EPA Form 3540-1

United States
ENVIRONMENTAL PROTECTION AGENCY
Washington, DC 20460

OMB Control No. 2070-0020
Expires on 1/31/2025

Notice of Arrival of Pesticides and Devices
Send Completed Form to Appropriate Regional Office Listed in the Instructions for this Form.
Note: Read instructions before completing form.
1.

Part I: To Be Completed by Importer of Record or Licensed Customs Broker
Name, Complete Mailing Address, and Email Address of the
2. Name, Complete Mailing Address, and Email Address of the
Licensed Customs Broker
Importer of Record

3.

Return Form to This Address
Name, Complete Mailing Address, and Email Address of the
Shipper

7.

Active Ingredients and Percentage of Each

8.

Unit Size (e.g., 500 lbs.)

9.

4.

Return Form to This Address
EPA Registration Number

5.

EPA Producer Establishment Number

6.

Brand Name of Pesticide Product or Pesticide Device

Quantity (e.g., 10 bags)

10. Total Net Weight (e.g., 5,000 lbs.)

11. Country of Origin

12. Port of Entry (Enter port code, or the city and state)

13. Name, Complete Mailing Address and Email Address of the
Carrier

14. Entry Number

15. Anticipated Entry Date

16. I assert that information constituting Confidential Business
Information (CBI) is shown in the above blocks numbered:

17. Location of Goods for Examination after Importation

Note: Blocks 4, 5, 6 and 7 are not entitled to CBI treatment--see instructions.

18. [Optional] For pesticides without an EPA Registration Number, select all that apply:
(The following information may expedite the processing of the Notice of Arrival.)
18a. A pesticide transferred between registered establishments operated by the same producer.
Domestic Producer Establishment Number (40 CFR §152.30(a)):
18b. A pesticide transferred between registered establishments not operated by the same producer.
Domestic Producer Establishment Number (40 CFR §152.30(b)):
EPA Registration Number of Product being Formulated, if applicable:
18c. A pesticide distributed under an Experimental Use Permit.
Experimental Use Permit Number (40 CFR §152.30(c)(1)):
18d. A Pesticide distributed for research and development purposes without an Experimental Use Permit. (40 CFR §152.30(c)(2)
EPA Form 3540-01 (Rev 3/22) Previous versions are obsolete.

Page 1 of 2

Part I (continued): To Be Completed by Importer of Record or Licensed Customs Broker
EPA Registration Number:

Product Name:

Total Net Weight:

Entry Number:

18e. A pesticide transferred solely for export. (40 CFR §152.30(d)/ PRN 99-1)
Enter the foreign purchaser details in Box 19.
Domestic Producer Establishment Number (40 CFR §152.30(b)):
18f. A pesticide distributed under an emergency exemption.
Emergency Exemption Number (40 CFR §152.30(e)):
18g. A pesticide transferred for the purposes of disposal. (40 CFR §152.30(f))
18h. Other. Provide an explanation including the intended use and a description of why the product is being imported into the
United States in Block 19 -- Remarks.
19. Remarks. Provide additional information here.
It is recommended that a copy of the label affixed to the product be submitted with the NOA.

Certification

I certify that the statements I made on this form and all attachments thereto 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.
20. Printed Name of Importer of Record
or Licensed Customs Broker:

Telephone No.:

21. Signature of Importer of Record or
Date:
Licensed Customs Broker:
Part II: To Be Completed by U.S. Environmental Protection Agency
Action to be taken by U.S. Customs and Border Protection:
Release Shipment

Detain for inspection

Request CBP to collect samples (19 CFR §12.116)

Release shipment to consignee under bond.
Shipment must be held intact pending inspection.

Other. (Specify)
EPA Remarks:

Signature and Title
of EPA Official:

Date:

Part III: To Be Completed by U.S. Customs and Border Protection
The information shown in Part I was compared with the entry papers for this shipment and no discrepancies were noted.
The shipment was handled as instructed by EPA in Part II. Any deviations should be brought to the attention of EPA before releasing the
shipment and should be noted in "Remarks."
CBP Remarks:

Signature of District
Director of Customs:

Date:

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 No. 2070-0020).
Responses to this collection of information are mandatory (19 CFR 12). An agency may not conduct or sponsor, and 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 recordkeeping burden for this collection of information is estimated to 26 minutes
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.

EPA Form 3540-01 (Rev 3/22) Previous versions are obsolete.

