|
ELECTRONIC FORMS
Welcome to the Agricultural Marketing Service
(AMS) Electronic Forms
Manager (EFM).
The EFM is provided to assist users who wish to conduct electronic
business transactions with AMS. Users that prefer to use paper forms
may continue to obtain them through normal channels or download the forms
from this site for printing. Most Forms are in Adobe PDF format which
requires Adobe Acrobat 6.0.1 or later, Reader or full version. To get
Reader, click on the Adobe Acrobat Reader icon.
ALL POP-UP BLOCKERS MUST BE DISABLED
FOR THIS SITE TO FUNCTION
The forms are displayed by OMB Number, AMS
Forms Number, Title, and File Authority.
Customers
IMPORTANT: You must be using Adobe
Acrobat 6.0.1 or later, Reader or full version.
ALL POP-UP
BLOCKERS MUST BE DISABLED FOR THIS SITE TO FUNCTION
Customers
IMPORTANT: You must be using Adobe
Acrobat 6.0.1 or later, Reader or full version.
ALL POP-UP
BLOCKERS MUST BE DISABLED FOR THIS SITE TO FUNCTION
OMB Number |
Form Number |
Title |
Users |
Purpose |
Authority |
0505-0001 |
AD-755
|
Advisory Committee of Research and
Promotion Background Information National Fluid Milk Processor
Promotion Board |
Fluid Milk
Processors |
To Meet
Eligibility Requirements |
|
0505-0001 |
AD-755-2
|
Advisory Committee of Research and
Promotion Background Information National Dairy Promotion and
Research Board |
Milk Producers |
To Meet
Eligibility Requirements |
|
0581-0093 |
DA-15-CG
|
Application for
Initial or Continued Qualification of State or Regional Dairy
Product Promotion, Research, or Nutrition Education
Program |
State or Regional Dairy Product
Promotion, Research, or Nutrition Education Programs |
Initial or Continued Qualification |
|
0581-0032 |
DA-24
|
Annual Report of
Cooperative Milk Association |
Agricultural Cooperative Associations
|
To Satisfy Annual Requirement
Please mail your Annual Report of Cooperative Milk Association form to:
USDA-AMS-Dairy Programs Chief, Order Operations Branch Room 2753-South, Stop 0226 1400 Independence Ave., SW
Washington, DC 20250-0226
|
668000000 |
0581-0032 |
DA-25
|
Application for
Qualification of Cooperative Milk Marketing
Association |
Agricultural Cooperative Associations |
Original Application
Please mail your Application for Qualification of Cooperative Milk Marketing Association form to:
Deputy Administrator, Dairy Programs
2968-South, Stop 0225
Washington, D.C. 20250-0225
|
668000000 |
0581-0126 |
DA-155
|
Application to Use
Official ID |
Equipment Manufacturers,
Food Processors and Other Food
Industry |
For approval to use the USDA Grade Label shield on dairy product consumer-size packaging materials please fax 202-720-2643 or e-mail
Carrie.Sayasithsena@ams.usda.gov.
Please e-mail or call Carrie Sayasithsena at 202-720-9381 for questions regarding Grade Label on consumer-size packaging materials.
For Meat and Poultry applicants wishing to use our official identification please e-mail
Rocklyn.Bates@ams.usda.gov.
Please e-mail Rocklyn Bates for questions regarding Meat and Poultry applications.
|
6770a000 |
0581-0126 |
DA-156
|
Request to Display
Official ID |
Equipment Manufacturers,
Food Processors and Other Food
Industry |
For approval to display the USDA Grade Label shield on dairy product consumer-size packaging materials please fax 202-720-2643 or e-mail
Carrie.Sayasithsena@ams.usda.gov. Please e-mail or call Carrie Sayasithsena at 202-720-9381 for questions regarding Grade Label on consumer-size packaging materials.
For Meat and Poultry applicants wishing to display our official identification on the equipment and in literature please e-mail
Rocklyn.Bates@ams.usda.gov. Please e-mail Rocklyn Bates for questions regarding Meat and Poultry applications.
|
|
0581-0126 |
DA-157
|
Request to validate a prior meat and poultry equipment acceptance.
|
Equipment Manufacturers,
Food Processors and Other Food
Industry |
To validate a prior meat acceptance please e-mail
Rocklyn.Bates@ams.usda.gov.
Please e-mail Rocklyn Bates for questions.
|
|
0581-0126 |
DA-162
|
Equipment Review
Request (Dairy) |
Equipment Manufacturers,
Food Processors and Other Food
Industry |
Reporting requirements; Equipment review requests and scheduling, please e-mail
Rocklyn.Bates@ams.usda.gov Please e-mail Rocklyn Bates for questions.
|
|
0581-0126 |
DA-227a
Instructions to disable Pop-up blockers
|
OPEN DA-227a WITH INTERNET EXPLORER BROWSER ONLY
|
European Dairy Manufacturers,
Butter, Cheese Processors and Other Dairy
Industry |
Animal Health
Certificate
NOTE:This website has been shut down.
