are issued by agricultural commissioners in each county, where the forms are available.
- Pesticide use reporting, including notice of intent, monthly summary report, school site reporting, others.
- Registration of pesticide products - All pesticide products must be registered in California before they can be sold or used.
- Mill assessment - Reporting forms for pesticide registrants, licensed pest control dealers, and licensed pesticide brokers.
Aircraft pilot pest control certificate, PDF (63 kb) (PR-PML-005)
Agricultural pest control adviser license, PDF (65 kb) (PR-PML-084)
- Amend pesticide product, PDF (145 kb)
- Maintenance gardener pest control business license , PDF (104 kb)
- Pest control business license, PDF (52 kb) (PR-PML-042)
Pest control dealer designated agent license, PDF (67 kb)
- Pest control dealer license, PDF (107 kb) (PR-PML-041)
- Pesticide broker license, PDF (94 kb) (PR-PML-217)
- Qualified applicator certificate, PDF (85 kb) (PR-PML-001A)
- Qualified applicator license, PDF (82 kb) (PR-PML-001)
- Registration of pesticide product, PDF (150 kb)
(MS Word version, 336 kb), instructions
- Research authorization
- Section 18 emergency exemption request, PDF (126 kb)
- Section 24(c) special local need (SLN) request, PDF (58 kb)
- Structural pest control device registration, PDF (35 kb)
- Voluntary cancellation of pesticide product registration, PDF (99 kb)
- County Agricultural Commissioner (CAC) forms used by CACs for inspections, violation notices, other county enforcement activities.
- E-mail subscription to different electronic mailing lists that send news releases, regulatory notices, public notices, program updates or other postings made to our Web site. By subscribing, you will receive periodic E-mail notices when new information has been posted to your area of interest.
- IPM Innovator Award nomination forms, to nominate an individual or group for DPR’s annual awards that honor those that emphasize pest prevention, favor least-hazardous pest management, and share their successful strategies with others. Due on March 31 of each year.
- Pesticide illness report required to be filed by physicians who believe a patient has been made ill by pesticide exposure.
- School IPM - Sample forms and templates to assist schools in complying with the Healthy Schools Act.