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AGRICULTURAL COMMISSIONER

PESTICIDE COMPLAINT FORM

When submitting a pesticide complaint, please provide as much detail as possible.
Please provide your contact information in the form below.

Name:

Address:

City or Town:

State or Province:

Zip or Postal Code:

Phone:

Attach any files associated with the incident:


Location of the Incident (address, cross roads, distance to a marker):


Please select the type of complaint:


Please provide information about the incident, which may include the following: time, place, people, equipment: