Pest Control Dealer License Application, DPR PML 041 20180612 145141 PCDBL Packet

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STATE OF CALIFORNIA

PEST CONTROL DEALER BUSINESS LICENSE PACKET
PR-PML-041 (REV. 8/17)

DEPARTMENT OF PESTICIDE REGULATION
PEST MANAGEMENT AND LICENSING BRANCH
LICENSING AND CERTIFICATION PROGRAM
1001 I STREET
SACRAMENTO, CALIFORNIA 95814-2828
(916) 445-4038
Web site: http://www.cdpr.ca.gov

PEST CONTROL DEALER
BUSINESS LICENSE
PACKET

Contains the following documents:
• Licensing Requirements and Fact Sheet
• Application and Instructions
• Visa/Mastercard Transaction Form

State of California
PEST CONTROL DEALER
LICENSING REQUIREMENTS
Rev. 8/17

Do you need
this license?

DEPARTMENT OF PESTICIDE REGULATION
PEST MANAGEMENT AND LICENSING BRANCH
1001 I Street
P.O. Box 4015
Sacramento, California 95812-4015
Phone: (916) 445-4038 Fax: (916) 445-4033
Web site at 

You must possess a pest control dealer license if you are a person, manufacturer, distributor,
or retailer who does any of the following:
•
•
•

Sells agricultural use* pesticides, methods, or devices for the control of agricultural
pests
Solicits pest control sales through recommendations made by your field
representatives
Sells restricted use pesticides to users

Note: Registrants who sell their own pesticide products and licensed pesticide brokers are
excluded from this license requirement if they do not sell directly to the end user.
*California’s definition of agricultural use includes but is not limited to commercial
production of animals or plants, golf courses, parks, cemeteries, roadsides, power line
rights-of-way, and nurseries.

Basic licensing
requirements

You can obtain a pest control dealer license by submitting the application, appropriate fee,
and supporting business information and documents. The following criteria must be met
prior to the issuance of this license:
•
•
•

Qualified
person

Qualified person
Documents required to verify your business name and type
Worker’s compensation insurance

According to the Food and Agricultural Code (FAC) section 12101.5, you must have at least
one person in a supervisory position at each principle and branch location who
•
•

Is actively responsible for the operation of the dealership, and
Holds a valid pest control dealer designated agent license, agricultural pest control
adviser license, pest control aircraft pilot certificate, or a qualified applicator license

Please state the name of the qualified person, their license or certificate number, and their
license or certificate category on the application form.
Continued on next page

Pest Control Dealer
Licensing Requirements (Rev. 8/17)

Verifying your
business name
and type

Page 2

According to FAC section 11702(a), you must have the following documents to verify your
business name and type. If you are the sole proprietor (i.e., owner) and use your surname as
part of your business name, then no documents are required.
Document Name
Fictitious Business
Name Statement

•
•
•
•

Certificate of Good
Standing

•
•

Worker’s
compensation
insurance

Details
Obtainable from the County Clerk’s Office or County
Recorder’s Office
Applies to any business operating under a fictitious name
Obtainable from the California Secretary of State’s Office
Applies to any domestic or foreign corporation operating in
California
Must be registered with the California Secretary of State’s
Office
See the Secretary of State’s Web site at
 for registration
information

Each applicant, who is an employer as defined in Section 3300 of the Labor Code, is required
to carry worker’s compensation insurance. The Department of Pesticide Regulation’s (DPR)
policy on the worker’s compensation insurance requirement is listed in the table below.
Note: If you are interested in self-insurance to fulfill this requirement, please go to the
California Department of Industrial Relations’ Web site at
.
If you have a(n) …
Valid worker’s
compensation
insurance policy
Expired worker’s
compensation
insurance policy

Then you must …
• State the carrier’s name, policy number, and expiration date
on the application
• Write “not applicable” if your business has no employees
• Sign your application
Choose one of the following:
•
•

Submit a certificate of insurance from your insurer stating
that the policy is valid, along with the expiration date
Complete the Worker’s Compensation Insurance Verification
form (PR-PML-120), which can be found on DPR’s Web site
at 
Continued on next page

Pest Control Dealer
Licensing Requirements (Rev. 8/17)

Other
requirements

Once you obtain your license, you must do all of the following:
•

•
•
•
•
•
•

Application fee

Page 3

Maintain records of all purchases, sales, and distributions of pesticides at main and
branch offices for four years. You must report the total dollars of sales and total
pounds or gallons of agricultural use pesticides sold into or within California to
DPR’s director on a quarterly basis.
Pay the quarterly mill assessment to the director if the registrant or pesticide broker
has not paid it (FAC section 12406[b]).
Report purchases from other licensed dealers or registrants to the director on an
annual basis.
Retain agricultural pest control adviser’s written recommendations for two years.
Retain restricted material permits and operator identification statements records for
two years.
Retain Qualified Applicator License, Qualified Applicator Certificate, and Private
Applicator Certificate numbers and pest control category(ies) received from
purchasers when the operator identification number certificate was not required.
Obtain a copy of the ship vessel registration for tributyltin purchases.

The application fees are $160 (main) and $80 (branch) per calendar year (Title 3 of
California Code of Regulations [3 CCR], Code section 6502), which are based on the
following 2-year cycles:
If your business name begins with …
A through L
M through Z (including businesses
starting with “The”)

Then your license will …
Expire on December 31 of even-numbered
years (e.g., 2018, 2020, 2022, etc.)
Expire on December 31 of odd-numbered
years (e.g., 2017, 2019, 2021, etc.)

For example, if you applied for a license under the name “Pest Control Dealer Corporation”
in January 2017, then your license would expire on December 31, 2017 and the fee would
be $160. If you applied for a license under the name “Best Pest Control Dealers” in January
2017, then your license would expire on December 31, 2018 and the fee would be $320.

Renewal fee

The renewal fee is $320 (main) and $160 (branch) for the 2-year cycle (3 CCR section 6502).
We do not prorate your renewal fee if you renew your license late.

Late renewal
fee

A late fee of 50 percent of the total renewal fee will be assessed for each license postmarked
after December 31 of the expiration year.
Continued on next page

Pest Control Dealer
Licensing Requirements (Rev. 8/17)

Miscellaneous
fees

Page 4

The following chart lists the miscellaneous fees for this license. We charge a maximum fee
of $20 for all changes/requests that are submitted on a single application form.
Type
Name
change

Amount
$20

Address
change

$20

Duplicate

$20

Details
• You must immediately notify the Licensing and
Certification Office in writing (3 CCR section 6508).
• You must submit legal documents certifying the name
change.
• A new license will be automatically issued for all name
changes.
• The Address and/or Name Change Form is available on
our Web site at
.
• You must immediately notify the Licensing and
Certification Office in writing (3 CCR section 6508).
• This fee is only required if you request a new license.
• The Address and/or Name Change Form is available on
our Web site at
.
• This fee applies to requests for a duplicate or replacement
license.

Timelines for
processing
applications

DPR may take up to a hundred days to complete the processing of your application.

License
duration

A new license may be issued for up to two years, depending on when you apply and your
license cycle. Each renewed license is valid for two years unless you renew late.

Most common
mistakes and
how to avoid
them

The most common application errors made are
•
•
•
•

Incorrect fees
No insurance documents, or the insurance documents submitted do not meet our
requirements
No business type information provided
No qualified person listed

You can avoid these errors by reading the application instructions carefully and by mailing
your renewal application before your license expires.

Continued on next page

Pest Control Dealer
Licensing Requirements (Rev. 5/17)

Page 5

Our physical
address

Department of Pesticide Regulation
Pest Management and Licensing Branch
Licensing and Certification Program
1001 I Street
Sacramento, CA 95814-2828

Our mailing
address

Department of Pesticide Regulation
Pest Management and Licensing Branch
Licensing and Certification Program
1001 I Street
P.O. Box 4015
Sacramento, CA 95812-4015

For more
information

You can contact us between the hours of 8 a.m. to 5 p.m. at (916) 445-4038, or e-mail us
at .

