Application for New or Amended Registration

On this page:

• Application for New or Amended Registration (6005) Guidance
• Form

Application for New or Amended Registration (6005) Guidance

Help on accessing alternative formats, such as Portable Document Format (PDF), Microsoft Word and PowerPoint (PPT) files, can be obtained in the alternate format help section.

1. Submission Number

   Will be assigned by the Pest Management Regulatory Agency (PMRA). A copy of the application form will be returned to you with the assigned application number. This will acknowledge receipt of your application. Refer to application numbers in all correspondence.

2. Product Name

   The name should include words or phrases descriptive of the purpose, physical form and active ingredients for the product, and be specific to the product as on the label. The name must be consistent in all forms and correspondence.

3. Registration Number

   If the product has been previously registered under the Pest Control Products Act, show the assigned registration number. Do not enter any other number in this space.

4. Registrant Name and Address

   This is the current or intended registrant of the product. The name must be a legal entity (trademark names are not acceptable). Note that the PMRA reserves the right to ask for the legal documentation proving the legal existence of the intended or current registrant.

5. Regulatory Mailing Address

   The PMRA will direct the regulatory mail to this address. The mailing address must be the same for all products registered by the registrant that is specified in box 4. In accordance with Section 62 of the Pest Control Products Act, non-Canadian registrants are required to have a Canadian representative. The mailing address should be the Canadian representative's address.

6. Submission Contact

   This is where and to whom the PMRA will direct inquiries specific to this application.

7. Communication

   Formal correspondence, including the Registration Letter, Certificate of Registration, and Approved Label text will be sent to the Regulatory Mailing address identified in #5.

8. Type of Application

   Indicate if the application is for the registration of a new product or an amendment of the registration of a product currently registered under the Pest Control Products Act.

9. Type of Product

   Indicate by one or more codes the purpose of the product. (Use the list below to determine the code(s).)

   Invertebrate Pest Controls

   • ACA: acaricide
   • BIO: biological
   • IRP: insect repellent
   • INS: insecticide
   • MOL: molluscicide
   • PHE: pheromone

   Plant Disease Controls

   • FUN: fungicide (agricultural)
   • BAC: crop bactericide
   • NEM: nematicide
   • PRP: pruning paint

   Weed and Algae Controls

   • ALG: algaecide (agricultural)
   • HER: herbicide

   Other Controls

   • ADJ: adjuvant, surfactant
   • PGR: plant growth regulator

   Vertebrate Pest Controls

   • ARP: animal repellent
   • ATX: animal toxicant
   • BRP: bird repellent
   • BTX: bird toxicant
   • BST: bird chemosterilant
   • FTX: fish toxicant
   • ROD: rodenticide

   Antimicrobial Products

   • AFP: anti-fouling paint
   • AIS: air sanitizer
   • LAA: laundry additive
   • MPS: material preservative
   • SAN: sanitizer only
   • SLI: slimicide
   • SWA: swimming pool algaecide
   • SWB: swimming pool bactericide

   Wood Preservatives

   • HDW: heavy duty
   • JON: joinery
   • REM: remedial
   • SAP: anti-sapstain
   • STN: stain

10. Proposed Classification

    Indicate whether the product is an end-use product to be marketed for domestic (home or garden), commercial (agricultural, forestry, industrial, etc.), or restricted use, or if the product is a manufacturing use product to be marketed as a technical active ingredient (TGAI), integrated systems product (ISP), or manufacturing concentrate.

11. Size and Type of Container

    The size of the container(s) can be specified as a range of container sizes or individual sizes. When applying to amend a product's registration, please be sure to include all currently approved container sizes and any new sizes requested. Any container size that is to be removed from a product's registration should not be listed. Also indicate in the covering letter what container size(s) are requested to be added or removed when amending a product's registration.

    Material: Please indicate the type of material used for the container that is encapsulating the pesticide by selecting the appropriate checkbox. If the material is different than the choices listed, enter the container material beside "Other".

