Attachment D Form 8570-30

Please read Paperwork Reduction Act Notice in instructions.

Form Approved.

OMB No. 2070-0179.

United States Environmental Protection Agency

EPA

Pesticide Registration Maintenance Fee Filing Form

A. Registrant Identification:
Please enter address correction here:

*** SAMPLE ***
B. EPA Company Number(s):
C. Maintenance Fee Calculation:
1. Number of registrations on printout you will support by paying the fee:

______________

2. Number of registrations on printout already approved by EPA for transfer to another registrant:

______________

3. Number of registrations on printout previously canceled, or which you want EPA to cancel:

______________

4. Number of registration on printout not counted in lines C1, C2, or C3:

______________

5. Number of active registrations omitted from the printout you will support by paying the fee:

______________

6. Total number of registrations you will support by paying the fee (C1 + C5):

______________

7. Amount due, from fee table in instructions:

$ ____________

8. Check, bank draft, or money order number:

______________

Important! Registrations For Which The Fee Is Not Paid
Will Be Canceled!

D. Authorized Company Representative or Agent:
I certify that the statements that I have made on this form and all attachments thereto are true, accurate, and complete. I
acknowledge that any knowingly false or misleading statements may be punishable by fine or imprisonment or both under
applicable law.

Name

Signature and Date

Title

Telephone

Send Filing Form and Check via U.S. Postal
Service* to:

Send Filing Form and Annotated Printout via
U.S. Postal Service* to:

U.S. Environmental Protection Agency
Pesticide Maintenance Fees
P.O. Box 979031
St. Louis, MO 63197-9000
*See instructions for courier delivery address.

EPA Form 8570-30 (Rev. 08-07)

Email

U.S. Environmental Protection Agency
Office of Pesticide Programs (7504P)
Document Processing Desk (MFEE)
1200 Pennsylvania Ave., N.W.
Washington, D.C. 20460-0001
*See instructions for courier delivery address.

INSTRUCTIONS TO REGISTRANTS FOR FILING 2014
PESTICIDE REGISTRATION MAINTENANCE FEES
The Federal Insecticide, Fungicide and Rodenticide Act (FIFRA) requires everyone who holds an active or
suspended pesticide registration to pay an annual fee to keep the registration in effect.
The fee is $3,575 for each registration up to the maximum fees which can be assessed to a single registrant.
For certain qualified small businesses, there is now a provision for a 25% waiver of the fee on the first
product. A qualified small business must have 500 or fewer employees; during the 3-year period prior to the
most recent maintenance fee billing, have average annual global gross revenue from all sources (includes
pesticide and non-pesticide revenue) that did not exceed $10 million; and hold not more than 5 Section 3
and Section 24(c) pesticide registrations combined. See fee schedules on page 8 for details. The following
documentation is required in order for Agency staff to evaluate your eligibility for the 25% waiver:



Documentation of payroll information such as a recent IRS Form 941 or a statement certifying the
total number of individuals employed by the applicant;
Documentation of the 3-year average annual global gross revenue (2010, 2011 and 2012) from all
sources which may include the first page of IRS Forms 1065, 1120, or 1120S, as applicable, or
audited financial statements. Please note that financial information must include any parent company
or affiliates.
2014 MAINTENANCE FEES ARE DUE BY JANUARY 15, 2014

Pay On-Line (See Pages 5 and 6 for Instructions)
Registrations for which the fee is not paid will be canceled, by order and without a hearing. If you do not pay
the fee to keep a registration in effect, you will be permitted until January 15, 2014, to dispose of existing
stocks of the pesticide, except in special circumstances when less time may be granted.
Paperwork Reduction Act Notice
Public reporting burden for the collection of information is estimated to average 0.9 hours per response,
including time for reviewing the instructions, searching existing data sources, gathering and maintaining the
data needed, and completing and reviewing the collection of information. Send comments regarding the
burden estimate or any other aspect of this collection of information, including suggestions for reducing the
burden to:
Director, Collection Strategies Division (2822)
U.S. Environmental Protection Agency
1200 Pennsylvania Avenue NW
Washington, DC 20460
Or to: Office of Information and Regulatory Affairs
Office of Management and Budget
Washington, DC 20503
Include the OMB Number (OMB 2070-0179) in any correspondence.

required are identified in the printout by a threeelement number including the abbreviation of the
state issuing the registration, the last two digits of
the year it was issued, and a four-digit serial
number.

