Pesticide Incident Complaint Form - Illinois Department of Agriculture - agr state il 2026

1. Click ‘Get Form’ to open the Pesticide Incident Complaint Form in the editor.
2. Begin by filling out the Complainant Information section. Provide your name, address, and contact details clearly to ensure accurate communication.
3. Next, enter the Complaint Information. Specify the date and time of the incident, along with the type of applicator involved. Select from options such as Commercial Company, Farmer, Homeowner, or Other.
4. Indicate the method of application (Ground or Aerial) and provide any known details about the chemical involved and specific nature of your complaint.
5. If necessary, attach additional pages for more information. Ensure all sections are completed before signing and dating the form.
6. Finally, submit your completed form via mail or fax to the Illinois Department of Agriculture using the provided contact information.

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