Page 2 of 2

Instructions
U.S. Customs and Border Protection (CBP) Regulations. 19 CFR 12.112(a) requires an importer or the importer’s agent desiring to
import pesticides or devices into the United States to submit, prior to arrival of the shipment in the United States, a Notice of Arrival
of Pesticides and Devices on U.S. Environmental Protection Agency (EPA) Form 3540-1. In the alternative, the importer or the
importer’s agent may file an electronic alternative to the Notice of Arrival, with the filing of the entry documentation, via any CBPauthorized electronic interchange system. Upon entry and concurrent with the filing of the entry documentation, CBP must be in
receipt of a completed NOA, which includes EPA’s signature and recommended disposition with respect to the shipment. The NOA
will be used by:
Part I.

Importer of Record or Licensed Customs Broker: The importer of record or licensed customs broker must complete Part I
of the NOA form. A separate NOA must be submitted for each pesticide or device in each shipment prior to its arrival at the
port of entry. To expedite the handling of pesticide or device shipments, submit NOA(s) to the EPA office listed below
having jurisdiction over the state/territory of the port of entry. It is recommended that all applicable blocks in Part I be
completed prior to submission to EPA, and that a copy of the label affixed to the product be submitted with each NOA.
Additional supporting documentation (e.g., CBP Form 7501, 3461, or 3461 ALT) for validating information provided may
also be included with the submission. When providing an address, the complete address should include the mailing
location, e-mail address, and telephone number of the contact person. EPA may require and request additional
documentation in order to review and make final compliance determinations regarding import shipments. (FIFRA §§ 8(b)
and 17(c))

Part II. EPA: EPA will complete Part II, indicating the disposition of the shipment, sign and return the NOA(s) to the importer or
agent for presentation to CBP at the time of entry.
Part III. CBP: CBP will compare the information shown on the NOA(s) with the entry documents and the shipment, bringing any
discrepancies to EPA's attention before the shipment is released, and noting discrepancies in the Remarks section. If the
importation is not handled by CBP in the manner instructed in Part II, this should also be noted in the Remarks.
Instructions for Part I
1.

Name, Complete Mailing Address, and Email Address of the Licensed Customs Broker. Custom broker means a person who is
licensed under this part to transact customs business on behalf of others. (19 CFR § 111.1)

2.

Name, Complete Mailing Address, and Email Address of the Importer of Record. Importer means the person primarily liable for
the payment of any duties on the merchandise, or an authorized agent acting on his behalf. The importer may be the consignee,
or the importer of record, or the actual owner of merchandise, or the transferee of the merchandise.

3.

Name, Complete Mailing Address, and Email Address of the Shipper. The name and address of person primarily responsible for
exporting the pesticide or pesticide device to the United States.

4.

EPA Registration Number. The pesticide product registration number assigned at the time of registration that identifies the
product. The product registration number must be an approved EPA Registration No. as it appears on the pesticide product
label. If the pesticide does not have an EPA registration number, it is recommended that “OTHER” be written in block 4 and
block 18 be completed. If the product is a device, write the word “DEVICE” in block 4.

5.

EPA Producer Establishment Number. The EPA Producer Establishment No. that appears on the pesticide or device label, as
defined at 40 CFR 156.10, is the final producer establishment where the pesticide or device was produced, as “produce” is
defined at 40 CFR 167.3, just prior to shipment to the United States. This includes any activity defined as production at 40 CFR
167.3 (to package, repackage, label, relabel or otherwise change the container of any pesticide or device) which occurs at the
final producer establishment before the pesticide or device is shipped to the United States. Foreign establishments that produce
pesticides or devices for distribution in the United States are required to have an EPA-registered producer establishment
number pursuant to 40 CFR 167.20(a)(2).

6.

Brand Name of Pesticide Product or Pesticide Device. Name of the pesticide product as it appears on the label at the time of
import.

7.

Active Ingredients and Percentage of Each. List each active ingredient by percentage. If the product is a pesticide device, this
block may be left blank.

8.

Unit Size. Net weight or net contents as identified on the product label of the pesticide or device in the immediate container,
not including the wrapper or other packaging materials.

9.

Quantity. Number of units comprising the shipment as defined at 19 CFR § 101.1.

