gdige@helenamt.gov
316 N Park Avenue, Room 405, Helena, MT 59623
406-447-8458
Use only approved herbicides and rates that are listed on the application. No others will be reimbursed. Submit the completed reimbursement form, and attach a copy of the invoice for chemical or commercial applicator
Full Name
Full Address
Private Applicator (spray yourself):
Commercial Applicator:
A non-ionic surfactant is acceptable for use. Please write the brand name and the rate as the label directs.
USE HERBICIDES CONTIANING THESE ACTIVE INGREDIENTS (list in parenthesis) ONLY OR YOU WILL NOT BE REIMBURSED
Weather Conditions
Noxious Weeds Treated - Approximate Acres
Herbicide Treatment Information - 1
Herbicide Treatment Information - 2
Herbicide Treatment Information - 3
Herbicide Treatment Information - 4
Herbicide Treatment Information - 5
Upload invoice or receipt.
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