As noted in the July 24th
"Notice to Dairy Exporters and Milk Suppliers"
Applicants needing to make "Notifications"; request "Derogations";
or request "Raw Milk" or "Storage" certificates for the European Union must utilize
the USDA Electronic Trade Document Exchange (eTDE) system to access those functions.
Information on the eTDE system can be found at
http://www.etde.usda.gov/etdehelpcenter_Dairy.aspx
If you have any questions please contact Ken Vorgert at
Ken.Vorgert@USDA.gov ((630)437-5037)
or Carrie Sayasithsena at
Carrie.Sayasithsena@USDA.gov ((202)720-9381)
|
|
0581-0126 |
DRF
Derogation Request Form Instructions
|
OPEN DRF WITH INTERNET EXPLORER BROWSER ONLY
Notification of Farm in
Noncompliance/Derogation Request Form for EU Export Program |
Exporters to the EU; Manufacturers of Dairy
Products and/or Dairy Ingredients or
Traders |
To Provide Notification to AMS and to Request Derogations from EU
Requirements
NOTE: This website has been shut down.
As noted in the July 24th
"Notice to Dairy Exporters and Milk Suppliers"
Applicants needing to make "Notifications"; request "Derogations";
or request "Raw Milk" or "Storage" certificates for the European Union must utilize
the USDA Electronic Trade Document Exchange (eTDE) system to access those functions.
Information on the eTDE system can be found at
http://www.etde.usda.gov/etdehelpcenter_Dairy.aspx
If you have any questions please contact Ken Vorgert at
Ken.Vorgert@USDA.gov ((630)437-5037)
or Carrie Sayasithsena at
Carrie.Sayasithsena@USDA.gov ((202)720-9381)
|
|
Customers
who want to electronically transmit this form to the appropriate USDA
servicing office may do so by selecting 'SUBMIT AND CLOSE'
button on the bottom of each form. You will be
notified by e-mail that your application has been received and is being
processed along. If you would like a copy of your submission, please
print it prior to submission.
IMPORTANT: You must be using Adobe
Acrobat 6.0.1 or later, Reader or full version.
ALL POP-UP
BLOCKERS MUST BE DISABLED FOR THIS SITE TO FUNCTION
OMB Number |
Form Number |
Title |
Users |
Purpose |
Authority |
0581-0125 |
FV-DOV-1
|
Domestic Origin Verification (DOV) Program Application for Service |
Wholesalers - Distributors |
DOV program is a user-fee assessment service, available to suppliers, processor, and any financially interested party. It is designed to provide validation of an applicant's domestic origin verification program prior to bidding on
contracts to supply food product to the USDA's Domestic Feeding programs, and / or may be conducted after a contract is awarded. |
7 CFR 52.7 |
0581-0125 |
FV-24
|
Positive Lot
Identification |
Wholesalers - Distributors and
State and Local Governments |
Regulations Governing Inspection,
Certification, and Standards for Fresh Fruits, Vegetables and Other
Products |
6210C000 |
0581-0125 |
FV-237
|
Record of Request for
Inspection or Re-inspection of Food Products |
Wholesalers - Distributors |
Regulations Governing Inspection,
Certification, and Standards for Fresh Fruits, Vegetables and Other
Products.
Please email your Request for Inspection, Re-Inspection or Appeal Inspection of Food Products form to
FV237InspectionServices@ams.usda.gov.
PLEASE NOTE: The submit feature on the FV-237 Application for Inspection is currently not working.
Please contact your local office, or the National office at 800-811-2373, or fax your application to 202-720-0393. Thank you.
|
7230a000 |
0581-0125 |
FV-237A
|
Request for Audit
Services |
Wholesalers – Distributors, Other Food Industry, and State and Local Governments |
FV-237A is used by personnel of the grading service to record information when applications for services are made. This information is used by auditors to ensure that the correct audit service is provided, the correct operation is audited,
and that correct information appears on the official audit certificates. Other information is used by the grading office to properly direct
billing for these services. This request for service can be requested in person, by telephone, or facsimile to the nearest inspection office.
