13609 form 2025

1. Click ‘Get Form’ to open the 13609 form in the editor.
2. Begin with Part A, where you will provide your personal information. Fill in your last name, first name, and middle initial. Ensure that your primary residence address is accurate, including any apartment number.
3. Next, indicate whether this is a new application or a renewal application by checking the appropriate box. Remember to include the required fees: $50 for new applications and $10 for renewals.
4. In Part B, if applicable, have your physician complete the medical certification section. They must indicate their board certification status and specify any necessary notification distance for pesticide applications.
5. Proceed to Part C to list adjacent properties within the specified distance. Use additional sheets if necessary to ensure all relevant addresses are included.
6. Finally, review all sections for accuracy before submitting your completed form through our platform.

Start filling out your 13609 form online for free today!