STATE OF CALIFORNIA

DEPARTMENT OF PESTICIDE REGULATION
PEST MANAGEMENT AND LICENSING BRANCH
LICENSING AND CERTIFICATION PROGRAM
P.O. BOX 4015
SACRAMENTO, CALIFORNIA 95812-4015
(916) 445-4038
FAX - (916) 445-4033
Web site: http://www.cdpr.ca.gov/

PEST CONTROL DEALER LICENSE APPLICATION
DPR-PML-041 (REV. 08/11)
Page 1 of 4

PLEASE READ INSTRUCTIONS ON PAGES 3 AND 4.

A. Application Type. Check the appropriate box(es).
NEW APPLICATION

NAME / ADDRESS CHANGE

OTHER (Specify)

ADD BRANCH LOCATION

DUPLICATE / REPLACEMENT LICENSE

BUSINESS LICENSE #

B. Business Information (Main Location).

Please print or type.

BUSINESS NAME
FAX NUMBER

EMAIL ADDRESS

TELEPHONE NUMBER

(

(

)

BUSINESS MAILING ADDRESS (Number and Street or P.O. Box Number)

(City)

(County)

(State)

(ZIP Code)

BUSINESS LOCATION ADDRESS (Number and Street)

(City)

(County)

(State)

(ZIP Code)

BUSINESS TYPE (Check only one box.) See instructions for documentation requirements.

CORPORATION

INDIVIDUAL

LIMITED LIABILITY COMPANY

PARTNERSHIP

NON-PROFIT ASSOCIATION

LIMITED LIABILITY PARTNERSHIP

OTHER

C. Former Business Name. Enter former business name below.
FORMER BUSINESS NAME

D. Business Officers or Owners. Attach additional sheet if necessary.
1) NAME
MAILING ADDRESS (Number and Street or P.O. Box Number)

TITLE
(City)

(State)

2) NAME
MAILING ADDRESS (Number and Street or P.O. Box Number)

(ZIP Code)

TITLE
(City)

(State)

(ZIP Code)

E. Branch Locations. Attach additional sheet if necessary.
1) LOCATION ADDRESS (Number and Street or P.O. Box Number)

(City)

(County)

(State)

(ZIP Code)

2) LOCATION ADDRESS (Number and Street or P.O. Box Number)

(City)

(County)

(State)

(ZIP Code)

3) LOCATION ADDRESS (Number and Street or P.O. Box Number)

(City)

(County)

(State)

(ZIP Code)

F. Qualified Person. Each business location must have a qualified person, who possesses a valid license or certification in the
following: Pest Control Dealer Designated Agent License, Agricultural Pest Control Adviser License, Qualified Applicator License,
or Pest Control Aircraft Certificate. The qualified person is responsible for the operations of the pest control dealer business.
Attach additional sheet if necessary.
TYPE OF LICENSE/PILOT CERTIFICATE

1) QUALIFIED PERSON'S NAME

BUSINESS LOCATION ADDRESS (Number and Street)

BUSINESS LOCATION ADDRESS (Number and Street)

TYPE OF LICENSE/PILOT CERTIFICATE

LICENSE/PILOT CERT. NUMBER

(State)

(City)

3) QUALIFIED PERSON'S NAME
BUSINESS LOCATION ADDRESS (Number and Street)

(State)

(City)

2) QUALIFIED PERSON'S NAME

LICENSE/PILOT CERT. NUMBER

TYPE OF LICENSE/PILOT CERTIFICATE

(City)

Application Continued on Reverse Side

LICENSE/PILOT CERT. NUMBER

(State)

EXPIRATION DATE

(ZIP Code)

EXPIRATION DATE

(ZIP Code)

EXPIRATION DATE

(ZIP Code)

STATE OF CALIFORNIA

PEST CONTROL DEALER LICENSE APPLICATION
DPR-PML-041 (REV. 08/11)
Page 2 of 4

G. Pest Control Dealer Type.
Indicate the type(s) of pest control methods/devices or pesticides your business will be selling by checking the appropriate box(es) below.

