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Forms

Return to Licensing and Certification Program

Application and renewal packets

The complete packets include the application and other required forms, fact sheet on licensing or certification requirements, suggested study materials, exam schedule, and Visa/Mastercard transaction form. Individual forms are listed by category and do not include the required supplemental forms. See packets for all required forms and information.

Forms to apply for or request changes in a license or certificate

DPR-130, (PDF, 11 kb)    Qualified Applicator’s Qualifications and Employment Certification Statement
                                              (Field Fumigation Subcategory O)
PR-PML-005, (PDF, 64 kb)       Aircraft Pilot Pest Control Certificate Application

PR-PML-084, (PDF, 65 kb)       Agricultural Pest Control Adviser License Application

PR-PML-004, (PDF, 104 kb)     Maintenance Gardener Pest Control Business License Application

PR-PML-042, (PDF, 142 kb)      Pest Control Business License Application

PR-PML-043, (PDF, 57 kb)         Pest Control Dealer Designated Agent License Application

PR-PML-041, (PDF, 110 kb)      Pest Control Dealer License Application

PR-PML-217, (PDF, 104 kb)     Pesticide Broker License Application

PR-PML-045, (PDF, 20 kb)       Private Applicator Certificate Application
                                              Applicants will submit PR-PML-045 to County Agricultural Commissioners,
                                              not to the Department of Pesticide Regulation)

PR-PML-001A, (PDF, 85 kb)     Qualified Applicator Certificate Application

PR-PML-001, (PDF, 82 kb)       Qualified Applicator License Application

Financial Responsibility Forms

PR-PML-052, (PDF, 25 kb)       Certificate of Insurance

(PDF, 14 kb)                            Financial Responsibility Options for Pest Control Business

PR-PML-170, (PDF, 9 kb)          Liability Certification Statement - Maintenance Gardener Pest Control Business License

PR-PML-053, (PDF, 22 kb)        Pest Control Business Licensees Bond

Continuing Education Forms

PR-PML-123, (PDF, 90 kb)       Continuing Education Record Renewal Summary

PR-PML-131, (PDF, 44 kb)       Continuing Education Sponsorship Application

Miscellaneous Forms

PR-PML-085, (PDF, 17 kb)       Agricultural Pest Control Adviser Core Course Requirements for New License Applicants Form

PR-PML-002, (PDF, 176 kb)     Change of Address and/or Name Form

PR-PML-010, (PDF, 37 kb)       Pest Control Aircraft Pilot Statement of Supervision of Apprentice by Journeyman

PR-PML-083, (PDF, 60 kb)       Reexamination or Adding New Categories

PR-PML-143, (PDF, 10 kb)       Supplemental Application Information - Maintenance Gardener Pest Control

PR-PML-006, (PDF, 65 kb)       Supplemental Information for Pest Control Business License (Fee Exempt)

DPR-105, (PDF, 12 kb)             Visa/Mastercard Transaction

PR-PML-120, (PDF, 16 kb)       Worker's Compensation Insurance Verification

If you have questions about California’s licensing, certification, and training requirements to perform pest control work (new applications, renewals, change of address, qualifications, examinations, study materials, and continuing education), please contact the Licensing Program at licensemail@cdpr.ca.gov or by phone at (916) 445-4038