Form No. Pa-400 - Instructions For Application For Pesticide Applicator License printable pdf download

INSTRUCTIONS FOR

APPLICATION FOR PESTICIDE APPLICATOR LICENSE

FORM NO. PA-400

In order to obtain an Applicators License, you must submit a complete signed application along with the appropriate fees.

The license will be issued to the name appearing under Section B of this application. All applicators must first pass the

appropriate TDA exams. Test scores are valid for 12 months for noncommercial and noncommercial political. Test scores

are valid for 5 years for private pesticide applicators. After that time, applicants must retest. License fees are

nonrefundable. It is unlawful for any person to apply restricted-use or state-limited-use pesticides or regulated

herbicides without a license.

SECTION A

1. TYPE OF LICENSE

Check the box for the type of license you want.

•

Noncommercial Applicator -- A person required to use restricted-use or state-limited-use pesticides or regulated

herbicides but who is not a private applicator or commercial applicator. Noncommercial applicators must obtain

five CEUs each year.

•

Noncommercial Applicator Political Subdivision -- Government employees who apply restricted-use or state-

limited-use pesticides or regulated herbicides in the course of their employment. Noncommercial applicators must

obtain five CEUs each year.

•

Private Applicator -- A person who uses or supervises the use of restricted-use or state-limited-use pesticides or

regulated herbicides for the purpose of producing an agricultural commodity on property owned or rented by the

person or the person's employer or under the person's general control. Private applicators must obtain 15 CEUs

over their five-year license period.

•

Private Applicator Certificates were issued from 1977 through 1989. If you have a certificate and are applying

for a license, please check the box and provide your certificate number.

SECTION B

1. CLIENT INFORMATION

Information entered into this form will be used to generate your license. A driver license number is required. Indicate TX

issued, and if not issued by the state of Texas, then check OTHER. If a drivers license is not available, you must provide

a state issued identification number. If the state issued identification number provided is issued by another state, check

other.

For sole proprietors/individuals applying for this nonoccupational license, a social security number is voluntary and not

required. Social security numbers are used to assist in child support enforcement under Texas Family Code § 231.302. In

the event the applicant does not have a social security number or does not wish to provide their social security number, the

applicant must provide either a driver license number or a state-issued ID number. There is no penalty or consequence for

refusing to provide a social security number.

Provide your full legal name, address and phone number.

Licensing Department

Revised 01/16/08

Administrative Services Division

Nonoccupational

Form No. Pa-400 - Instructions For Application For Pesticide Applicator License