    Container Type: Provide information on the type of vessel encapsulating the pesticide. Some examples are:

    • drum
    • pressurized keg with valve
    • child resistant container
    • water soluble pouch
    • refillable container
    • foil pouch
    • box
    • closed transfer system

    Size Range: These two fields provide the lower and upper values for a range of container sizes. A size range includes all container sizes spanning between the lower and upper values. Please include the units when specifying a range.

    Size(s): Has multiple fields to specify individual container sizes. Include only one container size per box on the application form. Please include the units for each container size.

12. Purpose

    Identify which purpose of review best describes your application and then check all appropriate boxes. If "other" is chosen, indicate what is to be reviewed. Provide details in covering letter.

13. Initial / Master Product

    Check the appropriate box if applying for initial product and/or master product status. Please note that Initial/Master Product status cannot be applied for if the active ingredient used in the product is under re-evaluation.

14. Proposed New Uses and / or Uses to be Withdrawn

    In support of the transparency requirements of the Pest Control Products Act that received Royal Assent in 2002, the PMRA is now collecting information to support the requirements of Section 42 (2)(a)( i) of the Act. Applications to register or amend the registration of a pest control product must now identify, and submit with the application form, proposed new uses and/or any uses proposed to be withdrawn. This required use information is being collected on form 6023 Proposed New Uses and / or Uses to be Withdrawn.

15. Declaration

    The authorized signing officer must sign the declaration certifying that the information provided is true and complete.

Important:

Please submit a covering letter describing detailed purpose of this application. When necessary, the following must be submitted along with this application. Please contact PMRA for additional information requirements.

1. Electronic Label in pdf format
2. Product Specification Form
3. Supporting information and data
4. Letter of confirmation of source of supply of active ingredient(s)
5. Fees and Fee Form

Submit forms and accompanying fees to:

Health Canada,
Pest Management Regulatory Agency
2720 Riverside Drive
6606E
Ottawa ON K1A 0K9

Information required of an applicant to register a pest control product or to amend a registration may include some personal information as defined in the Privacy Act. In accordance with that Act, such personal information may be made public as authorized by the Pest Control Products Act and its regulations.

Under the Privacy Act, you have the right to look at your personal information.

For more information on how PMRA manages personal information, contact the PMRA Information Services at 1(800) 267-6315 within Canada and 1(613) 736-3799 outside of Canada or via e-mail at pmra_infoservice@hc-sc.gc.ca.

Form

Date received:

1. Submission No.:
2. Product name (full name, no abbrevations):
3. Registration No.:

4. Registrant Name and Address: This is the intended or current registrant of the product, in whose name this application is filed, and in whose name the Certificate of Registration will be issued. The Registrant Name must appear on the label. Please ensure the address provided is complete and capable of receiving postal mail delivery.

   Code

   Registrant name (full legal name - no abbreviations):
   Postal Delivery Address:
   City/Town:
   Prov/State:
   Country:
   Postal Code/ZIP:

   Contact

   Name:
   Job Title:
   Phone:
   Fax:
   Email:

5. Regulatory Mailing Address: This is to where the PMRA will direct the registrant's regulatory mail. Operational and system requirements dictate that the mailing address must be the same for all products registered to the registrant identified in Block 4 above. For non-Canadian registrants this must be the Canadian agent/representative's mailing address.

   • Same as block 4 above

   Code

   Registrant name (full legal name - no abbreviations):
   Postal Delivery Address:
   City/Town:
   Prov/State:
   Country:
   Postal Code/ZIP:

   Contact

   Name:
   Job Title:
   Phone:
   Fax:
   Email:

6. Submission Contact: This is to where and to whom PMRA will direct inquiries specific to this application.

   • Same as block 4 above
   • Same as block 5 above

   Code

   Registrant name (full legal name - no abbreviations):
   Postal Delivery Address:
   City/Town:
   Prov/State:
   Country:
   Postal Code/ZIP:

   Contact

   Name:
   Job Title:
   Phone:
   Fax:
   Email:

7. Communication

   Please indicate to which contact the Acknowledgement of Receipt of this application should be sent (Note: if not indicated it will be sent to Block 6).

