Fill Out a Valid South Dakota A 94 A Template Get Form Here

Fill Out a Valid South Dakota A 94 A Template

The South Dakota A 94 A form serves a crucial role for individuals aiming to operate as private aerial applicators within the state. It's a comprehensive application that must be submitted alongside the Private Pesticide Applicator License Application, detailing essential information like Federal Airman’s Certification, aircraft details, and prior aerial application experience. Filling out this form accurately is the first step toward ensuring compliance and safety in the unique field of aerial pesticide application. Click the button below to begin the process of filling out your form.

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Article Guide

In the realm of agriculture and aerial application in South Dakota, the Form A 94 A represents a key document for individuals seeking to operate as private aerial applicators. Nestled within the administrative framework of the Division of Agricultural Services, this form serves as an application that must be submitted alongside the Private Pesticide Applicator License Application, tailoring to the specifics required for aerial pesticide application. The form requires detailed applicant information, ranging from personal contact details to technical specifications about the aircraft intended for use. Additionally, it demands proof of Federal Airman’s and Agricultural Aircraft Operator’s FAA Certificates, alongside a comprehensive list of the aircraft's make, model, and registration details. Moreover, applicants must disclose their piloting experience, particularly focusing on flight and pesticide application hours, which underscores the importance of safety and proficiency in aerial application tasks. The form also inquires about any past denials of permission to spray in other states, ensuring a thorough vetting process. Further intricacies of the form include the necessity for supervision under certain conditions—highlighting a structured pathway for less experienced applicators to gain the requisite oversight. As it stands, the Form A 94 A embodies the meticulous regulatory landscape governing aerial pesticide application in South Dakota, ensuring that those who undertake this responsibility are both qualified and accountable.

Preview - South Dakota A 94 A Form

Division of Agricultural Services

 

 

 

 

 

 

 

Foss Bldg, 523 E Capitol Ave

 

 

 

 

 

 

 

 

 

 

Pierre, SD 57501-3182

 

 

 

 

 

 

 

 

 

Phone: (605) 773-4432

Fax: (605) 773-3481

 

 

 

 

 

 

 

 

 

 

Web: sdda.sd.gov/Ag_Services

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Form A 94 A

 

 

 

 

 

 

 

PRIVATE AERIAL APPLICATOR APPLICATION

 

 

 

 

 

 

 

 

(To be submitted with the P r i v a t e

Pesticide Applicator License Application)

Name:

 

 

 

 

 

 

 

 

 

 

 

 

 

First

 

 

Middle Initial

 

 

 

 

Last

Address:

 

 

 

 

 

 

 

 

 

 

 

 

 

Street or Box

City

State

 

Zip+4

Phone No.

Business Name or Employer:

 

 

 

 

 

 

 

 

 

 

Address:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Street or Box

City

State

 

Zip+4

Phone No.

Email Address:

 

 

 

 

 

 

 

 

 

 

 

1.

Federal Airman’s Certification number:

 

 

 

 

Rating:

 

 

 

 

2.

Agricultural Aircraft Operator’s FAA Certificate

number & Date issued:

 

 

 

 

3.Will cover: (List each aircraft below)

Make

 

Model

 

Year

 

 

Federal ‘N’ No. (required)

 

 

South Dakota Reg. No.

 

 

 

 

 

 

 

 

 

(contact SD DOT to pay fee 605-773-4430)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

4.Has listed aircraft (including attached equipment) received FAA approval?

5.a. Total Pilot In Command (PIC) flight hours

b. Total (PIC) Hours: Single Engine-Tricycle Gear:

; Single engine-Conventional/Trail Dragger:

;

Helicopter:

 

; Other:

 

 

 

 

 

 

6.In reference to 5b, number of hours within the preceding 12 months by type.

7.

a. Total hours of spraying and/or dusting experience:

 

Within past year:

 

 

b. Equivalent hours of experience within the past year (e.g. Practice time).

 

______________

 

c. Have you successfully completed an FAA approved aerial applicator school? __________________________________

If so, please attach a copy if this is the first time application.

8.a. Number of acres in South Dakota, treated by the applicant within the past year. b. Number of flight hours involved in the treatment of the acreage in 8a.

9.Anyone who has less than 750 PIC Hours and has not previously sprayed under a Class B permit for 2 years or successfully completed an FAA approved aerial applicators school or have a current aerial applicators license from another state, must operate under the supervision of a SD licensed FAA Part 137 license holder.

Name of supervisor pilot

 

Signature

 

(Print)

10. Have you or any employer (for which you have ever worked) been denied permission to spray in any state? If yes, indicate employer, company, year of denial and state where denial was issued.

