United States Environmental Protection Agency

Washington, DC 20460

Notice of Arrival of

Pesticides and Devices

Send Completed Form to 

Appropriate Regional Office Listed 

on the Reverse of this Form.

OMB Control No. 2070-0020

Approval Expires mm/dd/yyyy

Note: Read Instructions on reverse before completing form.

Part I: To Be Completed by Importer of Record or Licensed Customs Broker

1. Name and Complete Address of Licensed Customs Broker 2. Name and Complete Address of Importer of Record

Return Form to this Address Return Form to this Address

3. Name and Complete Address of Shipper 4. EPA Registration Number 5. EPA Producer Establishment No.

6. Brand name of Product

7. Active Ingredients and Percentage of Each

8. Unit Size 9. Quantity 10. Total Net Weight 11. Country of Origin

12. Port of Entry 13. Name and Complete Address of Carrier

14. Entry Number 15. Anticipated Entry Date

17. Location of Goods for Examination after Importation 16. I assert that information constituting Confidential Business 

Information is shown in the above blocks numbered: (Note: Blocks 4, 5, 

6, 7 are not entitled to CBI treatment–see Instructions)

18. Remarks

Certification

I certify that the statements I have made on this form and all attachments thereto are true, accurate, and complete. I acknowledge that any 

knowingly false or misleading statement may be punishable by fine or imprisonment or both under applicable law

19. Printed Name of Importer of Record or 

Licensed Customs Broker

Telephone Number 20. Signature of Importer of Record or Licensed

Customs Broker

Date Signed
OMB Control No. 2070-0020∙Approval Expires mm/dd/yyyy

EPA Form 3540-1 (Rev. #-##)

Part II: To Be Completed by U.S. Environmental Protection Agency

Action to be taken by U.S. Customs Service

Release Shipment Detain for Inspection Release shipment to consignee under bond. Shipment must 

be held intact pending inspection.

Other (Specify)

Remarks

Signature and Title of EPA Official Date

Part III: To Be Completed by U.S. Customs and Border Protection

The information shown in Part I was compared with the entry papers for this shipment and no discrepancies were noted. The shipment 

was handled as instructed by EPA in Part II. Any deviations should be brought to the attention of EPA before releasing shipment and 

should also be noted in “Remarks.”

Remarks

Signature of District Director of Customs Date

 
OMB Control No. 2070-0020∙Approval Expires mm/dd/yyyy

EPA Form 3540-1 (Rev. #-##)

Instructions

U.S. Customs and Border Protection (CBP) Regulations. 19 CFR 12.112 requires an importer desiring to import 

pesticides or devices into the United States to submit EPA Form 3540-1, Notice of Arrival of Pesticides and 

Devices (NOA) to the U.S. Environmental Protection Agency (EPA) prior to the arrival of shipment in the United 

States. The NOA will be used by: Importer of Record or Licensed Customs Broker: The importer of record or 

licensed customs broker must complete Part I of the NOA form. A separate NOA must be submitted for each 

pesticide or device in each shipment prior to its arrival at the port of entry. To expedite the handling of pesticide or 

device shipments, submit NOA(s) to the EPA office listed below having jurisdiction over the state/territory of the 

port of entry. It is recommended that all applicable blocks in Part I be completed prior to submission to EPA and 

that supporting documentation (e.g. a product label and either CBP Form 7501, 3461, or 3461 ALT) for validating

information provided be included with the submission of each NOA. When providing an address, the complete 

address should include the mailing location, email address, and telephone number of the contact person. EPA: EPA 

will complete Part II, indicating the disposition of the shipment, sign and return the NOA(s) to the importer or 

agent for presentation to CBP at the time of entry. CBP: CBP will compare the information shown on the NOA(s)

with the entry documents and the shipment, bringing any discrepancies to EPA’s attention before the shipment is 

released, and noting discrepancies in the Remarks section. If the importation is not handled by CBP in the manner 

instructed in Part II, this should also be noted in the Remarks. After completing Part III and signing the NOA(s), 

CBP will return the NOA(s) to EPA as the Official File Copy. 

1. Name and Complete Address of the Licensed Customs Broker. Person (such as private individual, 

partnership, association or corporation) who is licensed, regulated and empowered by CBP to assist and transact on 

behalf of others (importers and exporters) in meeting Federal requirements governing imports and exports (customs 

business).

2. Name and Complete Address of the Importer of Record. Owner, purchaser, or when designated by the owner, 

purchaser, or consignee, an authorized agent acting on importer’s behalf. The importer of record is the individual 

or firm liable for payment of all duties and meeting all statutory and regulatory requirements incurred as a result of 

importation.

3. Name and Address of Shipper. The name and address of person primarily responsible exporting the pesticide to 

the United States.

4. EPA Registration No. The pesticide product registration number assigned at the time of registration that 

identifies the product. The product registration number must be an approved EPA Registration No. as it appears on 

the pesticide product label. If the product is a device, write the word “DEVICE” in this block. If the pesticides 

product does not have an EPA-approved registration number or is not a device, to expedite review of the NOA, it is 

recommended that “OTHER” be entered and an explanation, including the intended use and a description of why 

the product is being imported into the United States, be provided in the remarks.

5. EPA Producer Establishment No. The EPA Producer Establishment No. that appears on the pesticide or device

product label. The EPA Producer Establishment No. on the product label is the final establishment where the 

product was produced prior to shipment to the U.S. Foreign establishments that produce pesticides or devices for 

distribution in the United States. are required to have an EPA-registered producer establishment number. 

6. Brand Name of Product. Name of the product as it appears on the label under which the pesticide or device is 

sold or distributed.

7. Active Ingredients and Percentage of Each. List each active ingredient by percentage of each. If block 4 

contains an EPA Reg. No., this block may be left blank. To expedite review of the NOA, it is recommended that 

each active ingredient and percentage be listed to ensure accuracy of information.

8. Unit Size. Net weight or net contents as identified on the product label of the pesticide or device in the 

immediate container, not including the wrapper or other packaging materials.

9. Quantity. Number of units.

10. Total Net Weight. Unit size multiplied by quantity.
OMB Control No. 2070-0020∙Approval Expires mm/dd/yyyy

EPA Form 3540-1 (Rev. #-##)

11. Country of Origin. The country of manufacture, production, or formulation of the pesticide or device of 

foreign origin entering the United States.

12. Port of Entry. The port of entry where the pesticide or device offered for import is processed for entry into the 

United States. Ports of entry are designated locations where CBP enforces the import and export laws and 

regulations of the United States federal government. Ports of entry are under the jurisdiction of a CBP port 

director.

13. Name and complete address of the carrier. The carrier is a person or carrier service (ship, airline, or trucking) 

who undertakes to transport goods or merchandise to and across the U.S. border.

14. Entry Number. The 11-character entry number using the format XXX-NNNNNNN-N, including the hyphens.

15. Anticipated Entry Date. Anticipated date of entry into the United States or anticipated date when the pesticide 

or device will arrive within the port of entry limits.

16. Confidential Business Information (CBI) designation. Please note that the information provided in blocks 

4,5, 6, and 7 is not entitled to confidential treatment under section 7(d) of FIFRA and under labeling requirements

for pesticides at 40 CFR 156.10. Information provided in those blocks will be made public with no further notice.

17. Location of Goods for Examination after Importation. Enter the physical address of the location of goods 

for examination after importation. In the case of unregistered pesticides products imported between establishments 

operated by the same producer, enter the EPA establishment number for importing registered establishment.

18. Remarks. This block may be used to provide additional information.

19. Printed Name of Importer of Record or Licensed Customs Broker. Print name of Importer of Record or 

Licensed Customs Broker.

20. Signature of Importer of Record or Licensed Customs Broker. Signature of Importer of Record or Licensed 

Customs Broker.

EPA Regional Offices States and Ports of Entry 

Locations in the US

EPA Regional Offices States and Ports of Entry 

Locations in the US

EPA Region 1

1 Congress Street (SEA)

Boston, MA 02114-2023

CT, MA, ME, NH, RI, VT EPA Region 6

445 Ross Avenue

Suite #1200 (6PD-P)

Dallas, TX 75202-2733

AR, LA, NM, OK, TX

EPA Region 2

MS-500, Bldg #5

2890 Woodbridge Ave.

Edison, NJ 08837-3679

NJ, NY, PR, VI EPA Region 7

901 N. 5th Street (PESTWWPD)

Kansas City, KS 66101

IA, KS, MO, NE

EPA Region 3

1650 Arch Street (3WC32)

Philadelphia, PA 19103-2029

DE, DC, MD, PA, VA, WV EPA Region 8

1595 Wynkoop Street

Denver, CO 80202-1129

CO, MT, ND, SD, UT, WY

EPA Region 4

61 Forsyth Street, SW 

(APT-PS)

Atlanta, GA 30303-8960

AL, FL, GA, KY, MS, NC, 

SC, TN

EPA Region 9

75 Hawwthorne Street (CED-5)

San Francisco, CA 94105-3901

AZ, AS, CA, GU, HI, NV, 

PI, WK

EPA Region 5

77 West Jackson Blvd. 

(DT-8J)

Chicago, IL 60604-3507

IL, IN, OH, MI, MN, WI EPA Region 10

1200 Sixth Avenue, 

Suite 900 (ECO-084)

Seattle, WA 98101-3140

AK, ID, OR, WA