Form 8570-34

OMB Control Nos. 2070-0060 and 2070-0174; Expiration Date: 6/30/2025 and 12/31/2025

UNITED STATES ENVIRONMENTAL PROTECTION AGENCY
1200 Pennsylvania Avenue, N.W.
WASHINGTON, D.C. 20460
Paperwork Reduction Act Notice: This collection of information is approved by OMB under the Paperwork Reduction Act, 44 U.S.C. 3501 et. seq. OMB Control Nos. 2070-0060 and 2070-0174.
Responses to this collection of information are mandatory 40 CFR 158. An agency may not conduct or sponsor, an a person is not required to respond to, a collection of information unless it displays a
currently valid OMB control number. The public reporting and record keeping burden for this collection of information is estimated 0.25 to 1.25 hours per response. Send comments on the Agency’s
need for this information, the accuracy of the provided burden estimates and any suggested methods for minimizing respondent burden to the Regulatory Support Division Director, U.S. Environmental
Protection Agency (2821T), 1200 Pennsylvania Ave., NW, Washington, D.C. 20460. Include the OMB control number in any correspondence. Do not send the completed form to this address.

Certification with Respect to Citation of Data
Applicant's/Registrant's Name, Address, and Telephone Number

EPA Registration Number/File Symbol

Active Ingredient(s) and/or representative test compound(s)

Date

General Use Pattern(s) (list all those claimed for this product using 40 CFR Part 158)

Product Name

NOTE: If your product is a 100% repackaging of another purchased EPA-registered product labeled for all the same uses on your label, you do not need to
submit this form. You must submit the Formulator's Exemption Statement (EPA Form 8570-27).
I am responding to a Data-Call-In Notice, and have included with this form a list of companies sent offers of compensation (the Data Matrix form should
be used for this purpose).

SECTION I: METHOD OF DATA SUPPORT (Check one method only)
I am using the cite-all method of support, and have included with this form
a list of companies sent offers of compensation (the Data Matrix form
should be used for this purpose).

I am using the selective method of support (or cite-all option
under the selective method), and have included with this form a
completed list of data requirements (the Data Matrix form must be
used).

SECTION II: GENERAL OFFER TO PAY
[Required if using the cite-all method or when using the cite-all option under the selective method to satisfy one or more data requirements]
I hereby offer and agree to pay compensation, to other persons, with regard to the approval of this application, to the extent required by FIFRA.

SECTION III: CERTIFICATION
I certify that this application for registration, this form for reregistration, or this Data-Call-In response is supported by all data submitted or cited in the
application for registration, the form for reregistration, or the Data-Call-In response. In addition, if the cite-all option or cite-all option under the selective method is
indicated in Section I, this application is supported by all data in the Agency's files that (1) concern the properties or effects of this product or an identical or
substantially similar product, or one or more of the ingredients in this product; and (2) is a type of data that would be required to be submitted under the data
requirements in effect on the date of approval of this application if the application sought the initial registration of a product of identical or similar composition and
uses .
I certify that for each exclusive use study cited in support of this registration or reregistration, that I am the original data submitter or that I have obtained
the written permission of the original data submitter to cite that study.
I certify that for each study cited in support of this registration or reregistration that is not an exclusive use study, either: (a) I am the original data
submitter; (b) I have obtained the permission of the original data submitter to use the study in support of this application; (c) all periods of eligibility for
compensation have expired for the study; (d) the study is in the public literature; or (e) I have notified in writing the company that submitted the study and have
offered (I) to pay compensation to the extent required by sections 3(c)(1)(F) and/or 3(c)(2)(B) of FIFRA; and (ii) to commence negotiations to determine the
amount and terms of compensation, if any, to be paid for the use of the study.
I certify that in all instances where an offer of compensation is required, copies of all offers to pay compensation and evidence of their delivery in
accordance with sections 3(c)(1)(F) and/or 3(c)(2)(B) of FIFRA are available and will be submitted to the Agency upon request. Should I fail to produce such
evidence to the Agency upon request, I understand that the Agency may initiate action to deny, cancel or suspend the registration of my product in conformity with
FIFRA.
I certify that the statements I have made on this form and all attachments to it are true, accurate, and complete. I acknowledge that any
knowingly false or misleading statement may be punishable by fine or imprisonment or both under applicable law.

Signature

EPA Form 8570-34 Electronic and Paper versions available. Submit only Paper version.

Date

Typed or Printed Name and Title