APPLICATION FOR RECIPROCAL PESTICIDE APPLICATOR

VIRGINIA DEPARTMENT OF AGRICULTURE AND CONSUMER SERVICES

OFFICE OF PESTICIDE SERVICES

P. O. Box 526 • Richmond, VA 23218

Phone: (804) 371-0152 • Fax: (804) 786-9149 • www.vdacs.virginia.gov

APPLICATION FOR RECIPROCAL PESTICIDE

APPLICATOR CERTIFICATE

(SEE PAGES 2 AND 3 FOR INSTRUCTIONS AND DEFINITIONS)

In accordance with the Virginia Pesticide Control Act, application is hereby made for CERTIFICATION as a COMMERCIAL

PESTICIDE APPLICATOR under the Reciprocal Agreement between the Commonwealth of Virginia and the State

of . All certificates must be renewed by June 30

of the year provided on the certificate.

(State you are certified in)

The non-refundable application fee is $100.00. Make the check payable to: Treasurer of Virginia. Mail the completed

application, check, copy of your out-of-state license and other required forms to the above address. Federal, state,

and local government employees are exempt from the fee.

CERTIFICATE CLASS DESIRED: (check only one appropriate class)

Commercial For-Hire (C) Not-For-Hire Commercial (N) Government Employee (G)

Please type or print the following information: E-MAIL ADDRESS:

Social Security # (REQUIRED): _______-__________-__________ HOME PHONE: _______________________________________

APPLICANT'S NAME: _______________________________________________________________ DOB: _____/______/_________

(Last) (First) (M.I.) MM / DD / YYYY

MAILING ADDRESS:_______________________________________________________HOME STATE CERT #_________________

(Street or RFD)

CITY:____________________________________________STATE:_____________ZIP CODE:______________________________

EMPLOYED BY (NAME OF BUSINESS):__________________________________________________________________________

VA. PESTICIDE BUSINESS LICENSE #: _____________________________BUSINESS PHONE #:___________________________

BUSINESS ADDRESS:________________________________________________________________________________________

(Street or RFD) (City, State, Zip)

I request to obtain the following VA categories through Reciprocity with the State of :

(State you are certified in)

CATEGORY # CATEGORY TITLE CATEGORY # CATEGORY TITLE

(1) __________ ___________________________ (2) _________ _____________________________

(3) __________ ___________________________ (4) _________ _____________________________

(See page 2 for VA applicator categories)

I certify by signing below that I am the person applying for certification and that I meet the eligibility requirements for commercial

certification. I further certify that I have been trained in the specific skills necessary to properly apply pesticides in the

performance of my job, and I agree to abide by all laws and regulations governing pesticide usage in Virginia. In addition, I

certify that I am over the age of 18, and eligible for pesticide certification in the Commonwealth of Virginia.

(Signature of Applicant) (Date)

AMOUNT TO REMIT: $ 100.00

VDACS ACCT: 756-09-02656

VDACS-07210 05/19

(SEE PAGES 2 AND 3 FOR CATEGORIES AND INSTRUCTIONS)

CA-R

FOR DEPARTMENT USE ONLY:

Certificate No.:

Date Issued:

Keyed By:

5/19

VA COMMERCIAL PESTICIDE APPLICATOR CATEGORIES

Category # Category Title

1-A Agricultural Plant Pest Control

1-B Agricultural Animal Pest Control

1-C Fumigation - Soil/Ag Products

1-D Chemigation

2 Forest Pest Control

3-A Ornamental Pest Control

3-B Turf Pest Control

4 **Seed Treatment

5-A Aquatic Pest Control-General

5-B Marine Antifoulant Paint

6 Right-Of-Way Pest Control

7-A **General Pest Control (including food processing)

7-B **Wood Destroying Pest Control

7-C Fumigation (Non-Agricultural)

7-D Vertebrate Pest Control (excluding structural

invaders)

7-E Sewer Root Pest Control

8 Public Health Pest Control

9 Regulatory Pest Control

10 Demonstration and Research Pest Control

11 Aerial Pesticide Application

12 Wood Preservation

** excluding fumigation

Definitions:

Commercial applicator means any applicator who has completed the requirements as determined by

the board, including appropriate training and time in service, to apply for a certification, and who uses or

supervises the use of any pesticide for any purpose or on any property other than as provided in the

definition of private applicator.

