Form DPR-REG-031 "Notification of Minor Changes" - California

What Is Form DPR-REG-031?

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

Form Details:

  • Released on October 1, 2015;
  • The latest edition provided by the California Department of Pesticide Regulation;
  • 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 fillable version of Form DPR-REG-031 by clicking the link below or browse more documents and templates provided by the California Department of Pesticide Regulation.

ADVERTISEMENT
ADVERTISEMENT

Download Form DPR-REG-031 "Notification of Minor Changes" - California

1022 times
Rate (4.3 / 5) 72 votes
State of California
NOTIFICATION OF
DPR USE ONLY:
Department of Pesticide Regulation
Tr. ID#
MINOR CHANGES
Notification of Minor Changes
DPR-REG-031 (Rev. 10/15)
Reg. No.
Page 1 of 2
R.S. Assigned
Applicant Information
Important: Read all instructions before completing this form
1. Firm Name
2. Mailing Address of Firm
City
State
Zip Code
Check box if new address
City
State
Zip Code
3.
Street Address (if different from above) or
Agent Address
4. Name of Authorized Representative/Agent
5. Telephone Number of Representative/Agent
6. Fax Number
7. E-mail Address
8. Product Brand Name (exactly as shown on label)
9. U.S. EPA or CA Registration Number
10. Type of California notification action requested (check all applicable)
Delete redundant label statements
Delete pests or delete use sites
Add symbols or graphics
Add indoor nonfood sites for certain antimicrobial products
Correct typographical or grammatical errors
Add or include U.S. EPA Pesticide Registration Notice specified
wording
Redesign label format
Change in stated nominal concentration of inert ingredient
Change size/content of child-resistant packaging
Change Non-FIFRA related label elements
Change warranty statement
Note: Products distributed or sold that do not meet the DPR notification process criteria are considered unregistered and subject
to enforcement action.
I certify, under penalty of perjury, that all information submitted on this notification is accurate and complete.
X
/
/
Signature of Authorized Representative/Agent
Type or Print Name and Title
Date Signed
DPR USE ONLY:
Mail completed application to:
RC #
For correspondence only:
Department of Pesticide Regulation
Fee $
Pesticide Registration Branch
P.O. Box 4015
RC Date
Sacramento, California 95812-4015
Date Received
For package deliveries, FedEx, etc.:
Department of Pesticide Regulation
OK by
Date Licensed
Pesticide Registration Branch
1001 I Street
Returned
Sacramento, California 95814-2828
State of California
NOTIFICATION OF
DPR USE ONLY:
Department of Pesticide Regulation
Tr. ID#
MINOR CHANGES
Notification of Minor Changes
DPR-REG-031 (Rev. 10/15)
Reg. No.
Page 1 of 2
R.S. Assigned
Applicant Information
Important: Read all instructions before completing this form
1. Firm Name
2. Mailing Address of Firm
City
State
Zip Code
Check box if new address
City
State
Zip Code
3.
Street Address (if different from above) or
Agent Address
4. Name of Authorized Representative/Agent
5. Telephone Number of Representative/Agent
6. Fax Number
7. E-mail Address
8. Product Brand Name (exactly as shown on label)
9. U.S. EPA or CA Registration Number
10. Type of California notification action requested (check all applicable)
Delete redundant label statements
Delete pests or delete use sites
Add symbols or graphics
Add indoor nonfood sites for certain antimicrobial products
Correct typographical or grammatical errors
Add or include U.S. EPA Pesticide Registration Notice specified
wording
Redesign label format
Change in stated nominal concentration of inert ingredient
Change size/content of child-resistant packaging
Change Non-FIFRA related label elements
Change warranty statement
Note: Products distributed or sold that do not meet the DPR notification process criteria are considered unregistered and subject
to enforcement action.
I certify, under penalty of perjury, that all information submitted on this notification is accurate and complete.
X
/
/
Signature of Authorized Representative/Agent
Type or Print Name and Title
Date Signed
DPR USE ONLY:
Mail completed application to:
RC #
For correspondence only:
Department of Pesticide Regulation
Fee $
Pesticide Registration Branch
P.O. Box 4015
RC Date
Sacramento, California 95812-4015
Date Received
For package deliveries, FedEx, etc.:
Department of Pesticide Regulation
OK by
Date Licensed
Pesticide Registration Branch
1001 I Street
Returned
Sacramento, California 95814-2828
State of California
Instructions for
Department of Pesticide Regulation
Notification of Minor Changes
Notification of Minor Changes
DPR-REG-031 (Rev. 10/15)
Page 2 of 2
INCOMPLETE FORMS WILL NOT BE PROCESSED
If any section does not apply to your product, please mark it N/A. A separate application form must be completed for each product
brand name. Additional information on the California Notification Process can be found at <http://www.cdpr.ca.gov>. If you require
further assistance, contact the Pesticide Registration Branch at 916-445-4400.
1.
Firm Name: If federally registered, this must be the same as on file with U.S. EPA. For California registered products that do not
require federal registration, this must match what is currently on file with DPR.
