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Reporting Unlicensed Structural Pest Operators Form

Structural Pest Office
pest@agr.georgia.gov Tel: (404) 656-3641 Fax: (404) 463-6671

Anyone who advertises or performs structural pest control work in Georgia must have either a certified operator’s license or a registered employee license and must work for a licensed company. For more information, please visit the Reporting Unlicensed Operators page.

Your Observations

Date & Time

Observations

Address Involved

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

County

Vehicle Involved (if any)

TAG

state

Indicate if vehicle displayed any markings/company name (if any)

Indicate location where vehicle is parked/garaged (if known)

Make

Model

Color

Year

Suspected Customers (If Any)

Name of Individual(s)

Contact telephone number

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Your Contact Information

Name

Your Contact Number

(optional)

Email Address:

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