   • 4
   • or 5
   • or 6

   Formal correspondence, including the Registration Letter, Certificate of Registration, and Approved Label text will be sent to the Regulatory Mailing address identified in Block 5.

   Would you like a copy sent to the Submission Contact identified in Block 6? Yes
8. Application for:
   • New
   • Amended
   • Renewal
   • Reinstatement
9. Type of product code(s):
10. Proposed classification:
    
    End-Use Product:
    • Domestic
    • Commercial
    • Restricted
    Manufacturing Use Product:
    • Manufacturing Concentrate
    • Technical
    • Integrated System Product
11. Type and size of container
    
    Container material:
    • Metal
    • Glass
    • Plastic
    • Paper
    • Other (specify)

    Container type:

    Size range / units: to

    or Size(s) / units:

12. Purpose - Check all appropriate boxes which apply to your submission. If unsure, consult the Pest Management Information Service. (1-800-267-6315 or 613-736-3799).

    Category A:

    New active ingredient:

    • Canadian registration
    • Import MRL only
    • URMUR
    • Major New Use

    Category B:

    • New or amended product chemistry
    • New or amended label statements
    • Conversion/Renewal of Conditional Registration
    • New MRL(s) for previously assessed active ingredient
    • Other (specify in covering letter)

    Category C:

    • New or amended product chemistry
    • New or amended label statements
    • Similar product or use already registered.
      Cite Registration number of precedent product:

    Administrative changes:

    • Change in source of registered active ingredient
    • Registration or addition of minor use
    • Other (specify in covering letter)

    Category D:

    • IMEP
    • Label Improvement Program
    • New Master Copy based on Master Product Reg. No.
    • Renewal

      Is this product currently marketed in Canada? - Est-ce que ce produit est présentement disponible sur le marché au Canada?

      • Yes
      • No

      An exemption from the bilingual labelling requirements is requested as this product is not manufactured, imported, sold or used in Canada.

      • Yes
      • No
13. I am applying for Master/Initial Product Status:
    • Initial Product
    • Master Product
14. In support of the transparency requirements of the Pest Control Products Act that received Royal Assent in 2002, the PMRA is now collecting information to support the requirements of section 42(2)(a)(i) of the Act. Applications to register or amend the registration of a pest control product must now identify, and submit with the application form, proposed new uses and/or any uses proposed to be withdrawn. This required use information is being collected on Form 6023, Proposed New Uses and/or Uses to be Withdrawn.

    Proposed new Uses and/or Uses to be Withdrawn Form 6023 submitted?

    • Yes
    • No
15. Declaration:

    In compliance with the Pest Control Products Act, application is hereby made for the registration of a control product as outlined in this application, product specification form and labelling. It is certified that the information is true and complete.

    Signature:
    Printed name:
    Date:
    Company affiliation of the signer:
    Phone:
    Email:
    Registration has been granted subject to the following conditions:

    Pursuant to the application and attachments and subject to amendments (if any) made therein, registration is granted and the above registration number is hereby assigned.

This certificate is for the registration period ending December 31, 20

Note: This registration is not an endorsement or an approval by Health Canada of this control product.

HC/PMRA Official:
Date:
Officer's remarks:

Information required of an applicant to register a pest control product or to amend a registration may include some personal information as defined in the Privacy Act. In accordance with that Act, such personal information may be made public as authorized by the Pest Control Products Act and its regulations.

Under the Privacy Act, you have the right to look at your personal information.

For more information on how PMRA manages personal information, contact the PMRA Information Services at 1-800-267-6315 within Canada and 1-613-736-3799 outside of Canada or via e-mail at pmra_infoserv@hc-sc.gc.ca.