Private pesticide applicators are required to keep and maintain records for all restricted use pesticides for two years. The federal regulations also require private pesticide applicators to record the below information within 14 days of the restricted use pesticide application. Use this form to fill out the required information for a restricted use pesticide application, however, there is no official form for application records. Descriptions of required items can be found on page two.

Download options include Form 1 for use by a single applicator or Form 2 for multiple applicators.