Pesticide Renewal/Recertification Application
Bureau of Pesticides Management Pesticide Applicator/Technician 625 Broadway - 9th Floor Renewal/Recertification Albany NY. 12233-7254 Phone: 518-402-8748 Application Form CERTIFICATION ID#: COMPLETE ALL FIELDS BELOW, INCOMPLETE applications WILL NOT BE ACCEPTED. Last Name: ____________________________ First Name: ____________________________ _____. Date of Birth: _____/_____/_____ Have you been convicted of a Felony? Yes: _____ No: _____. Since your last Renewal/Recertification : Have you moved? Yes: _____ No: ______ If yes, your new residence is: Street ________________________________________ __ Apt# _______.
Application Checklist Fee Please send a check or money order made payable to Commissioner NYSDEC Certified Commercial Pesticide …
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