Agricultural Use Pesticides Only

Tributyltin

Restricted Use Pesticides Only (Either California or Federal)

Livestock/Poultry Pesticides

Both Agricultural Use and Restricted Use Pesticides

Biological Control Agents

Other

H. Worker's Compensation Insurance. Each applicant who is an employer, as defined in Section 3300 of the Labor Code, is
required to carry worker's compensation insurance. If your business has no employees, write "Not Applicable" below.
WORKER'S COMPENSATION INSURANCE CARRIER NAME

EXPIRATION DATE

POLICY NUMBER

I. Fees. All fees are non-transferable and non-refundable.
Main Location
Branch Location
Name/Address Change, Duplicate/Replacement Fee

1-Year
$160
$80
$20

or
or

2-Year
$320
$160

#Branches
-x
x

=
=
=

Total Fees
$
$
$
$

Total Fee(s) Due/Enclosed

Enclose a check, money order or credit card payment for the total amount due payable to: Cashier, Department of Pesticide
Regulation. Mail your completed application, required documentation, and fees to: Cashier, Department of Pesticide Regulation,
P.O. Box 4015, Sacramento, California 95812-4015.
J. Read Before Signing. During the last three years, have you had any administrative, civil, or criminal action taken against you
for violation of any State or federal laws or regulations relating to the application or use of pesticides that resulted in disciplinary
actions or in which any disciplinary action is pending?
YES (State explanation below or attach separate page.)

NO

K. I declare under penalty of perjury, under laws of the State of California, that the above information is true and correct.
DATE SIGNED

APPLICANT SIGNATURE

FOR OFFICIAL
USE ONLY

BUSINESS LICENSE NUMBER

PROBLEM

COMPUTER ENTRY DATE

STATE OF CALIFORNIA

PEST CONTROL DEALER LICENSE APPLICATION INSTRUCTIONS
DPR-PML-041 (REV. 08/11)
Page 3 of 4

A.

B.

Application Type.
ƒ

New Application: If you are applying for the Pest Control Dealer License for the first time.

ƒ

Add Branch Location: Adding a pest control dealer branch location to your license.

ƒ

Duplicate/Replacement License: Requesting a duplicate or replacement license.

ƒ

Name/Address Change: Requesting name/address changes. Submit a copy of the legal document
substantiating the name change. Address changes may be made directly on the application form with a $20
fee.

ƒ

Other: Any other change, please specify the change.

Business Information (Main Location). Complete the information requested in this section. If you are changing
your business name, enter your former business name in Section “C”. If there is a change in business name or
address you must immediately notify the Director in writing. If your business is a:
ƒ

Corporation, submit a current copy of the “Certificate of Good Standing” which may be obtained from the
Secretary of State, Certificate Department, 1500 11th Street, Sacramento, California 95814.

ƒ

Limited Liability Company or Limited Liability Partnership, submit a current copy of the “Certificate of
Good Standing” which may be obtained from the Secretary of State, Certificate Department,
1500 11th Street, Sacramento, California 95814.

ƒ

Partnership, submit a “Fictitious Business Name Statement” which may be obtained from the county clerk’s
office.

ƒ

Individual, if the business name is different than your surname (last name), submit a “Fictitious Business
Name Statement” which may be obtained from the county clerk’s office.

ƒ

Non-Profit Association, if the business is a corporation, submit a current copy of the “Certificate of Good
Standing” which may be obtained from the Secretary of State, Certificate Department, 1500 11th Street,
Sacramento, California 95814. If the business name is different than your surname (last name), submit a
“Fictitious Business Name Statement” which may be obtained from the county clerk’s office.

C.

Former Business Name. If your business name has changed, enter the former name in this section of the
application.

D.

Business Officers or Owners. List the name, title, and mailing address of the business officers and/or owners. If
necessary, use an additional sheet of paper. If there is a change in the business ownership or organization, notify
the Director immediately in writing. A new application and fee must be submitted for this change.

E.

Branch Locations. Complete this section to add a branch location to your business. Enter the business location
address for each branch location added. If the branch name is different from the main business name, indicate the
branch name and submit a “Fictitious Business Name Statement” which may be obtained from the county clerk’s
office.