11.The information provided above is true and correct, to the best of my knowledge.

 

 

Signature

 

Date

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OFFICE USE ONLY

 

 

 

APPROVED BY THE SOUTH DAKOTA AERONAUTICS COMMISSION

Date

 

 

Program

 

 

Class

 

 

 

 

 

Manager

 

 

 

 

Revised 04/2012

Form Specifications

Fact Description
Form Title Private Aerial Applicator Application
Associated License To be submitted with the Private Pesticide Applicator License Application
Governing Body Division of Agricultural Services, South Dakota Aeronautics Commission
Location Foss Building, 523 E Capitol Ave, Pierre, SD
Contact Information Phone: (605) 773-4432, Fax: (605) 773-3481
Website sdda.sd.gov/Ag_Services
Key Requirements Federal Airman’s Certification number, Agricultural Aircraft Operator’s FAA Certificate, South Dakota Aircraft Registration
Experience Verification Includes total and type-specific Pilot in Command (PIC) flight hours, spraying/dusting experience
Supervision Clause Applicants with less than 750 PIC Hours and specific qualifications must operate under a SD licensed FAA Part 137 license holder

Steps to Filling Out South Dakota A 94 A

Filling out the South Dakota A 94 A form is an important step in the process of becoming a licensed private aerial applicator. This form accompanies the Private Pesticide Applicator License Application and requires careful attention to detail. The information you provide will be reviewed by the Division of Agricultural Services, so it's crucial to ensure accuracy and completeness. Following the steps outlined below will help streamline the process and increase the likelihood of a successful application.

  1. Start by entering your full name: First, Middle Initial, Last in the designated area.
  2. Fill in your Address, including Street or Box, City, State, Zip+4.
  3. Provide your Phone No. where you can be reached.
  4. Under Business Name or Employer, list the relevant details if applicable, including the Address and Phone No.
  5. Include your Email Address for communication purposes.
  6. Enter your Federal Airman’s Certification number and Rating.
  7. Provide the Agricultural Aircraft Operator’s FAA Certificate number & Date issued.
  8. For the section that requests information about the aircraft, include each aircraft's Make, Model, Year, Federal ‘N’ No., and South Dakota Reg. No. Contact SD DOT as necessary for registration.
  9. Confirm whether the listed aircraft, including attached equipment, has received FAA approval.
  10. Detail your flight experience in the following categories:
    • Total Pilot In Command (PIC) flight hours
    • By type: Single Engine-Tricycle Gear; Single engine-Conventional/Trail Dragger; Helicopter; Other.
  11. Specify the number of hours within the preceding 12 months by aircraft type as per 5b.
  12. Record your spraying and/or dusting experience in terms of total hours and within the past year. Also, note any equivalent experience.
  13. If you have completed an FAA approved aerial applicator school, indicate so and attach a copy of your certificate if this is your first application.
  14. Note the number of acres in South Dakota you treated in the past year and the flight hours involved.
  15. If applicable, identify your supervisor pilot as per the criteria outlined.
  16. Disclose if you or any employer you have worked for has been denied permission to spray in any state, providing the employer, company, year of denial, and state where the denial was issued.
  17. Sign the form to confirm that the information provided is true and correct. Include the Date.

Upon completion, review your form for accuracy, then submit it along with any required documentation to the address provided on the form. This ensures your application will be processed without unnecessary delays. Remember, this form is a key component of the licensing process, aimed at ensuring safety and compliance within the aerial application industry in South Dakota. It's an opportunity to demonstrate your qualifications and commitment to responsible agricultural practices.

Key Details about South Dakota A 94 A

What is the Form A 94 A and who needs to fill it out?

The Form A 94 A, known as the Private Aerial Applicator Application, is a required document for anyone looking to receive a private pesticide applicator license in South Dakota. This form is specifically for individuals intending to apply pesticides through aerial means, such as with an aircraft. It must be submitted alongside the Private Pesticide Applicator License Application and is geared towards pilots who operate agricultural aircraft. This includes those flying planes or helicopters to disperse agricultural chemicals over croplands.

What information is required to complete the Form A 94 A?

To complete the Form A 94 A, applicants must provide various pieces of information, including:

  • Personal contact information and business details, if applicable.
  • Federal Airman’s Certification number and rating.
  • Agricultural Aircraft Operator’s FAA Certificate number and the date it was issued.
  • Details about the aircraft to be used, including make, model, year, and registration numbers.
  • Details regarding FAA approval for listed aircraft and attached equipment.
  • Total Pilot In Command (PIC) flight hours and specific details related to the type of aircraft.
  • Details of spraying and/or dusting experience, including total hours and acres treated.
  • Supervision information for those with less than the required experience or certification.
  • Disclosure of any previous denials of permission to spray in any state.
Applicants are also required to confirm that all provided information is true and correct to the best of their knowledge, to sign and date the form, and to attach any necessary documents, such as proof of completion of an FAA-approved aerial applicator school if applicable.

