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EPA Form 3540-16 Pesticide Report for Pesticide-Producing and Device-Producing Establishments

You must print, sign and date the form. Submit reports to the pesticide establishment coordinator where your company headquarters is located.

You must use Adobe Acrobat version 8 or higher to complete the form. Please read the instructions carefully to complete and submit the form

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    1. on this page, place your cursor on the link "EPA Form 3540-16 (PDF). Do not open the file.
    2. right click the mouse to either "save / save as / save link as" depending on your browser.
    3. save the file “estabreport.pdf” to an area on your computer such as your desktop, or download folder.
    4. go to your download folder or wherever you saved the file, and open the “estabreport.pdf” file from there. The PDF reader, installed on your computer, should be able to open the fill-and-print file from where you saved the file.

Note: EPA will not accept any copies, faxes or emails of establishment initial or annual reports (EPA Form 3540-16)

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