COMPLETENESS OF MAILING
Please make sure you received all of the following
items in this mailing:





A transmittal letter from Steven Bradbury,
the Director of the Office of Pesticide
Programs;
A computer printout listing all your active
or suspended registrations under either
section 3 or section 24(c), as shown in our
records in October, 2013; and
The Pesticide Registration Maintenance Fee
Filing Form already labeled with your EPA
company number and company name and
address of record for filing your response.

FEE WAIVER FOR MINOR
AGRICULTURAL USE
The 1990 Farm Bill amended FIFRA to allow the
Administrator to reduce or waive maintenance
fees for minor agricultural use registrations, when
she determines that the fee would be likely to
cause significant impact on the availability of the
pesticide for the use. If you believe that one or
more of your registrations may qualify for this
reduction or waiver, please call the toll free
maintenance fee line at 1-800-444-7255 for
special instructions.

You will need all of these items. If any of them are
missing, you can get replacements by calling our toll
free maintenance fee line at 1-800-444-7255.
GENERAL INSTRUCTIONS

FEE WAIVER FOR PUBLIC HEALTH
PESTICIDES AS DEFINED BY THE FOOD
QUALITY PROTECTION ACT

You must choose which of your registrations to
support by paying the maintenance fee, and which to
ask us to cancel. You report your decisions about
individual registrations to us by annotating the
enclosed computer printout. You then summarize
your decisions on the Pesticide Registration
Maintenance Fee Filing Form and return the
annotated printout, a copy of the form and your
check for the appropriate fee to EPA or pay on-line
at www.pay.gov. Payment instructions can be found
on page 6.

The Food Quality Protection Act (FQPA) allows
the Administrator to waive the maintenance fee for
public health pesticides if the Administrator
determines, based on information supplied by the
registrant that the economic return to the registrant
from sales of the pesticide does not support the
registration or reregistration of the pesticide.
To qualify as a public health pesticide, as defined
by FQPA, the following conditions must be met:

REGISTRATIONS SUBJECT TO THE
MAINTENANCE FEE

1. The public health use of the pesticide
product must be a minor use. FIFRA
defines “minor use” in Section 2(ll).
2. The pesticide must be registered for use
and used predominantly in public health
programs.
3. The use of the pesticide in the public
health program must be for vector control
or for other recognized public health
protection purposes.

The fee must be paid to keep in effect all primary
registrations granted under FIFRA section 3, and all
registrations to meet special local needs granted
under FIFRA section 24(c).
Section 3 registrations for which the maintenance
fee is required are identified in the printout by a twoelement registration number in which your EPA
Company Number is the first element. Section 24(c)
registrations for which the maintenance fee are

2

If you believe that one or more of your registrations
meet all three of these criteria, please include a
written justification which identifies the product(s)
and explains why the product(s) meet the statutory
definition of a public health pesticide and why the
fee should be waived.

FIRMS WITH MORE THAN ONE EPA
COMPANY NUMBER
If your firm holds registrations under more than
one EPA company number, you will receive a
separate mailing of each account. It may be to
your advantage to combine your maintenance fee
filings for all subdivisions of your firm, and
discard the other filing forms you received. On
this single form for your combined return please
be sure to (a) list in block B all the EPA company
numbers covered by the combined return, (b)
report in block C only the combined totals for all
company numbers included in the return, and (c)
append to the form you send to EPA in
Washington, D.C. the annotated printouts for all
the company numbers included in the return.

25% WAIVER OF THE FEE ON THE FIRST
PRODUCT FOR QUALIFIED SMALL
BUSINESSES
For certain qualified small businesses, there is now a
provision for a 25% waiver of the fee on the first
product. A qualified small business must have 500
or fewer employees; during the 3-year period prior
to the most recent maintenance fee billing, have
average annual global gross revenue from all
sources (includes pesticide and non-pesticide
revenue) that did not exceed $10 million; and hold
not more than 5 Section 3 and Section 24(c)
pesticide registrations combined. The following
items are required to allow Agency staff to evaluate
your eligibility for the 25% waiver:
 Documentation of payroll information such
as a recent IRS Form 941 or a statement
certifying the total number of individuals
employed by the applicant;
 Documentation of the 3-year average annual
global gross revenue (2010, 2011 and 2012)
from all sources which may include the first
page of IRS Forms 1065, 1120, or 1120S, as
applicable, or audited financial statements.
Please note that financial information must
include any parent company or affiliates.

FEE PAYMENT FOR THIRD-PARTY
REGISTRATIONS
If you wish to pay the maintenance fee for a
registration held by another firm or third party,
please call the toll-free maintenance fee
information line at 1-800-444-7255 for special
instructions.