What are the training and experience requirements for applicants?

Applicants of the Form A 94 A must meet specific training and experience requirements:

  1. Successful completion of an FAA-approved aerial applicator school, especially for first-time applicants.
  2. Demonstration of substantial Pilot In Command (PIC) flight hours, including details of flight hours by aircraft type within the preceding 12 months.
  3. Specific experience in aerial spraying and/or dusting, including both total hours and those obtained within the last year.
  4. For those with less than 750 PIC Hours and without prior qualification under a Class B permit or an equivalent certification, the form mandates operation under the supervision of a SD licensed FAA Part 137 license holder.
These requirements are designed to ensure that all private aerial applicators in South Dakota are skilled, knowledgeable, and capable of safely applying pesticides from the air.

What happens if an applicant has been previously denied permission to spray in any state?

If an applicant has been previously denied permission to spray in any state, they must disclose this information on the Form A 94 A by indicating the employer or company involved, the year of the denial, and the state where the denial was issued. This does not automatically disqualify an applicant, but it does prompt further review by the South Dakota Aeronautics Commission. The commission assesses these cases individually, considering the reasons for the previous denial and any corrective actions taken by the applicant since then. Full disclosure and honesty in these situations are crucial for a fair evaluation process.

Where can one find more information or get assistance with Form A 94 A?

For more information or assistance with the Form A 94 A, individuals can contact the Division of Agricultural Services in South Dakota directly. They can be reached at:

The Division's staff can provide guidance on completing the form, clarify any requirements, and offer support for questions related to the application process. Additional resources may also be available on their website, including application materials, instructional guides, and contact information for further inquiries.

Common mistakes

Filling out the South Dakota A 94 A form, required for Private Aerial Applicator Applications, can be a bit daunting. Common errors can lead to delays or the rejection of the application. It is crucial to pay attention to detail and double-check all entered information.

Here are seven mistakes often made on the South Dakota A 94 A form:

  1. Incorrect Federal Airman’s Certification number and Rating: These numbers are essential for verification purposes. Providing inaccurate or incomplete information here can invalidate the entire application.
  2. Failing to list each aircraft: Applicants might overlook the requirement to list each aircraft that will be used, including make, model, year, and the necessary Federal ‘N’ No. and South Dakota Reg. No. This oversight can lead to unauthorized aircraft usage.
  3. Incomplete information on FAA approval for aircraft and equipment: Question 4 requires confirmation of FAA approval. Neglecting to verify this approval or failing to provide complete information can halt the application process.
  4. Errors in reporting flight hours: Accurately reporting total Pilot In Command (PIC) flight hours, including breakdown by aircraft type and hours within the preceding 12 months, is crucial. Mistakes or omissions here can misrepresent an applicant's experience level.
  5. Not specifying experience: The form asks for detailed spraying and/or dusting experience and equivalent experience within the last year. Leaving these sections blank or providing vague responses can raise questions about the applicant's qualifications.
  6. Inaccurate acreage and flight hours: Item 8 requires information on the number of acres treated and the flight hours involved. Underestimating or overestimating these figures can lead to suspicions of falsified records or a lack of experience.
  7. Supervision requirements not met for applicants with less than 750 PIC Hours: Applicants with less than 750 PIC hours must provide the name of a supervisory pilot. Failing to meet this requirement can disqualify the application.

To avoid these common pitfalls, applicants should thoroughly review their applications before submission. It’s advisable to have all the necessary information, including aircraft registration numbers and accurate flight hours, at hand. Ensuring that all sections are completed in full and with accurate details will smooth the application process and help avoid unnecessary setbacks.

Meticulous attention to detail and adherence to the form’s requirements are key to a successful Private Aerial Applicator Application in South Dakota.

Documents used along the form

Completing and submitting the South Dakota A 94 A form is a crucial step for individuals looking to become licensed private aerial applicators in South Dakota. However, this form is often just one component of a package of required documents needed for the full application process. Understanding these additional forms and documents can help streamline the application, ensuring that candidates provide all the necessary information in a timely manner.

