VPA-028 12/08 NJ Department of Environmental Protection Pesticide Control Program - MC401-04A PO Box 420, Trenton, NJ 08625-0420 Web page: www.pcpnj.org OFFICE USE ONLY License # GE? APPLICATION FOR.

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How to fill out the NJ VPA-028 online

Completing the NJ VPA-028 form properly is essential for obtaining a pesticide operator license in New Jersey. This guide provides thorough instructions to help you navigate the online form with ease.

Follow the steps to complete the NJ VPA-028 online.

  1. Press the ‘Get Form’ button to access the NJ VPA-028 form and open it in your editor.
  2. Begin by filling in the pesticide operator's name and primary identification information. Include your first name, middle initial, last name, and birth date in the specified format (month/day/year). Ensure you provide the last four digits of your Social Security number.
  3. Next, input your home mailing address. This includes an optional address line for a business or apartment complex name, followed by your street address or P.O. Box, city, state, zip code, and county code.
  4. In the telephone and physical identification section, enter your home phone number, sex, eye color, and height in feet and inches. If you are employed by a licensed pesticide applicator business, also provide the business license number here.
  5. Fill in the employer's name and their telephone number. Ensure this is a pesticide use-related employer. Then, complete the employer's mail address and physical address, including the county code.
  6. Provide details regarding your basic pesticide training course, including the trainer's number and the course date in the specified format (month/day/year).
  7. Enter the information for the responsible certified pesticide applicator. Include their license number and print or type their first and last name.
  8. Lastly, you need to sign the form. If you are submitting electronically, the responsible certified pesticide applicator must enter their birth date and last four digits of their Social Security number.
  9. Upon completing the form, ensure you attach proof of attendance at the basic pesticide training course. Save your changes, then download, print, or share the completed form as required.

Complete your NJ VPA-028 application online today to ensure a smooth licensing process.

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