Form DP-37 "Dealer's Record of Purchaser of Restricted Use Pesticides" - Arkansas

What Is Form DP-37?

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 October 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-37 by clicking the link below or browse more documents and templates provided by the Arkansas Agriculture Department.

ADVERTISEMENT
ADVERTISEMENT

Download Form DP-37 "Dealer's Record of Purchaser of Restricted Use Pesticides" - Arkansas

Download PDF

Fill PDF online

Rate (4.8 / 5) 93 votes
Form DP-37 (Revised 10-20)
Arkansas Department of Agriculture
Plant Industries Division, Pesticide Section
1 Natural Resources Dr, Little Rock, Arkansas 72205
DEALER’S RECORD OF PURCHASER OF RESTRICTED USE PESTICIDES
Instructions: Complete for sales or distributions of all EPA Restricted Use Pesticides and for Pesticides
classified as “E”, “F”, or “H” under the Arkansas Regulations on Pesticide Classification when purchased
in containers of more than one (1) quart. Records must be retained for two (2) years and be made
available for inspection by representatives of the Plant Board upon request. Dealers are required to
obtain and keep on file a copy of the purchaser’s current license.
Dealer’s Name ___________________________ Address _______________________________
______________________________________________________________________________
License No. ________________ Type of License: Commercial___ Non-Commercial__Private__Dealer__
Date _________ Purchaser’s Name____________________ Address_____________________________
Name and Address of Delivery Location_____________________________________________________
Amount
Name of
EPA Reg.
Name of
Purchased
Product
Number
Manufacturer
License No. ________________ Type of License: Commercial___ Non-Commercial__Private__Dealer__
Date _________ Purchaser’s Name____________________ Address_____________________________
Name and Address of Delivery Location_____________________________________________________
Amount
Name of
EPA Reg.
Name of
Purchased
Product
Number
Manufacturer
License No. ________________ Type of License: Commercial___ Non-Commercial__Private__Dealer__
Date _________ Purchaser’s Name____________________ Address_____________________________
Name and Address of Delivery Location_____________________________________________________
Amount
Name of
EPA Reg.
Name of
Purchased
Product
Number
Manufacturer
License No. ________________ Type of License: Commercial___ Non-Commercial__Private__Dealer__
Date _________ Purchaser’s Name____________________ Address_____________________________
Name and Address of Delivery Location_____________________________________________________
Amount
Name of
EPA Reg.
Name of
Purchased
Product
Number
Manufacturer
Form DP-37 (Revised 10-20)
Arkansas Department of Agriculture
Plant Industries Division, Pesticide Section
1 Natural Resources Dr, Little Rock, Arkansas 72205
DEALER’S RECORD OF PURCHASER OF RESTRICTED USE PESTICIDES
Instructions: Complete for sales or distributions of all EPA Restricted Use Pesticides and for Pesticides
classified as “E”, “F”, or “H” under the Arkansas Regulations on Pesticide Classification when purchased
in containers of more than one (1) quart. Records must be retained for two (2) years and be made
available for inspection by representatives of the Plant Board upon request. Dealers are required to
obtain and keep on file a copy of the purchaser’s current license.
Dealer’s Name ___________________________ Address _______________________________
______________________________________________________________________________
License No. ________________ Type of License: Commercial___ Non-Commercial__Private__Dealer__
Date _________ Purchaser’s Name____________________ Address_____________________________
Name and Address of Delivery Location_____________________________________________________
Amount
Name of
EPA Reg.
Name of
Purchased
Product
Number
Manufacturer
License No. ________________ Type of License: Commercial___ Non-Commercial__Private__Dealer__
Date _________ Purchaser’s Name____________________ Address_____________________________
Name and Address of Delivery Location_____________________________________________________
Amount
Name of
EPA Reg.
Name of
Purchased
Product
Number
Manufacturer
License No. ________________ Type of License: Commercial___ Non-Commercial__Private__Dealer__
Date _________ Purchaser’s Name____________________ Address_____________________________
Name and Address of Delivery Location_____________________________________________________
Amount
Name of
EPA Reg.
Name of
Purchased
Product
Number
Manufacturer
License No. ________________ Type of License: Commercial___ Non-Commercial__Private__Dealer__
Date _________ Purchaser’s Name____________________ Address_____________________________
Name and Address of Delivery Location_____________________________________________________
Amount
Name of
EPA Reg.
Name of
Purchased
Product
Number
Manufacturer