Pesticides Complaint Form Complaints to the Kentucky Department of Agriculture related to the misuse of pesticides must be submitted in writing, as mandated by Kentucky Law, KRS217B.140. Please complete this form in its entirety. Date Damage First Noticed* Date You Believe Pesticide Misuse Occurred I Don't Know Misuse Date Individiual Responsible for Misapplication* Damage Claimed:* Crop (Includes Fruits and Vegetables) Landscape/Nursery Structural (Termites, Bed Bugs, Roaches, etc.) Estimated number of acres damaged (if known) Are you providing this notice for information purposes only? Are you requesting an official investigation? Comments* Your Details First Name* Middle Name Last Name* Your Address* Apt/Suite/Other County* ---County--- ADAIR ALLEN ANDERSON BALLARD BARREN BATH BELL BOONE BOURBON BOYD BOYLE BRACKEN BREATHITT BRECKINRIDGE BULLITT BUTLER CALDWELL CALLOWAY CAMPBELL CARLISLE CARROLL CARTER CASEY CHRISTIAN CLARK CLAY CLINTON CRITTENDEN CUMBERLAND DAVIESS EDMONSON ELLIOTT ESTILL FAYETTE FLEMING FLOYD FRANKLIN FULTON GALLATIN GARRARD GRANT GRAVES GRAYSON GREEN GREENUP HANCOCK HARDIN HARLAN HARRISON HART HENDERSON HENRY HICKMAN HOPKINS JACKSON JEFFERSON JESSAMINE JOHNSON KENTON KNOTT KNOX LARUE LAUREL LAWRENCE LEE LESLIE LETCHER LEWIS LINCOLN LIVINGSTON LOGAN LYON MADISON MAGOFFIN MARION MARSHALL MARTIN MASON MCCRACKEN MCCREARY MCLEAN MEADE MENIFEE MERCER METCALFE MONROE MONTGOMERY MORGAN MUHLENBERG NELSON NICHOLAS OHIO OLDHAM OWEN OWSLEY PENDLETON PERRY PIKE POWELL PULASKI ROBERTSON ROCKCASTLE ROWAN RUSSELL SCOTT SHELBY SIMPSON SPENCER TAYLOR TODD TRIGG TRIMBLE UNION WARREN WASHINGTON WAYNE WEBSTER WHITLEY WOLFE WOODFORD OUT-OF-STATE City Zip Contact Method* ---Select--- Email Phone Text Email* Phone
