MERC Vermont | Mercury-Added Product Manufacturer Requirements

Forms for Vermont's Mercury-Added Product Manufacturer Requirements

Forms are available in a number of formats and each format is identified by one of the following icons:

Forms identified by this symbol are electronic forms that can be completed and submitted online.

Forms identified by this symbol are Microsoft Word forms which can be opened and completed in Word. Once completed, these forms must be printed and submitted by mail. If you don't have Microsoft Word, a free copy of Microsoft Word Viewer is available on Microsoft's website.

Forms identified by this symbol are Adobe Acrobat PDF forms and can be opened in Adobe Acrobat Reader. Theses forms must be printed first and completed either by hand or with a typewriter. If you don't have Adobe Acrobat Reader, a free copy of the software is available on Adobe's website.

Certified Labeling Plans

The Certifed Labeling Plan form has been split into two files. The first, "clpinfo", contains Sections A thru C. The second, "clpproducts", contains Section D. Please complete both "clpinfo" and "clpproducts" in one of the two formats provided below (either Microsoft Word or Adobe Acrobat ) and mail both to the address shown on the bottom of "clpinfo".

Sections A thru C

Form: clpinfo.doc [61 KB]

Form: clpinfo.pdf

[142 KB]

Section D

Form: clpproducts.doc

[97 KB]

Form: clpproducts.pdf

[89 KB]

Alternative Labeling Requests

Alternative Labeling Request Form

Use one of these forms to apply for approval of an alternative labeling proposal.

Form: altrequestform.cfm

Form: altrequest.doc [60 KB]

Form: altrequest.pdf [143 KB]

Certification Statement for the Sale or Distribution of Elemental Mercury

Certification Statement Form

Use one of these forms to submit a Certification Statement for the Sale or Distribution of Elemental Mercury.

Form: elementalcert.doc [80 KB]

Form: elementalcert.pdf [47 KB]

Mercury Education & Reduction Campaign 103 South Main Street Waterbury, VT 05671-4911 802-241-3455
MERC is a program of the Vermont Department of Environmental Conservation