F.

Qualified Person. Each principal and branch office must have a qualified person who possesses a valid Pest
Control Dealer Designated Agent License, Agricultural Pest Control Adviser License, Qualified Applicator License, or
Pest Control Aircraft Certificate. The qualified person is responsible for the operations of the pest control business.
Use an additional sheet of paper if necessary. If there is a change in the qualified person for the business, notify the
Director immediately. There is no fee required for this change.

G.

Pest Control Dealer Type. Indicate the type of pesticides the business will be selling. Check all that apply.

H.

Worker’s Compensation Insurance. Each applicant who is an employer as defined in Section 3300 of the Labor
Code is required to carry worker’s compensation insurance. If applicable, enter the name of the worker’s
compensation insurance carrier, the policy number, and the policy expiration date.

STATE OF CALIFORNIA

PEST CONTROL DEALER LICENSE APPLICATION INSTRUCTIONS
DPR-PML-041 (REV. 08/11)
Page 4 of 4

I.

Fees. All fees are non-transferable and non-refundable.

Main Location:
Branch Location:

One-Year*
$160
$ 80

Two-Year*
$320
$160

Name/Address Change Fee: $20 (See Note)
Duplicate/Replacement Fee: $20 (See Note)
NOTE: A fee for an address change is only required when the licensee requests a new license be issued (printed
and mailed). A maximum fee of $20 is due for all name/address changes and requests for a duplicate/replacement
licenses submitted on a single application.
* The following information and table will assist you in determining the appropriate application fee.
New Application Fee Schedule Example:
Year Submitting
Application

License
Name

License
Expiration Year

Main License
Application
Fee

Branch License
Application
Fee

2010

A-L
M-Z

2010
2011

$160
$320

$80
$160

2011

A-L
M-Z

2012
2011

$320
$160

$160
$80

2012

A-L
M-Z

2012
2013

$160
$320

$80
$160

If your business name begins with A - L, the expiration date of the business license is on even-numbered years.
If your business name begins with M - Z, the expiration date of the business license is on odd-numbered years.
J.

Read Before Signing. Check appropriate box.

K.

Declaration/Signature Block. Sign and date your application. Enclose a check, money order or credit card payable
to “Cashier, DPR” and mail to: Cashier, Department of Pesticide Regulation, P.O. Box 4015, Sacramento, California
95812-4015.

Failure to complete or provide the requested information may delay the processing of your application.

STATE OF CALIFORNIA
DEPARTMENT OF PESTICIDE REGULATION
1001 I STREET
SACRAMENTO, CA 95814-2828

Web site: http://www.cdpr.ca.gov
DPR-105 (Rev. 08/17)
Page 1 of 1

VISA/MASTERCARD TRANSACTION

Mail completed application with this payment form to:
For Licensees:

For Continuing Education Sponsors:

ATTN: Cashier
Department of Pesticide Regulation
P.O. Box 4015
Sacramento, CA 95812

Cashier
ATTN: CE
Department of Pesticide Regulation
P.O. Box 1379
Sacramento, CA 95812

ALL SECTIONS MUST BE COMPLETED. DO NOT E-MAIL OR FAX this form.
FAILURE TO COMPLETE ALL SECTIONS WILL RESULT IN YOUR APPLICATION BEING DELAYED OR REJECTED.
NAME OF CARDHOLDER (NAME APPEARING ON THE CARD)

VISA or MASTERCARD ONLY. No other cards are accepted.

CHECK ONE:

VISA

MASTERCARD

CARD NUMBER
(16 DIGITS)

Expiration Date
Total Amount of Payment
SIGNATURE OF CARDHOLDER (NAME APPEARING ON THE CARD)

PAYMENT FOR:

MAILING ADDRESS (Street or P.O. Box Number)

TELEPHONE NUMBER (include area code)

City, State, and ZIP Code

(DEPARTMENT USE ONLY) - ENTERED ON POS BY:

TODAY'S DATE

DATE MAILED

BY:



---

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