Kentucky Private Applicator Certification Instructions

To submit this form, ensure all fields are accurately filled and print the completed document. You can either mail it to your local county extension office or deliver it in person. For email submission, contact your county office to ask about the preferred procedures and email address.

For 2024, ensure your certification is renewed before its expiration to maintain compliance. The certification is valid for three years, so plan to attend training sessions by the expiration date in 2025.

The purpose of this form is to certify individuals who will be applying restricted use pesticides. This certification ensures that applicators have the necessary knowledge of safe pesticide usage practices. By completing the form, individuals fulfill their legal obligations under state regulations.

• 1. Certification Number: Unique number assigned to the applicator for identification.
• 2. Expiration Date: Date by which the certification must be renewed.
• 3. Name: Full name of the applicant.
• 4. Address: Residential address of the applicant.
• 5. City: City of residence.
• 6. ZIP Code: Postal code for the applicant's address.

Failure to submit this form may result in a loss of certification, rendering you unable to legally purchase restricted use pesticides. It is crucial to follow the submission guidelines accurately.

• Legal Consequences: Operating without valid certification may lead to fines and legal action.
• Inability to Purchase Pesticides: Without certification, you cannot buy restricted use pesticides legally.
• Impact on Farming Operations: This may hinder your ability to manage crops effectively.

• 1. Post-Training Certification: Use this form after completing required training to obtain your license.
• 2. Certification Renewal: Required every three years to maintain your ability to apply pesticides.
• 3. Documentation for Pesticide Purchase: You must present this form to purchase restricted use pesticides.