Form DP-61 "Application for 2,4-d Hardship Permit" - Arkansas

What Is Form DP-61?

This is a legal form that was released by the Arkansas Agriculture Department - a government authority operating within Arkansas. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on September 1, 2020;
  • The latest edition provided by the Arkansas Agriculture Department;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form DP-61 by clicking the link below or browse more documents and templates provided by the Arkansas Agriculture Department.

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Download Form DP-61 "Application for 2,4-d Hardship Permit" - Arkansas

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Form DP-61 (Rev. 9/20)
APPLICATION FOR 2,4-D HARDSHIP PERMIT
Section XI, Paragraph (D) of the Arkansas Regulations on Pesticide Classification does not allow the
application of 2,4-D containing products that are labeled for agricultural use in Clay, Greene, Craighead,
Poinsett, Cross, Crittenden, St. Francis, Lee, Phillips, and Mississippi Counties in Arkansas by ground
th
th
or aerial application between April 16
and September 15
unless a Hardship Permit has been issued by
the Department. Said permit may be applied for by a producer by providing the required information
and submitting the indicated permit fee to the Pesticide Section of the Arkansas Department of
Agriculture.
Please Print
First Name: ____________________ Middle Initial: _____ Last Name: ____________________
Farm Entity: _____________________________________________________________________
Address: _________________________________________________________________________
City: __________________________ State: _________ Zip Code: ____________
Phone: _________________________ Email: __________________________________________
For each field to which 2,4-D containing products are to be applied, complete a FIELD ID form and attach
to this application.
Enter the number of fields for which FIELD ID forms will be completed: ____________
The application for the permit must be on forms authorized by the Plant Board.
The permit must be obtained prior to application and will require a permit application fee.
st
Permit will expire December 31
of each year.
Items to be submitted with this application:
Submit to: Arkansas Department of Agriculture
Plant Industries Division, Pesticide Section
Field ID forms for each field, completed
1 Natural Resources Dr
$100 application fee per farmer
Little Rock, AR 72205
∼ Mail
∼ E-mail
Please indicate how you wish to receive your permit:
I, the undersigned, understand that in addition to the specific requirements for the application of products
assigned to this class, I must also comply with all other applicable State and Federal laws and regulations.
Signed: __________________________________________
Dated: ______________________________
**If you have any questions, please email
pesticide.hardshippermits@arkansas.gov
**
*Please be advised that incomplete or inaccurate information will delay the issuance of the requested permit.
Permit Number:
Issue Date:
Form DP-61 (Rev. 9/20)
APPLICATION FOR 2,4-D HARDSHIP PERMIT
Section XI, Paragraph (D) of the Arkansas Regulations on Pesticide Classification does not allow the
application of 2,4-D containing products that are labeled for agricultural use in Clay, Greene, Craighead,
Poinsett, Cross, Crittenden, St. Francis, Lee, Phillips, and Mississippi Counties in Arkansas by ground
th
th
or aerial application between April 16
and September 15
unless a Hardship Permit has been issued by
the Department. Said permit may be applied for by a producer by providing the required information
and submitting the indicated permit fee to the Pesticide Section of the Arkansas Department of
Agriculture.
Please Print
First Name: ____________________ Middle Initial: _____ Last Name: ____________________
Farm Entity: _____________________________________________________________________
Address: _________________________________________________________________________
City: __________________________ State: _________ Zip Code: ____________
Phone: _________________________ Email: __________________________________________
For each field to which 2,4-D containing products are to be applied, complete a FIELD ID form and attach
to this application.
Enter the number of fields for which FIELD ID forms will be completed: ____________
The application for the permit must be on forms authorized by the Plant Board.
The permit must be obtained prior to application and will require a permit application fee.
st
Permit will expire December 31
of each year.
Items to be submitted with this application:
Submit to: Arkansas Department of Agriculture
Plant Industries Division, Pesticide Section
Field ID forms for each field, completed
1 Natural Resources Dr
$100 application fee per farmer
Little Rock, AR 72205
∼ Mail
∼ E-mail
Please indicate how you wish to receive your permit:
I, the undersigned, understand that in addition to the specific requirements for the application of products
assigned to this class, I must also comply with all other applicable State and Federal laws and regulations.
Signed: __________________________________________
Dated: ______________________________
**If you have any questions, please email
pesticide.hardshippermits@arkansas.gov
**
*Please be advised that incomplete or inaccurate information will delay the issuance of the requested permit.
Permit Number:
Issue Date: