Initial to indicate certification as to information on this page (full text of certification is on page one). Date INSTRUCTIONS: Please type or print in ink. Please read carefully the attached instructions and supply the information requested on this form. Use additional sheet(s) if necessary.
2. Case # and Name 3. Date and Type of DCI and Number

4. EPA Product Registration 5. I wish to cancel this product registration voluntarily 6. Generic Data 7. Product Specific Data 6a. I am claiming a Generic Data Exemption because I obtain the active ingredient from the source EPA registration number listed below. 6b. I agree to satisfy Generic Data Requirements as indicated on the attached form entitled "Requirements Status and Registrant's Response." 7a. My product is an MUP and I agree to satisfy the MUP requirement on the attached form entitled "Requirements Status and Registrant's Response." 7b. My product is an EUP and I agree to satisfy the EUP requirement on the attached form entitled "Requirements Status and Registrant's Response." OMB Approval 2070-0174

1. Company Name and Address 4031 - 2-(2-Ethoxyethoxy)ethyl 2-benzimidazole carbamate Chemical # and Name: 115001 2-(2-Ethoxyethoxy)ethyl 2-benzimidazole carbamate 01-Apr-2011 GENERIC ID # GDCI-115001-852 

### United States Environmental Protection Agency

Washington, D.C. 20460 DATA CALL-IN RESPONSE 1 Page of 1

8. Certification: I certify that the statements made on this form and all attachments are true, accurate, and complete. I acknowledge that any knowingly false or misleading statement may be punishable by fine, imprisonment or both under applicable law. Signature and Title of Company's Authorized Representative ______________________________________________________ 10. Name of Company N/A N/A N/A N/A N/A N/A

9. Date

11. Phone NumberDate Initial to indicate certification as to information on this page (full text of certification is on page one) 13. Phone Number 10. Certification: I certify that the statements made on this form and all attachments are true, accurate, and complete. I acknowledge that any knowingly false or misleading statement may be punishable by fine, imprisonment or both under applicable law.

12. Name of Company 11. Date OMB Approval 2070-0174 

### United States Environmental Protection Agency

Washington, D.C. 20460 REQUIREMENTS STATUS AND REGISTRANT'S RESPONSE INSTRUCTIONS: Please type or print in ink. Please read carefully the attached instructions and supply the information requested on this form. Use additional sheet(s) if necessary.

4. Guideline Requirement Number 5. Study Title Progress Reports



### 2 3 1 6. Use

Pattern 7. Test Substance 8. Time Frame (Months) 9. Registrant

Response P R O T O C O L 1. Company Name and Address 2. Case # and Name 3. Date and Type of DCI and Number

Signature and Title of Company's Authorized Representative _________________________________________________________________

Terrestrial and Aquatic Nontarget Organisms Data Requirements (Conventional Chemical) 850.3020 Honey bee acute contact toxicity 4031 - 2-(2-Ethoxyethoxy)ethyl 2-benzimidazole carbamate Chemical # and Name: 115001 2-(2-Ethoxyethoxy)ethyl 2-benzimidazole carbamate 01-Apr-2011 GENERIC ID # GDCI-115001-852

C TGAI 12 1 of Page

(1) N 1

### United States Environmental Protection Agency Washington, D.C. 20460 FOOTNOTES AND KEY DEFINITIONS FOR GUIDELINE REQUIREMENTS 4031 - 2-(2-Ethoxyethoxy)ethyl 2-benzim GDCI-115001-852

1 Key: Residue of Concern = Residue of Concern; TEP = Typical End Use Product [TEP]; TGAI = Technical Grade Active Ingredient [TGAI]; TGAI/PAIRA = Technical Grade of the Active Ingredient or Pure Active Ingredient, Radio Labelled; TGAI, TEP = Technical Grade of the Active Ingredient or Technical End-Use Product; TGAI/PAI = Technical Grade Active Ingredient, Pure Active Ingredient

Data using the EUPs Fungisol, Imisol, and Abasol are required to support all uses of this chemical - this footnote supersedes the test substance identified in column 7 of form B of the DCI and identifies the required test substances for the Guideline Number 850.3020 testing requirement imposed by this DCI. Data are generally not required to support end-use products in the form of a gas, a highly volatile liquid, a highly reactive solid, or a highly corrosive material. Case # and Name: DCI Number: 1 Page: of 1

Footnotes: The following footnotes are referenced in column two (5. Study Title) of the Requirements Status and Registrant's Response form. These footnotes apply in addition to any test notes included in 40 CFR Part 158 with respect to the particular data requirement. Use Categories Key: C - Terrestrial nonfood crop

### United States Environmental Protection Agency Washington, D.C. 20460 LIST OF ALL REGISTRANTS SENT THIS DATA CALL-IN NOTICE 4031 - 2-(2-Ethoxyethoxy)ethyl 2-benzim Case # and Name: 1 Page: of 1

7946 J. J. MAUGET CO. Co. Nr. Company Name Agent For Company SCIREG, INC. 12733 DIRECTOR'S LOOP Address City ZIP

WOODBRIDGE 22192 OMB Approval 2070-0174

State

VA DCI Number: GDCI-115001-852

# LINKS TO FORMS: The pesticide registration forms that are listed below can be found at: http://www.epa.gov/opprd001/forms/ Link to C onfidential Statement of Formula and Instructions (Form # 8570 -4 

# ) http://www.epa.gov/opprd001/forms/8570 - 4.pdf C ertification of Attempt to Enter Into an Agreement With Registrants for Development of Data (Form # 8570
- 32 

# ) http://www.epa.gov/opprd001/forms/8570 - 32.pdf

C ertification With Respect to Citation of Data (Form # 8570
- 34 

# ) http://www.epa.gov/opprd001/forms/8570 - 34.pdf