  • Private Pesticide Applicator License Application: This is the primary application document that must accompany the A 94 A form. It collects personal data, qualifications, and other pertinent information necessary for obtaining a pesticide application license.
  • Federal Airman's Certificate: A copy of this certificate is required to verify that the applicant has the proper federal aviation qualifications to operate as an aerial applicator.
  • FAA Agricultural Aircraft Operator Certificate (FAA Part 137): Evidence of this certification confirms that the applicant is authorized by the FAA to conduct agricultural aircraft operations.
  • Proof of Insurance: Documents showing that the applicant has liability insurance coverage are necessary to protect both the applicator and clients in the event of accidental damage or injury.
  • Logbook Records: Applicants must provide their flight logbook showing total pilot-in-command hours, as indicated on the A 94 A form, to verify experience.
  • FAA Approved Aerial Applicator School Certificate: For first-time applicants, a certificate of completion from an FAA-approved school is required to ensure the applicator has received proper training.
  • South Dakota Department of Transportation Aircraft Registration: Since the form requires the South Dakota Registration Number, proof of this registration confirms that the aircraft is legally registered to operate within the state.
  • Pilot Medical Certificate: This certificate ensures that the applicant meets the health and fitness criteria necessary to safely operate an aircraft.
  • Letter of Recommendation: For new applicants, a letter from a licensed professional can provide credibility and support for the applicant’s ability and character.
  • Chemical Use Plan: In some cases, applicants may be asked to submit a detailed plan of the pesticides they intend to use, including rates and methods of application, to ensure safe and responsible use of chemicals.

In summary, while the South Dakota A 94 A form is specific to those seeking licensure as private aerial applicators, the completion of the application process usually involves the submission of numerous other forms and documents. Each document serves a specific purpose, from verifying qualifications and experience to ensuring safety and compliance. Together, these documents provide a comprehensive profile of the applicant, ensuring that only qualified and competent individuals are granted the privilege of aerial application in South Dakota.

Similar forms

The South Dakota A 94 A form, which is required for private aerial applicators wishing to apply for a license to operate, draws similarities with a variety of other regulatory documents, specifically those that also pertain to professional licensing and certification in specialized fields. These forms, while serving unique purposes, share commonalities in their structure, intent, and the type of information they solicit from applicants. Below, notable resemblances are drawn with two specific types of documents.

Federal Aviation Administration (FAA) Forms

The structure and detailed requirements of the South Dakota A 94 A form bear resemblance to certain Federal Aviation Administration (FAA) forms, particularly those related to pilot and aircraft certification, such as the Medical Certificate Application and the Aircraft Registration Application. Both sets of documents:

  • Require detailed personal information about the applicant, including name, address, and phone number.
  • Ask for specific certifications or ratings, similar to how the A 94 A requests the Federal Airman’s Certification number and the Agricultural Aircraft Operator’s FAA Certificate number.
  • Demand information on equipment or aircraft to be used, mirroring the A 94 A’s inquiries about the make, model, and year of aircraft, along with their registration details.
These forms collectively ensure that the individuals and equipment meet the necessary standards for safe operation within their respective fields.

State Pesticide Applicator Certification Forms

Another document type similar to the South Dakota A 94 A form is found in the realm of state pesticide applicator certification forms, which many states require for various types of pesticide application businesses. These forms, like the A 94 A, aim to regulate and ensure safe practices in specialized applications by:

  • Gathering applicant information, including educational background and professional experience.
  • Mandating details of any certifications held and the type of application the license will cover, akin to the A 94 A's section that details the applicant's flight and spraying experience.
  • Requiring information on the scope of operations, such as the number of acres treated and the amount of flying hours dedicated to spraying activities. This ensures that applicants have the requisite experience and are operating within controlled parameters.
Through these requirements, each form seeks to uphold public safety and environmental protection by establishing a baseline of qualifications and operational transparency.

Dos and Don'ts

When filling out the South Dakota Form A 94 A for a Private Aerial Applicator Application, certain practices can enhance the accuracy and acceptance of your application, while others can lead to unnecessary delays or rejection. Here are key dos and don'ts to keep in mind:

