This form is to be completed by the Applicant/Registrant or their nominated New Zealand Agent/Consultant. Registration (section 21) of a non-exempt ACVM trade name product is required to avoid committing an offence (section 8) under the Agricultural Compounds and Veterinary Medicines (ACVM) Act 1997. Under section 10 of the ACVM Act, you must fill out this form as part of your application to either register a trade name product, provisionally register a trade name product or vary the registration of a trade name product. Send this completed form and all required supporting documentation electronically to approvals@mpi.govt.nz. Refer to the Privacy Act 1993 and Official Information Act 1982 notices at the end of this form regarding collection of information by the Ministry for Primary Industries.

Use this form to report an adverse event (unexpected effect) with an agricultural chemical

Use this form to report an adverse event (unexpected effect) with a VTA.

Use this form to report an adverse event (unexpected effect) with a veterinary medicine.

Use this form to report an adverse event (unexpected effect) with an animal feed.

When you have a large number of blocks to report, attach copies of this form to your Emissions Return.

Template which draws together all related data in support of the application

Use this form to provide a data assessment for the efficacy component of an agricultural chemical ACVM registration.