Form DP-69B "Field Id Form for Dicamba Permit" - Arkansas

What Is Form DP-69B?

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-69B by clicking the link below or browse more documents and templates provided by the Arkansas Agriculture Department.

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Download Form DP-69B "Field Id Form for Dicamba Permit" - Arkansas

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Form DP-69B (Rev. 9/20)
FIELD ID FORM for DICAMBA
(A separate form must be filled out for each field)
(Make copies as needed)
Applicant Name: ________________________________________________
Farm Entity: ___________________________________________________
Field Name or Number:
County:
Number of Acres:
Crop Planted:
Planting Date:
GPS Coordinates in decimal degrees at the primary entrance of field:
Important: GPS Coordinates are required in Decimal Degree Format!
Example: Latitude 34.5862171 Longitude -94.2396554
Latitude:
Longitude:
Distance (feet or miles) and Direction
to any susceptible non Dicamba tolerant crops:
Number of prior in crop dicamba applications made to this field to date:
Describe in sufficient detail (other than cost) why Dicamba alternatives will not be practical at this location:
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
**PLEASE SUBMIT RECORDS TO
pesticide.hardshippermits@arkansas.gov
**
*Please be advised that incomplete or inaccurate information will delay the issuance of the requested permit.
Form DP-69B (Rev. 9/20)
FIELD ID FORM for DICAMBA
(A separate form must be filled out for each field)
(Make copies as needed)
Applicant Name: ________________________________________________
Farm Entity: ___________________________________________________
Field Name or Number:
County:
Number of Acres:
Crop Planted:
Planting Date:
GPS Coordinates in decimal degrees at the primary entrance of field:
Important: GPS Coordinates are required in Decimal Degree Format!
Example: Latitude 34.5862171 Longitude -94.2396554
Latitude:
Longitude:
Distance (feet or miles) and Direction
to any susceptible non Dicamba tolerant crops:
Number of prior in crop dicamba applications made to this field to date:
Describe in sufficient detail (other than cost) why Dicamba alternatives will not be practical at this location:
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
**PLEASE SUBMIT RECORDS TO
pesticide.hardshippermits@arkansas.gov
**
*Please be advised that incomplete or inaccurate information will delay the issuance of the requested permit.