In an acute oral toxicity study (MRID [number]), groups of (fasted), (age) (strain) (species) (#/sex) were given a single oral dose of  chemical name (% a.i.) in (name of vehicle) at doses of   x, x, or  x  mg/kg bw and observed for (#) days.

Oral LD₅₀ Males =  mg/kg bw (95% C.I. if available)

      Females =  mg/kg bw (95% C.I. if available)

      Combined =  mg/kg  bw (95% C.I. if available)

[or note if no mortality occurred, note if limit test]

(Chemical name) is of (LOW, SLIGHT, MODERATE, HIGH) Toxicity based on the LD₅₀ in (males or females which ever is lower) [include EPA Toxicity Category I, II, III or IV if joint review]. Label comment if applicable.

Include only major treatment related clinical signs, body weight or necropsy signs including onset and/or duration if any or the following statement:  There were no treatment related clinical signs, necropsy findings or changes in body weight.  Note if there was a NOAEL for clinical findings (for Acute reference dose consideration during subsequent risk assessment.)