Pest Control Business Renewal Application Packet
2024 Renewal Information for Business License Holders
Dates for Renewal
October 1,
2024
DPR encourages submitting completed
renewal applications to DPR by this
date to best ensure you receive your
new license/certificate before January
1, 2025.
November 1,
2024
Processing time is 60 days for
applications with payments processed
by this date. Applications received
after Nov 1 may experience a longer
processing time and you may not
receive your license/certificate by
January 1.
January 1,
2025
Your license/certificate must be
renewed by this date to continue
working legally and without
interruption.
Maili
ng of Renewal Packets
DPR is mailing renewal packets in September
to provide sufficient time for business license
holders to submit their applications by
October 1. Renewal applications must be
postmarked on or before December 31, or a
late fee applies.
If you did not receive your
renewal application or misplaced
it, download a renewal packet
from DPR’s website:
Busine
ss License Renewal Application
The following forms will be included in the
renewal packet:
•
Renewal Application
•
Business License Renewal Information
•
Visa/MasterCard Transaction
Renewal applications must be filled out
completely, signed by the qualified applicator
or business owner, and submitted with the
correct fee.
Financial Responsibility
Submit a copy of each policy with your
business renewal application
•
Proof of valid Chemical Liability
Insurance
•
Proof of valid Workers’ Compensation
Insurance if you have employees
Check your renewal status on
DPR’s Valid License List Web
page:
Qual
ified Applicators
A qualified applicator cannot supervise the
operations of more than one main or branch
location.
Note: Your qualified applicator’s renewal must be
processed before the business license can be
renewed. DPR recommends sending the business
renewal and the qualified applicator renewal in
together and sending them in early to best ensure
they are processed timely, late fees are avoided,
and your business remains licensed.
Address Changes
Always notify DPR in writing immediately of any
address or name changes. When emailing DPR it is
best to include your full name, business name, as
well as your DPR Business License Number.
Name Changes
Always notify DPR immediately of any changes
regarding the name of your business.
Note: A name change may affect your renewal cycle
and additional fees may apply.
Ownership or Entity Type Changes
Licenses are not transferable. You must notify DPR
immediately of any changes in ownership or entity
type. Typically, you will need to re-apply as a new
applicant and pay the appropriate fees.
Questions about your a
pplication?
For questions regarding your application please
email DPR at: L[email protected]
DPR El
ectronic Mailing List
Sign up for important information
and updates from DPR about
Licensing and CE
License or Certificate Type
DPR Staff Name and Contact Information
General Questions [email protected].gov
Pest Control
Businesses
Alpha: A-D, S-Z
R
egina Maglia
Regina.Maglia@cdpr.ca.gov
Alpha: E-R
Heather Allen
Heather.Allen@cdpr.ca.gov
When emailing DPR, it is best to include your full name, your business name, and your DPR Business License
Number, as well as any payment processing information that you have.
Owner E-Mail:
Page 1 of 2
Officer E-Mail:
Policy Number
Expiration Date
Owner Name:
State of California
Pest Control Business Renewal Application
LIC-192 (Rev. 07/24)
Department of Pesticide Regulation
Licensing and Certification Program
PO Box 4015
Sacramento, CA 95812-4015
E-Mail:[email protected]
v
Web site:
http://www.cdpr.ca.gov
Owner Information
Check if Information is Correct
Business Information
Check if Information is Correct
Business License Number:
Business Name:
Owner Phone Number:
Address:
List information for additional owners on a separate sheet of paper, if necessary.
City, State, ZIP:
Check if Information is Correct
Officer Information
E-Mail Address:
Business Phone Number:
Officer Phone Number:
List information for additional officers on a separate sheet of paper, if necessary.
Information Corrections
(If above information is incorrect, include updated information here.)
Business Information Changes:
Officer Name:
Officer Information Changes:
Owner Information Changes:
Important - Please Read
Complete all fields below, see page 2 for complete instructions.
Qualified Applicator. Each business location must have a qualified applicator who possesses a valid Qualified Applicator License with the
appropriate pest control category(ies) to engage in pest control work from each location. If you need additional space, attach a separate sheet
of paper.
Qu
alified Applicator's Name, License Number,
and Category(ies) (i.e., A, B, C)
The Qualified Applicator's License must be renewed before the Business
License is renewed.
Main/Branch Location
Address
Main/Branch
License Number
Worker's Compensation Insurance. If you have employees, provide the name of the Worker's Compensation Insurance Carrier, policy number, and
policy expiration date. If you do not have employees please note 'no employees' in the carrier name field below.
W
orker's Comp. Insurance Carrier Name
Financial Responsibility Requirement (check one). Submit current financial responsibility documents with your renewal.
I have complied with this requirement by obtaining a surety bond or certificate of deposit, in an amount not less than what is specified in the financial
responsibility requirements (3CC
R section 6524)
I have complied with this requirement by obtaining liability insurance, through the following expiration date, in an amount not less
than what is specified in the financial responsibility requirements (3CCR section 6524)
Fees. Enclose a check, money order, or credit card information for the total amo
unt due. Make payable to "Cashier, DPR." Mail the payment,
completed application form, and proof of financial responsibility documents to: Department of Pesticide Regulation, Attn: Cashier MS-4A, PO Box
4015, Sacramento, CA 95812-4015. All fees are non-transferable and non-refundable.
Amount Enclosed: $
I declare under penalty of perjury, under laws of the State of California, that the information submitted is true and correct. (Signature must be
owner, officer, or QAL holder.)
Signature Print Name Title Date Signed
Page 2 of 2
State of California
Pest Control Business Renewal Application Instructions
LIC-192 (Rev. 07/24)
Failure to complete or provide the requested information may delay the processing of your application.
Instructions: To ensure that your renewal application is completed before mailing, review the following:
Changes in Information. Verify that the information provided is correct. 3CCR Section 6508 requires all license/certificate
holders to notify DPR immediately, in writing, of any change in information required on the application including, but not
limited to: business name changes, owner changes, and officer changes (this includes E-Mail, phone number, and address).
Indicate any corrections to the information included on the front of the renewal form in the space provided. Include additional
owners or officers information not stated on a separate sheet of paper, if necessary.
Licenses are not transferable. A new application and fee are required for a change of business organization
(Corporation, Partnership, Individual, Non-Profit, Limited Liability, and Limited Liability Partnership), or ownership.
Qualified Applicator. Each pest control business location (Main or Branch) must have a qualified applicator who possesses a
valid Qualified Applicator License (QAL) with the appropriate pest control category(ies) to engage in pest control work from
each location. Provide the name(s), license number and category(ies) of the qualified applicator who is responsible for
supervising the pest control operations at each location. If additional space is needed, attach a separate sheet of paper. If the
Qualified Applicator’s license is expiring this year, the license must be renewed before the business can be
renewed. The QAL can only supervise one Pest Control Business Main or Branch location.
Worker Compensation Insurance.
Each applicant who is an employer as defined in Section 3300 of the Labor Code is
required to carry worker’s compensation insurance. If applicable, complete the information on the renewal form; otherwise
indicate 'no employees'.
Financial Responsibility Requirement.
This requirement must be met. Provide a copy of the documents that meet the
requirements of Food and Agriculture Code Section 11702(c)(2) and 3CCR Section 6524. The Pest Control Business
license will not be renewed without meeting this requirement.
Fees.
All fees are non-transferable and non-refundable. Fees must be paid for each pest control business
license location
(Main and Branch) as totaled on the renewal form. A late penalty fee of fifty percent (50%) of the renewal fee will be assessed
for each license postmarked after December 31. Enclose a check, money order, or credit card information payable to
“DPR Cashier.”
License Renewal (2 Year) and Late Penalty Fees
Renewal
Late Fee
Renewal
Late Fee
Pest Control Business (Main) $720
$360
Pest Control Business (Branch) $360 $180
Declaration/Signature. Sign here to indicate that all of the information submitted is true and correct. Signature must be
owner, officer, or QAL holder.
Mail. Send payment, completed renewal application form, and all
proof of financial responsibility documents to:
Department of Pesticide Regulation
Attn: Cashier MS-4A
PO Box 4015
Sacramento, CA 95812-4015
Your license number will be posted to the valid license list on DPR’s web site as soon as your license is renewed.
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◻
◻
/
State of California
Department of Pesticide Regulation
Sacramento, CA
Web site: http://www.cdpr.ca.gov
Email: [email protected]
DPR-105-A (Rev. 7/20)
Page 1 of 1
Licensing Visa / Mastercard Transaction Form
Complete this payment form and mail with completed application form(s) to:
ATTN: Cashier
Department of
Pestici
de Regulation
PO Box 4015
Sacramento,
CA 95812-4015
All sections must be completed. Do not e-mail or fax this form. Electronically received forms will not be
accepted.
Failure to complete all sections of this form will result in your application and payment being delayed or rejected.
Cardholder Information.
Name (as it appears on the card) Telephone Number
Card Information. (Visa and Mastercard only. No other cards are accepted)
Card Type (check one):
Visa Mastercard
Card Number (16 digits):
Expiration Date: Billing ZIP Code:
Total Amount of Payment: $
Signature of Cardholder
Billing Address (Street or PO Box Number)
If the cardholder is not the licensee, or if the cardholder is paying for multiple licensees, indicate who the
payment is for below. Please attach an additional sheet if needed.
1) Licensee Name
4) Licensee Name
License Number
(if applicable):
License Number
(if applicable):
2) Licensee Name 5) Licensee Name
License Number
(if applicable): License Number (if applicable):
City State
ZIP Code
3) Licensee Name 6) Licensee Name
License Number
(if applicable): License Number (if applicable):
(Department Use Only) – Entered on POS by: Date Entered: Date Mailed: Mailed By:
Notes:
( )