EPA'S FEDERAL TAX IDENTIFICATION
NUMBER
In case you need it for your internal records of fee
payments, the Environmental Protection Agency’s
Federal Tax Identification Number is 52-0852695.

REGISTRATIONS NOT SUBJECT TO THE
MAINTENANCE FEE

TOLL-FREE ASSISTANCE
If you have questions about entries on the
computer printout or about how to respond to the
maintenance fee requirement, you can get help by
calling the toll-free maintenance fee information
line at 1-800-444-7255.

The maintenance fee requirement does not apply to
supplemental registrations of distributors which are
identified by a three-element registration number in
which your EPA company number is the third
element. No supplemental registrations are included
on the enclosed printout.

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product name. Please mark this response
ONLY for transfers EPA has already
approved. If you aren't sure whether a
transfer has been approved by EPA, call
the toll-free number for help.

STEP-BY STEP INSTRUCTIONS
Step 1. Check the enclosed computer printout
carefully against your own records and confirm the
accuracy of the information. The printout may
include some errors, it may include some entries for
which you've already requested cancellation, or it
may omit some registrations you think are active.
Please call any such errors or omissions to our
attention when you file your response. Handle any
errors or omissions as described below. Call the
toll-free line for help if you're not sure.

f.

Registrations included in error: If the
printout includes entries which are not
your registrations and were included in
error, circle the keyword "ERR" beside
the registration number.

g. Omitted Registrations: If you think an
active registration for which you wish to
pay the fee has been omitted from the
printout, identify it by registration number
and product name (or by 24(c) number
and description) on a separate sheet of
paper, and include that supplemental list
with your response.

a. Errors in Product Name:
Correct
misspellings or other errors in the product
name directly on the printout.
b. Previously Canceled Registrations: If the
printout includes registrations you think
have already been canceled, circle the
keyword "CAN" beside the registration
number, and we'll correct the entry in our
records. Note that paying the fee will not
reactivate a registration which has already
been canceled.

Step 2. Decide which registrations to support,
and which to cancel. When you've identified and
corrected any discrepancies between the printout
and your own records, you must decide which
registrations to support by paying the maintenance
fee, and which to cancel. This choice is entirely
up to you.

c. Pending Cancellations: If the printout
includes registrations you have already
asked us to cancel, circle the keyword
"CAN" beside the registration number.

Step 3. Report your decisions by annotating the
printout. Make sure to circle one of the four
keywords beside the registration number for each
entry. Circle "PAY" if you decide to support the
registration by paying the fee. Circle "CAN" if
you decide not to pay the fee, and want EPA to
cancel the registration.

d. Suspended Registrations: YOU must pay
the fee to maintain a registration which has
been suspended.
Circle the keyword "PAY". Payment of the
fee for a suspended registration does not lift
the suspension, but non-payment of the fee
will result in its cancellation.

When you reach the bottom of each page of the
printout, count the number of times you've circled
each keyword on that page, and write the counts
for that page at the bottom of the keyword
columns. Continue through any additional pages
of the printout. Please double check to ensure that
you have circled one keyword for every line on
the printout.

e. Transferred Registrations: If the printout
includes registrations for which EPA has
already approved in writing a transfer to
another registrant, circle the keyword
"TRN" beside the registration number, and
identify the registrant who received the
transfer in the blank to the right of the

4

paying the fee.
Line 7. Enter the fee due. Determine which Fee
Table to use.

Step 4. Complete the Maintenance Fee Filing
Form

A Small Business registrant employed 500 or
fewer people and during the 3-year period ending
on January 15, 2014, had average annual global
gross revenue from chemical sales that did not
exceed $60 million. If you qualify, please write
“Small Business” in the space to the right of line 7
and provide documentation of the number of
employees (documentation may, in part, include
payroll information and a recent IRS Form 941,
together with a statement certifying the total
number of individuals employed by the applicant)
and the 3-year average annual global gross
revenue from chemical sales (documentation may
include the first page of income tax returns filed
with the Internal Revenue Service which includes
gross receipts or sales, such as IRS Forms 1065,
1120, or 1120S, as applicable, the applicant’s most
recent IRS 941, and audited financial statements).
A Small Business shall use Fee Table B on page 8
of these instructions.