2.
Firm Mailing Address: Correspondence, licenses, notices, etc. will be sent to this address.
4.
Name of Authorized Representative: The person who is authorized to answer questions about your application. Generally, this
person prepares the application. If the person is an agent, a letter from the firm authorizing the agent to act on their behalf is
required.
7.
E-mail address: Supplying DPR with this information will automatically enroll the applicant (firm or agent) into the automatic
notification program.
8.
Product Brand Name: This must be EXACTLY the same as the brand name registered by U.S. EPA and the product labeling.
For California registered products that do not require federal registration, this must match what is currently on file with DPR.
9.
U.S. EPA or CA Registration Number: Required unless the product is exempt from, or does not require, registration under the
Federal Insecticide Fungicide and Rodenticide Act (FIFRA) such as spray adjuvants, FIFRA §25(b) exempt pesticides, or the
product is being submitted concurrent with submission to U.S. EPA under the DPR’s current policy. For California only
registered products that do not require federal registration, the CA Reg. No. is required.
10. Type of California Notification Action Requested:
• Delete pests or delete use sites: Pests or use sites can be deleted, if all other label references pertaining to the deleted pest
or use site are also deleted.
• Add indoor nonfood sites for antimicrobial products: Indoor non-food sites for antimicrobial products can be added as
allowed by U.S. EPA's Pesticide Registration (PR) Notice 98-10. This is if no additional data were required by U.S. EPA,
exposure is not increased, sites are within an already registered use pattern for the product, a directive does not prohibit it, the
technical product label does not prohibit it, and the dosage, concentration, frequency, and method of application are
unchanged.
• Add or include U.S. EPA Pesticide Registration (PR) Notice specified wording: Label statements specified in U.S. EPA
Pesticide Registration (PR) Notices may be submitted by notification, if the exact language in the PR Notice is used (e.g.,
storage and disposal statements in U.S. EPA’s PR Notice 2007-04). It may be necessary for DPR to make exceptions as new
U.S. EPA PR Notices are issued.
• Change in stated nominal concentration of inert ingredient: The stated nominal concentration of an inert ingredient may
be changed by notification, if it falls within the certified limits for the inert ingredient as listed on the statement of formula.
• Change Non-FIFRA related label elements: Non-FIFRA label elements as allowed by U.S. EPA PR Notice 98-10 may be
revised, added, or deleted. Examples include symbols or graphics required by other government agencies such as the
Department of Transportation. Other non-FIFRA elements are the date of manufacture, date of label approval, and use of
metric units in addition to standard U.S. units.
• Delete redundant label statements: Statements may be removed or combined to remove redundancy, if required label
statements are not removed or changed.
• Add symbols or graphics: Symbols and graphics can be added, but cannot substitute for, or conflict with, the label text, and
cannot be false or misleading.
• Correct typographical or grammatical errors: Typographical and grammatical errors can be corrected by notification, if the
phrasing does not change how the product will be used.
• Redesign label format: A label may be redesigned or rearranged; changes allowed include color, font size and type, use of
space, or configuration and placement of label elements. These changes are allowed by notification, if they do not modify
approved text and are consistent with U.S. EPA format requirements and policy.
• Change size/content of child-resistant packaging: The package size and net contents may be changed by notification (as
allowed by U.S. EPA PR Notice 98-10) for products, which are subject to child-resistant packaging if all criteria specified in
California Notice 2002-01 are met.
• Change warranty statement: Warranty statements may be added, revised, or deleted by notification as allowed in U.S.
EPA's PR Notice 98-10 and California Food and Agriculture Code §12853 and §12854, if the statements do not disclaim the
efficacy or safety of the product when used in accordance with label directions.
The Application Package shall include the following:
A cover letter describing the type of notification action
Three (3) copies of the product labeling (printer's proofs or
requested and what is being submitted to DPR
final printed labels are required)
A completed application form (electronic signatures are not
Copy of U.S. EPA stamped accepted label and acceptance
accepted). For formulation changes, submit a copy of the
letter, if applicable
U.S. EPA Confidential Statement of Formula or complete a
U.S. EPA Notification Submission (EPA Form 8570-1) to
Product Formulation Information Form
support other label changes not addressed by the U.S. EPA
An application fee of $25 is required. Make check or money
stamped-accepted label, if applicable
order payable to “Cashier, Department of Pesticide Regulation”
Page of 2