Do:
  • Read the form thoroughly before starting to fill it out to understand all the requirements and directions.
  • Ensure that your Federal Airman’s Certification number and Agricultural Aircraft Operator’s FAA Certificate number are current and accurately entered.
  • List all aircrafts accurately, including the make, model, year, Federal ‘N’ No., and South Dakota Registration Number.
  • Provide a detailed account of your Total Pilot In Command (PIC) flight hours and spraying/dusting experience, as these are crucial for your application.
  • If applicable, attach a copy of your certificate from an FAA-approved aerial applicator school, especially if this is your first-time application.
  • Answer truthfully about any past denials to spray in any state and provide details as requested.
  • Sign and date your application, certifying that all the information provided is true and correct to the best of your knowledge.
Don't:
  • Leave any sections incomplete — if a question does not apply to you, mark it with N/A (not applicable).
  • Provide estimated or rounded-off flight hours — be precise in detailing your experience.
  • Forget to contact the South Dakota Department of Transportation for your South Dakota Reg. No., if you haven’t done so already.
  • Overlook the requirement to operate under supervision if you have less than 750 PIC Hours and lack other specified qualifications — be sure to fill in the supervisor pilot’s name clearly.
  • Submit your application without rechecking all the facts and figures. Errors or inaccuracies can delay the processing.
  • Miss attaching supporting documents, such as your FAA-approved aerial applicator school certificate, if this applies to your situation.
  • Assume approval without confirmation from the South Dakota Aeronautics Commission — wait for the official approval before beginning any aerial applicator operations.

Misconceptions

Understanding the South Dakota A 94 A form is crucial for those operating in the agricultural and aerial application sectors. However, there are several misconceptions that need addressing to ensure compliance and proper use of the form. Here are six common misconceptions:

  • It's just a formality: Some might think that filling out the South Dakota A 94 A form is a mere formality without understanding its importance. In reality, this form is a critical component of ensuring safe and responsible aerial application practices, required by state regulations.
  • No need for accuracy: The thought that approximate information is sufficient when completing the form is misleading. Accuracy is essential, especially concerning flight hours, aircraft details, and experience, to meet strict regulatory requirements.
  • Email address is optional: Every section of the form, including the email address, plays a crucial role in maintaining communication and record-keeping. Providing a current email address is necessary for receiving important updates and information.
  • FAA certifications don’t need to be current: There's a misconception that as long as you have obtained FAA certifications at some point, they don’t need to be current. This is incorrect. Both Federal Airman’s Certification and Agricultural Aircraft Operator’s FAA Certificate numbers must be up to date and valid at the time of application.
  • Previous experience can be overlooked: For those new to the profession, it might seem that their lack of experience can be glossed over. However, the form requires detailed information on previous experience, particularly to verify the eligibility for operating under certain conditions or supervision requirements.
  • One-time submission is enough: A common fallacy is believing that once the A 94 A form is submitted, no further action is required in subsequent years. In fact, this application must be updated and resubmitted with the Private Pesticide Applicator License Application regularly to ensure all information remains current and to comply with ongoing regulatory changes.

Proper comprehension and accurate completion of the South Dakota A 94 A form are indispensable for private aerial applicators. By dispelling these misconceptions, applicators can better navigate the regulatory landscape, ensuring both compliance and the safety of their operations in South Dakota.

Key takeaways

Understanding the South Dakota A 94 A form, specifically designed for private aerial applicators, is crucial for ensuring compliance with the local regulations governing aerial application of pesticides. Here are key takeaways from the document:

  • Application Integration: The Form A 94 A must be submitted alongside the Private Pesticide Applicator License Application, highlighting its role as part of a larger documentation process required for aerial pesticide application authorization in South Dakota.
  • Contact Information: It mandates the provision of detailed personal and business contact information, reinforcing the importance of accessibility and accountability of the applicator.
  • Certification Requirements: Applicants must provide their Federal Airman’s Certification number and Agricultural Aircraft Operator’s FAA Certificate number, underlining the need for federal compliance in addition to state-specific regulations.
  • Aircraft Information: Detailed information about the aircraft used, including make, model, year, and registration numbers, is required. This ensures that only approved and properly registered aircraft are used for aerial application.
  • Flight Experience: The form asks for a breakdown of Pilot In Command (PIC) flight hours by aircraft type and within the last 12 months, emphasizing the importance of experienced pilots in ensuring the safe application of pesticides.
  • Application Experience: Applicants must disclose their total hours of spraying and/or dusting experience, including an accounting of the past year's activities, to assess their practical expertise in pesticide application.
  • Education and Supervision: Information must be provided on completion of FAA-approved aerial applicator schools or the requirement to operate under supervision if lacking the necessary experience. This requirement aims to maintain high standards of safety and competence in aerial pesticide application.
  • Operational Record: Details of acreage treated and flight hours spent on treatment within South Dakota in the previous year are required. This record supports the evaluation of the applicant's experience and impact on local agriculture.
  • Compliance and Accountability: The form includes questions about previous denials of permission to spray in any state and a declaration that the information provided is accurate, ensuring that applicants with a history of non-compliance or misleading disclosures are identified.

These elements collectively ensure that the process of licensing for aerial pesticide application in South Dakota is thorough, combining aspects of federal compliance, practical experience, and personal accountability to safeguard both the environment and agricultural interests in the state.

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