Section A. Registrant Identification
The EPA company number, registrant name, agent
of record (if any) and address of record will all
appear on a special label on the form. Type or print
legibly any corrections to this information to the
right of the label.
Section B. Company Numbers
Leave this area blank unless your firm holds
registrations under more than one EPA company
number and you are filing a combined return for
more than one account on a single form. If this is
the case enter here all EPA-assigned company
numbers covered by this return, and be sure to
include all annotated printouts with your response to
EPA in Washington, D.C.
Section C. Maintenance Fee Determination

A Qualified Small Business registrant employed
500 or fewer people and during the 3-year period
ending on January 15, 2014, had average annual
global gross revenue from all sources (includes
pesticide and non-pesticide revenue) that at did
not exceed $10 million and hold not more than
five (5) Section 3 and Section 24(c) pesticide
registrations combined. If you qualify, please
write “Qualified Small Business” in the space to
the right of line 7 and provide documentation of
the number of employees (documentation may, in
part, include payroll information and a recent IRS
Form 941, together with a statement certifying the
total number of individuals employed by the
applicant) and the 3-year average annual global
gross revenue from all sources, pesticide and nonpesticide (documentation may include the first
page of income tax returns filed with the Internal
Revenue Service which includes gross receipts or
sales, such as IRS Forms 1065, 1120, or 1120S, as
applicable, the applicant’s most recent IRS 941,
and audited financial statements). A Qualified
Small Business shall use Fee Table C on page 8 of

Line 1. Enter the total number of registrations on all
attached printouts for which you circled the keyword
"PAY".
Line 2. Enter the total number of registrations on all
attached printouts for which you circled the keyword
"TRN".
Line 3. Enter the total number of registrations on all
attached printouts for which you circled the
keyword"CAN".
Line 4. Enter the total number of registrations on all
attached printouts for which you circled the keyword
"ERR".
Line 5. Enter the total number of registrations
omitted from the printouts which you've listed
separately as additions, and which you will support
by paying the fee.
.
Line 6. Enter the sum of lines 1 and 5. This is the
total number of registrations you will support by

5

these instructions.
If you do not qualify as a Small Business or a
Qualified Small Business, use Fee Table A on page
8 of these instructions.

Telephone: (314) 425-1818
Pay Maintenance Fees On-Line
Maintenance fees may be paid on-line via credit
card or electronic fund transfer. To submit a
payment on-line, visit www.pay.gov. From the
pay.gov home page, select "search by form
name." From the next page, select "P," then
click on "Pesticide Registration Maintenance
Fee" and complete the form. The maximum
amount that may be charged to a credit card is
$49,999. There is no limit on the amount that
may be paid via electronic fund transfer.

Using the appropriate Fee Table, either Table A,
Table B or Table C, determine the fee due by
looking up the number you've entered on line 6--the
number of registrations you will support--in the
appropriate Fee Table at the end of these
instructions, and enter the fee amount from the table
in line 7. This is the amount due by January 15,
2014. If the number on line 6 is zero, enter a zero on
line 7 as well.

If you pay on-line do not mail a copy of the form
to St. Louis. Please, however, mail a copy of the
form and listing to the Washington, DC address.

Line 8. If paying by check, bank draft, or money
order, enter the ID number to ensure proper credit in
case the check and filing form become separated. If
paying through Pay.gov, enter the 8-digit Pay.gov
Tracking ID.

Step 6. Mail your return. Attach all pages of
the annotated printout and any supplemental
listings of omitted registrations and the original
copy of the filing form, and mail it to:

Section D. Authorized Company Representative
Type or print the name, title, telephone number, and
email address of the person signing the filing form.
Sign it and date it.

U.S. Environmental Protection Agency
Office of Pesticide Programs (7504P)
Document Processing Desk (MFEE)
William Jefferson Clinton Building
1200 Pennsylvania Ave., NW
Washington, DC 20460-0001

Step 5. Pay the Fee. If you do not pay on-line,
payments must be in U.S. currency by check, bank
draft or money order drawn to the order of the U.S.
Environmental Protection Agency. To ensure proper
credit of your payment, write the company number
printed on the label in Section A of the filing form
on the face of your check. Attach the check to the
second copy of the filing form and mail to:

If you prefer to send the filing form and annotated
printout via private courier, please use the
following address:
U.S. Environmental Protection Agency
Office of Pesticide Programs (7504P)
Document Processing Desk (MFEE)
Room S-4900
2777 South Crystal Drive
Arlington, VA 22202

U.S. Environmental Protection Agency
Pesticide Maintenance Fees
PO Box 979031
St. Louis, MO 63197-9000
If you prefer to send payment via private courier,
please use the following address:
U.S. Bank
Government Lockbox 979031
1005 Convention Plaza
SL-MO-C2-GL
St. Louis, MO 63179

6

FINAL CHECKLIST
Before you mail your response make sure you:


Circle one of the four keywords on every numbered line in the printout.