10. Total Net Weight. Unit size multiplied by quantity.
EPA Form 3540-01 (Rev 3/22) Previous versions are obsolete.

Instructions - Page 1 of 3

11. Country of Origin. The country of manufacture, production, or formulation of the pesticide or device of foreign origin entering
the United States.
12. Port of Entry. The port of entry where the pesticide or device offered for import is processed for entry into the United States.
Ports of entry are designated locations where CBP enforces the import and export laws and regulations of the United States
federal government. Ports of entry are under the jurisdiction of a CBP port director. Enter either the port code or the city and
state.
13. Name, Complete Mailing Address, and Email Address of the Carrier. The carrier is a person or carrier service (rail, ship, airline,
trucking) who undertakes to transport goods or merchandise to and across the U.S. border.
14. Entry Number. The 11-character entry number using the format XXX-NNNNNNNN, including the hyphen as defined at
19 CFR 142.3a(b).
15. Anticipated Entry Date. Anticipated date of entry into the United States or anticipated date when the pesticide or device will
arrive within the port of entry limits.
16. Confidential Business Information (CBI) Designation. Please note that the information provided in blocks 4, 5, 6, and 7 is not
entitled to confidential treatment under section 7(d) of FIFRA and under labeling requirements for pesticides at 40 CFR 156.10.
Information provided in those blocks will be made public with no further notice.
17. Location of Goods for Examination after Importation. Enter the physical address of the location of goods after release to the
consignee. This is the physical location where the goods will be available for EPA inspection. In the case of unregistered
pesticides products imported between establishments operated by the same or different producer(s), enter the EPA
establishment number for the importing registered establishment. [Note: Section 17(c) of FIFRA and 19 CFR 12.115 give EPA the
authority to instruct CBP to conditionally release a shipment of pesticides or pesticide devices into the importer of record’s
custody, under a bond, pending resolution of certain issues with the shipment. Typically, the shipment is held by the importer of
record until EPA conducts an inspection under FIFRA § 8(b) and makes a determination of compliance.]
18. Importation of Pesticides without an EPA Registration Number. It is recommended that block 18 be completed when importing
an unregistered pesticide. Check all that apply and provide additional information as indicated.
19. Remarks. This block may be used to provide additional information. It is recommended that a copy of the label affixed to the
product be submitted with the Notice of Arrival (NOA).
20. Printed Name of Importer of Record or Licensed Customs Broker. Print name and telephone number of the Importer of Record
or Licensed Customs Broker.
21. Signature of Importer of Record or Licensed Customs Broker. Signature of Importer of Record or Licensed Customs Broker.
Table 1- EPA Form 3540-1 should be addressed to "Pesticide Imports Coordinator"
EPA Regional Offices
EPA Region 1
5 Post Office Square Suite #100
(OES 05-4)
Boston, MA 02109-3912
EPA Region 2
2890 Woodbridge Avenue
MS-500, Bldg #205
Edison, NJ 08837-3679
EPA Region 3
1650 Arch Street PAPB/LCD (ED23)
Philadelphia, PA 19103-2029
EPA Region 4
ECAD
61 Forsyth Street, SW
Atlanta, GA 30303-8960

States and Ports of Entry
Locations in the U.S.
CT, MA, ME, NH, RI, VT

NJ, NY, PR, VI

DE, DC, MD, PA, VA, WV
AL, FL, GA, KY, OH*, MS,
NC, SC, TN
*includes ports of entry
Cincinnati, OH (4102) and
Cincinnati DHL Hub
(4197)

EPA Form 3540-01 (Rev 3/22) Previous versions are obsolete.

EPA Regional Offices
EPA Region 6
1201 Elm Street
Mail code: LCRPT
Dallas, TX 75270
EPA Region 7
11201 Renner Boulevard
(ECAD/CB)
Lenexa, KS 66219-9601
EPA Region 8
1595 Wynkoop Street
Denver, CO 80202-1129
EPA Region 9
75 Hawthorne Street (CED-5)
San Francisco, CA 94105-3901

States and Ports of Entry
Locations in the U.S.
AR, LA, NM, OK, TX

IA, KS, MO, NE

CO, MT, ND, SD, UT, WY
AS, AZ, CA, GU, HI, MP, NV,
Trust Territories

Instructions - Page 2 of 3

EPA Region 5
77 West Jackson Boulevard. (ECP17J)
Chicago, IL 60604-3507

IL, IN, OH*, MI, MN, WI
*excludes ports of entry
Cincinnati, OH (4102) and
Cincinnati DHL Hub
(4197)

EPA Form 3540-01 (Rev 3/22) Previous versions are obsolete.

EPA Region 10
1200 Sixth Avenue
Suite 155 (20-C04)
Seattle, WA 98101-3140

AK, ID, OR, WA

Instructions - Page 3 of 3