Texas Department of Agriculture

TEXAS DEPARTMENT OF AGRICULTURE

COMMISSIONER SID MILLER
Certificate of Free Sale, Manufacture, and or Origin Request

The Texas Department of Agriculture (TDA), processes and provides official notarized documents free of charge as a courtesy to external stakeholders to prove that products are manufactured in a facility located in Texas to meet standard domestic regulations.
Information Needed for Request
Type of Certificate(s) Being Requested

Select all that apply
1. Free Sale Certificate
Enter requesting Country for Free Sale Certificate. (separate countries with comma(s)):

0/250
2. Manufacture Certificate
Enter requesting Country for Manufacture Certificate (separate countries with comma(s)):

0/250
3. Orgin Certificate
Enter requesting Country for Origin Certificate (separate countries with comma(s)):

0/250
4. What is the Company Name:

0/250
5. What is the EPA Establishment Number?
6. What is the Pesticide Product Name? (if applicable)

0/250
7. What is the Pesticide Product EPA Registration Number? (if applicable)
8. How many original copies needed?
Enter the physical address where the original copies should be sent.
9. Name of Person to Receive Certificate(s)
10. Phone Number
Format: (000) 000-0000.
11. Address of where to send Certificate(s)

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Enter your email address below to receive confirmation of this submission.
12. E-mail

Confirmation EmailEnter your email address to receive confirmation of this submission
If you have any additional questions, please contact the Pesticide Registration Program by Email Product.Registration@TexasAgriculture.gov or by Phone at (512) 463-7407.
If you would like to print a copy of this form in it's entirety, select the "Print Form" button at the bottom of this page before selecting the "Submit" button.
Select the "Submit" button only when you have completed all entries, printed your completion documentation and are ready to send information to the Texas Department of Agriculture. After you select the "Submit" button, you will no longer be able to access the completed form.
Submission Date:

MonthDayYear
This information becomes public record and is subject to disclosure, with few exceptions, you have the right to request and be informed about the information that the State of Texas collects about you. You are entitled to receive and review the information upon request. You also have the right to ask the state agency to correct any information that is determined to be incorrect. (Reference: Government Code, Sections 552.021, 552.023, and 559.004.)
TEXASAGRICULTURE.GOV

P.O. Box 12847, Austin, Texas 78711

(512) 463-7476
Hearing impaired: (800) 735-2988 voice, (800) 735-2989 (TTY)
Should be Empty:

Certificate of Free Sale, Manufacture, and or Origin Request

Type of Certificate(s) Being Requested