List by registration number and product name any registrations omitted from the printout that are
active registrations for which you are paying the fee.



Write the number of your check on line C8 of the filing form.



Write your EPA company number on the face of your check.



Sign and date the filing form and include in Section D the name, email address and telephone number
of someone who will be able to answer questions about your response.



Make two copies of the filing form.



Keep one copy of the filing form for your records.



Attach your check securely to one copy of the filing form and send it to St. Louis.



Attach all pages of the annotated printout(s) to one copy of the filing form and mail it to Washington,
DC or send it by courier to Arlington, VA. If you are a Small Business or a Qualified Small
Business, please include documentation of the number of employees. Documentation may, in part,
include payroll information and a recent IRS Form 941, together with a statement certifying the total
number of individuals employed by the applicant and the 3-year average sales. This documentation
may include the first page of income tax returns filed with the Internal Revenue Service which
includes gross receipts or sales, such as IRS Forms 1065, 1120, or 1120S, as applicable, the
applicant’s most recent IRS 941, and audited financial statements.
REMINDERS



Maintenance fee responses and checks must be postmarked by January 15, 2014



EPA Federal Tax Identification Number: 52-085-2695.



Make checks payable to: U.S. Environmental Protection Agency



Toll-free Maintenance Fee Information Line: 1-800-444-7255.

Notice to Customers Making Payment by Check
If you send us a check, it will be converted into an electronic funds transfer (EFT). This means we will copy your check
and use the account information on it to electronically debit your account for the amount of the check. The debit from
your account will usually occur within 24 hours, and will be shown on your regular account statement.
You will not receive your original check back. We will destroy your original check, but we will keep the copy of it. If
the EFT cannot be processed for technical reasons, you authorize us to process the copy in place of your original check.
If the EFT cannot be completed because of insufficient funds, we may try to make the transfer up to 2 times.

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Fee Table A
# Regs
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15

Fee Payments Required to Maintain Registrations in 2014
Fee ($)
# Regs
Fee ($)
# Regs
Fee ($)
# Regs
$3,575
16
$57,200
31
$110,825
63
$7,150
17
$60,775
32
$114,400
64
$10,725
18
$64,350
33 - 50
$115,500
65
$14,300
19
$67,925
51
$119,075
66
$17,875
20
$71,500
52
$122,650
67
$21,450
21
$75,075
53
$126,225
68
$25,025
22
$78,650
54
$129,800
69
$28,600
23
$82,225
55
$133,375
70 +
$32,175
24
$85,800
56
$136,950
$35,750
25
$89,375
57
$140,525
$39,325
26
$92,950
58
$144,100
$42,900
27
$96,525
59
$147,675
$46,475
28
$100,100
60
$151,250
$50,050
29
$103,675
61
$154,825
$53,625
30
$107,250
62
$158,400

Fee ($)
$161,975
$165,550
$169,125
$172,700
$176,275
$179,850
$183,425
$184,800

Fee Table B
Fee Payments Required to Maintain Registrations in 2014 for a Small Business
# Regs
Fee ($)
# Regs
Fee ($)
# Regs
Fee ($)
# Regs
Fee ($)
1
$3,575
11
$39,325
51
$74,175
61
$109,925
2
$7,150
12
$42,900
52
$77,750
62
$113,500
3
$10,725
13
$46,475
53
$81,325
63
$117,075
4
$14,300
14
$50,050
54
$84,900
64
$120,650
5
$17,875
15
$53,625
55
$88,475
65 +
$122,100
6
$21,450
16
$57,200
56
$92,050
7
$25,025
17
$60,775
57
$95,625
8
$28,600
18
$64,350
58
$99,200
9
$32,175
19
$67,925
59
$102,775
10
$35,750
20 - 50
$70,600
60
$106,350
Note: Use this table only if you qualify as a small business as defined in FIFRA Section 4(i)(5). Documentation
is required in order to use Fee Table B. See page 5 of these instructions.

Fee Table C
Fee Payments Required to Maintain Registrations in 2014 for a Qualified Small Business
# Regs
Fee ($)
1
$2,681
2
$6,256
3
$9,831
4
$13,406
5
$16,981
Note: Documentation is required in order to use Fee Table C. See page 5 of these instructions.

8