"Pesticide Registrant Point of Contact Form" - Alabama

Pesticide Registrant Point of Contact Form is a legal document that was released by the Alabama Department of Agriculture and Industries - a government authority operating within Alabama.

Form Details:

  • The latest edition currently provided by the Alabama Department of Agriculture and Industries;
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  • Fill out the form in our online filing application.

Download a fillable version of the form by clicking the link below or browse more documents and templates provided by the Alabama Department of Agriculture and Industries.

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Download "Pesticide Registrant Point of Contact Form" - Alabama

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Print Form
PESTICIDE REGISTRANT
POINT OF CONTACT FORM
Correct completion of this form and subsequent updates ensure better assistance with the registration/
maintenance of your pesticide products
RESPONSIBILITIES OF THE POINT OF CONTACT (P.O.C.)
It is the responsibility of the registering company or their assigned agent to complete the
P.O.C. form.
Only ONE P.O.C. is to be listed per each EPA identified company - INCLUDING SUB-
REGISTRANT COMPANIES. Example: A subregistrant company has the EPA identified
company number of 10234. ALL products registered under the #10234 must be handled by
ONE P.O.C.
The listed P.O.C. is responsible for ALL PRODUCTS under a single company EPA number, which
includes: NEW PRODUCT REGISTRATIONS, SUB-REGISTRANT PRODUCTS and ALL RENEWALS.
This P.O.C. form must accompany any new product application when submitted for a
company with no current history in Alabama.
If the person identified as the P.O.C. should change (i.e. retire, change jobs, leave, etc.) the
registrant company is responsible for immediately submitting an updated P.O.C. form.
*Company name must correspond with the EPA company number
COMPANY:
EPA COMPANY NUMBER:
MAILING ADDRESS:
*POINT OF CONTACT
NAME OF PERSON:
COMPANY or AGENCY:
MAILING ADDRESS:
TELEPHONE NUMBER:
EXTENSION:
EMAIL ADDRESS:
Alabama Department of Agriculture & Industries
MAIL COMPLETED FORM TO:
Pesticide Registration
1445 Federal Drive
Montgomery AL 36107-1123
Print Form
PESTICIDE REGISTRANT
POINT OF CONTACT FORM
Correct completion of this form and subsequent updates ensure better assistance with the registration/
maintenance of your pesticide products
RESPONSIBILITIES OF THE POINT OF CONTACT (P.O.C.)
It is the responsibility of the registering company or their assigned agent to complete the
P.O.C. form.
Only ONE P.O.C. is to be listed per each EPA identified company - INCLUDING SUB-
REGISTRANT COMPANIES. Example: A subregistrant company has the EPA identified
company number of 10234. ALL products registered under the #10234 must be handled by
ONE P.O.C.
The listed P.O.C. is responsible for ALL PRODUCTS under a single company EPA number, which
includes: NEW PRODUCT REGISTRATIONS, SUB-REGISTRANT PRODUCTS and ALL RENEWALS.
This P.O.C. form must accompany any new product application when submitted for a
company with no current history in Alabama.
If the person identified as the P.O.C. should change (i.e. retire, change jobs, leave, etc.) the
registrant company is responsible for immediately submitting an updated P.O.C. form.
*Company name must correspond with the EPA company number
COMPANY:
EPA COMPANY NUMBER:
MAILING ADDRESS:
*POINT OF CONTACT
NAME OF PERSON:
COMPANY or AGENCY:
MAILING ADDRESS:
TELEPHONE NUMBER:
EXTENSION:
EMAIL ADDRESS:
Alabama Department of Agriculture & Industries
MAIL COMPLETED FORM TO:
Pesticide Registration
1445 Federal Drive
Montgomery AL 36107-1123