Commercial applicator not for hire means any commercial applicator who uses or supervises the use

of pesticides as part of his job duties only on property owned or leased by him or his employer. This

definition shall also apply to governmental employees who use or supervise the use of pesticides,

whether on property owned or leased by them or their employers or not, in the performance of their

official duties.

Renewal is required biennially by June 30

of the year indicated on your certificate. This is accomplished

by submitting a commercial renewal application before the expiration date listed on the applicator’s

certificate. As a reciprocal Commercial Applicator, you will need to present your home’s states

unexpired certificate each time you renew your Virginia Certificate.

Recertification is also required biennially. This is accomplished by attendance at a Virginia approved

recertification course for each category you wish to maintain, or by re-testing in lieu of attending training

courses. You are required to take at least one course in a two year period, but can take enough courses

to obtain four years of credit.

05/19

INFORMATION FOR RECIPROCAL AGREEMENT PESTICIDE APPLICATOR

CERTIFICATION

All Commercial Applicators (CCAs) (with the exception of not-for-hire commercial applicators and

government employees) must either obtain, or work for a firm that has obtained a Virginia Pesticide

Business License issued by the Virginia Department of Agriculture and Consumer Services. This should not

be confused with any county or city business license or license from another government agency or state.

Both Recertification and Renewal are required for Applicators to maintain their certificates.

Recertification is required biennially. This is usually accomplished by attending a Virginia

approved recertification course. Reciprocal recertification may be granted to out-of-state applicators if they:

1. Maintain certification in their home state, AND;

2. Provide proof of Virginia recertification credits to the Office of Pesticide Services, OR;

3. Provide proof of home-state recertification credits (if the home state grants reciprocal recertification to

Virginia applicators) to the Office of Pesticide Services.

Renewal is also required biennially. This is accomplished by submitting a commercial renewal

application every other year before the expiration date listed on the applicator’s certificate (June 30th).

INSTRUCTIONS FOR COMPLETING APPLICATION

FOR RECIPROCAL COMMERCIAL APPLICATOR CERTIFICATION

1. Fill in “Application for Reciprocal Applicator Certificate” completely. Be sure to sign and date your

application. The state you are reciprocating from MUST be a state where you tested and passed

commercial pesticide applicator examinations. You cannot obtain Virginia reciprocity from a

state you reciprocated into from another state.

2. If you are an out-of-state resident and your business address is also out-of-state, you must

enclose a completed and notarized Power of Attorney form. Please have your notary use an ink

seal. If your business has a Resident Agent registered with the Virginia State Corporation Commission,

please indicate them on form.

3. Enclose a front and back copy of your current state’s certificate. Be sure this is an unexpired

certificate.

4. If you are an aerial applicator, you must submit a copy of your FAA Certificate.

5. Enclose the fee of $100.00 for certification made payable to THE TREASURER OF VIRGINIA. All

fees are non-refundable and non-transferable (Fees are waived for government employees).

6. Once you have obtained your certification, you are responsible for maintaining an active certificate

through recertification training and renewing your certificate biennially. Your expiration AND

recertification deadlines will be displayed on your certificate. It is your responsibility to notify OPS of any

mailing address or employer changes to ensure you receive updates on when to recertify and renew.

Should your certificate expire for any reason, you will be required to re-take all examinations needed to

reinstate your certificate.

If you have further questions or need additional help applying, call our office at (804) 371-0152 or email

opsclrt.vdacs@vdacs.virginia.gov.