Import Certificate For The Grower Requested Own Use (GROU) Program

Privacy Notice Statement

Health Canada
Collection and use of personal information in this application is in accordance with the federal Privacy Act.

The personal information you provide is collected under the authority of section 42(2)(a) of the Pest Control Product Regulations for the purpose of contacting the applicant in regards to the application and to communicate any decisions and outcomes of the application.

The Privacy Act gives you the rights of access to, correction of and protection of your personal information. For further information about this Privacy statement please contact Health Canada’s Access to Information and Privacy Coordinator by email at atip-aiprp@hc-sc.gc.ca.

Instructions

Application for a Certificate to import and use a foreign-registered pest control product that has been approved through the GROU Program. See the Pest Management Regulatory Agency (PMRA) website or call 1-800-267-6315 for details on the GROU Program.

When authorized by a Pest Management Regulatory Agency official, the application becomes the Import Certificate, and is not transferable. The Certificate is valid for one importation prior to the Certificate expiry date. Additional importations will require a new Certificate.

Instruction 1

NAME: State name of importer.

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Instruction 2

LOCATION (Residence): Indicate legal (i.e., lot/concession/township) location of importer’s home farm.

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Instruction 3

TELEPHONE NUMBER: Include area code.

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Instruction 4

MAILING ADDRESS: Indicate mailing address and postal code for importer.

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Instruction 5

FOREIGN PRODUCT NAME: State name of foreign pest control product.

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Instruction 6

FOREIGN REGISTRATION NUMBER: Indicate pest control product registration number, e.g., for U.S. product, state the U.S. EPA registration number.

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Instruction 7

GROU EQUIVALENCY CERTIFICATE NUMBER: Indicate the Equivalency Certificate number appearing on the GROU Approved Labels (Container Label and Direction for Use Booklet) that are available on the PMRA website. The Container Label must be sent with this application.

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Instruction 8

ACTIVE INGREDIENT: Indicate common or chemical name of the active ingredient as identified in the "GUARANTEE" on the GROU Approved Labels or Directions for Use Booklet.

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Instruction 9

TOTAL AREA OF LAND TO BE TREATED (consistent with quantity in Box 12): metric or imperial units.

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Instruction 10

CROP OR USE: Identify use or crop to be treated.

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Instruction 11

TIMING OF APPLICATION: Indicate timing of application (see examples below)

  • Post-harvest
  • Preplant
  • Pre-emergent
  • Early postemergent
  • Spot treatment - pre-harvest, fall stubble

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Instruction 12

QUANTITY OF PRODUCT FOR ONE USE SEASON: State the total amount of product (not to exceed the amount required for one calendar year) in metric, imperial or U.S. units you are importing.

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Instruction 13

PROVINCE(S) WHERE PRODUCT IS TO BE APPLIED: List the province(s) where treatment will occur.

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Instruction 14

DATE OF IMPORT: Indicate the date the product is expected to enter Canada.

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Instruction 15

POINT OF ENTRY: Indicate the expected Canadian point of entry (border crossing).

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Instruction 16

NAME OF TRANSPORTER (IF APPLICABLE): If applicable, indicate the name of the transportation company or individual bringing the shipment into Canada. Only required if individual or company transporting the shipment does not match the name in Box 1. See PMRA website for restrictions and further details.

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Instruction 17

PESTICIDE PRODUCT TO BE APPLIED AT (if applicable): List the field locations to be treated. Not required for all products. See PMRA website for restrictions and further details.

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Instruction 18a

Fax or mail a copy of the container label with this application. The GROU Approved Labels (the Container Label and the Directions for Use Booklet) are available on the PMRA website.

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Instruction 18b

For GROU, it is a requirement to send with this form proof of participation in an acceptable container disposal program consistent with registered pest control products. See the PMRA website for details.

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Instruction 19

LIABILITY STATEMENT: Date and signature required. The completed and signed Grower Requested Own Use (GROU) Import application must be mailed or faxed to the Pest Management Regulatory Agency:

The GROU Program
Pest Management Regulatory Agency
Health Canada
Compliance, Laboratory Services and Regional Operations Directorate
2720 Riverside Dr. (A.L. 6607E)
Ottawa, ON K1A 0K9
Fax: 613-736-3540

For any questions, contact the Pest Management Information Service at 1-800-267-6315 or 613-736-3799 or by e-mail at pmra.infoserv@hc-sc.gc.ca.

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Form

Instruction 1
Instruction 2
Instruction 3
Instruction 4
Instruction 5
Instruction 6
Instruction 7
Instruction 8
Instruction 9
Instruction 10
Instruction 11
Instruction 12
Instruction 13
Instruction 14
Instruction 15
Instruction 16
18a. Instruction 18a
18b. Instruction 18b

19. Liability Statement Instruction 19
I, the importer and user, accept responsibility for compliance with the terms and conditions of the authorization of this certificate and assume all risks and responsibility for and in connection with the import, handling and use of this product and I shall be liable for all loss or damage resulting from the import, handling and use of the product including damage to treated crops and properties or properties of others, injury to persons and occupational health and safety, etc. and shall indemnify and save harmless the Crown from all such loss or damage. I am aware that as an importer I am responsible for the disposal of pesticide containers covered by this Certificate as indicated on the GROU Approved Labels.

DECLARATION (required)
  the importer and user do hereby certify that this information is complete and correct in respect of this shipment of pest control product for importation into Canada.



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