Form SFN19309 "Running Inventory of Restricted Use Pesticide Sales (By Product)" - North Dakota

What Is Form SFN19309?

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

Form Details:

  • Released on February 1, 2013;
  • The latest edition provided by the North Dakota Department of Agriculture;
  • 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 SFN19309 by clicking the link below or browse more documents and templates provided by the North Dakota Department of Agriculture.

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Download Form SFN19309 "Running Inventory of Restricted Use Pesticide Sales (By Product)" - North Dakota

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Pesticide Trade Name
RUNNING INVENTORY OF RESTRICTED USE PESTICIDE SALES (BY PRODUCT)
NORTH DAKOTA DEPARTMENT OF AGRICULTURE
EPA Registration Number
PESTICIDE AND FERTILIZER DIVISION
SFN 19309 (2-2013)
Certification
Purchaser's Name
Quantity
Date of
Amount
Class
Certification Number
Person Making Sale
Purchased/
Purchaser's Signature
on Hand
Sale
Address, City, State, ZIP Code
Expiration Date
Sold
Instructions: This record will satisfy the minimum requirements of the North Dakota Administrative Rules 60-03-01-07 (Every pesticide dealer shall keep separate, accurate, and
complete records of all of the dealers purchases and sales of restricted use pesticides and all pesticides used under section 18 (emergency exemption) and section 24-c (special local
needs) of FIFRA. Dealers shall positively identify all purchasers of restricted use pesticides using any trustworthy proof of identification. If a restricted use pesticide is to be delivered to
a person other than the certified applicator making the purchase, the dealer must have a completed and signed authorization to receive restricted use pesticides form on file for the
purchaser for the current year.)
Pesticide Trade Name
RUNNING INVENTORY OF RESTRICTED USE PESTICIDE SALES (BY PRODUCT)
NORTH DAKOTA DEPARTMENT OF AGRICULTURE
EPA Registration Number
PESTICIDE AND FERTILIZER DIVISION
SFN 19309 (2-2013)
Certification
Purchaser's Name
Quantity
Date of
Amount
Class
Certification Number
Person Making Sale
Purchased/
Purchaser's Signature
on Hand
Sale
Address, City, State, ZIP Code
Expiration Date
Sold
Instructions: This record will satisfy the minimum requirements of the North Dakota Administrative Rules 60-03-01-07 (Every pesticide dealer shall keep separate, accurate, and
complete records of all of the dealers purchases and sales of restricted use pesticides and all pesticides used under section 18 (emergency exemption) and section 24-c (special local
needs) of FIFRA. Dealers shall positively identify all purchasers of restricted use pesticides using any trustworthy proof of identification. If a restricted use pesticide is to be delivered to
a person other than the certified applicator making the purchase, the dealer must have a completed and signed authorization to receive restricted use pesticides form on file for the
purchaser for the current year.)