This government document is issued by Department of Agriculture for use in Pennsylvania
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https://www.google.com/url?client=internal-element-cse&cx=007572080359491747877:qqxrx9mf39e&q=https://www.agriculture.pa.gov/Plants_Land_Water/PlantIndustry/health-safety/pesticide-programs/PesticideCART/Documents/Technician%2520Registration%2520Form.pdf&sa=U&ved=2ahUKEwj8j5mH8tL8AhWjUKQEHWRCAm04ChAWegQIBhAC&usg=AOvVaw02Xv0tQ5KnonQ5W7wfHXi1