This request for service can be requested in person, by telephone, fax or email
FVAudits@ams.usda.gov
to the nearest inspection office.
|
7 CFR 51 |
0581-0125 |
FV-356
Form Fill Instructions
|
Application for
Inspection and Certification of Sampling |
Commodity Brokers |
Regulations Governing Inspection,
Certification, and Standards for Processed Fruits, Vegetables and Other
Products. |
7 CFR 52.7 |
0581-0125 |
FV-358
|
Request for
Surety Bond |
Food Processors and Other Food Industry |
Assure the insepction service that fees and charges for any inspection service are paid by the interested party making the application for such service, in accordance with the applicable provisions of the regulation. The FV-358 set
the agreement for surety and establish the amount to be paid. |
7 CFR 52.41 |
0581-0125 |
FV-468
|
Application for License to Sample Processed
Foods |
Food Processors and Other Food Industry |
Subcontract applicant desiring to sample processed food and certify as to the identifcation, location, and condition of containers of the
processed products that are sampled. |
7 CFR 52.30 |
0581-0125 |
FV-651
|
Agreement for Participation in Audit Verification Programs |
Wholesalers - Distributors and Other Food Industry |
FV-651 is used by applicants requesting audit services. This is a contractual agreement between the applicant and USDA which outlines the program requirements for the applicant and list the services provided by FPB upon signature.
Please email your Agreement for Participation in Audit Verification Programs request to
FVAudits@ams.usda.gov.
|
7 CFR 51 |
0581-0125 |
FV-652
|
Logo Use Request for Audit Programs |
Wholesalers - Distributors and Other Food Industry |
FV-652 is used by any participant in a USDA GAP&GHP; program, IP Program, or PIQ Program who would like to use the individual programs logo. This form will be used by USDA to document the use of specific audit programs logo.
As outlined in sections 51.49 and 51.59(e)(8) prior to printing, drawings or printer’s proofs of each packer’s or distributor’s label bearing
or referring in any manner to official inspection legends or grade marks must be submitted to the Fruit and Vegetable Programs for
approval. This is to ensure that these meet USDA specifications.
Please email your Logo Use Request for Audit Programs to
FVAudits@ams.usda.gov.
|
7 CFR 51.49 and 51.59(e)(8) |
Customers
IMPORTANT: You must be using Adobe
Acrobat 6.0.1 or later, Reader or full version.
ALL POP-UP
BLOCKERS MUST BE DISABLED FOR THIS SITE TO FUNCTION
OMB Number |
Form Number |
Title |
Users |
Purpose |
Authority |
0581-0128 |
LPS-109
|
Application for
Service |
Meat Producers, Feeders, Processors
and Other Members of the Food Industry |
Applicants interested in Receiving Quality Assessment Division Services, such as: Meat, Poultry or Shell Egg Grading or Certification |
7 CFR part 54
7 CFR part 56
7 CFR part 62
7 CFR part 70
|
0581-0128 |
LPS-110
|
Work Schedule Request |
Agricultural Producers, Feeders, Processors and Other Food Industry |
Applicants interested in Receiving Quality Assessment Division Services,
such as: Meat, Poultry or Shell Egg Grading or Certification |
7 CFR part 54
7 CFR part 56
7 CFR part 62
7 CFR part 70
|
0581-0113 |
LPS-222
|
Import Request (Shell Eggs) |
Importers or their agents |
Importation of Shell Eggs |
7 CFR part 57 |
0581-0128 |
PY-33
|
Application for
Specification Approval |
Retailers, Agricultural Producers,
Food Processors and Other Food Industry |
Regulations for Voluntary Grading of
Poultry and Rabbit Products |
7710a000 |
0581-0113 |
PY-155
|
Registration of Shell
Egg Handlers |
Agricultural Producers, Food
Processors and Other Food Industry |
Regulations for the Inspection of
Eggs |
|
Customers
IMPORTANT: You must be using Adobe
Acrobat 6.0.1 or later, Reader or full version.
ALL POP-UP
BLOCKERS MUST BE DISABLED FOR THIS SITE TO FUNCTION
OMB Number
|
Form Number
|
Title
|
Users
|
Purpose
|
Authority
|
0581-0191
|
NOP 2110-1
|
NOP
Import Certificate
USDA,
AMS, National Organic Program Accreditation and International Activities
Division
1400 Independence Avenue, SW Room 2648-South Washington, DC 20250
Phone: (202) 720-3252 Email: AIAInBox@usda.gov
|
Certifying Bodies for Imported
Organic Agricultural Products
|
To import organic agricultural
products that are certified to an international
standard equivalent to the USDA organic regulations.
|
7
CFR Part 205
|
0581-0191 |
TM-10CG
|
Application for
Accreditation |
Certifying Agents |
National Organic Program |
|
Customers
IMPORTANT: You must be using Adobe
Acrobat 6.0.1 or later, Reader or full version.
ALL POP-UP
BLOCKERS MUST BE DISABLED FOR THIS SITE TO FUNCTION
OMB Number |
Form Number |
Title |
Users |
Purpose |
Authority |
0581-0004 |
TB-26
|
Tobacco Stocks
Report |
Dealers and Manufacturers |
For Reporting Leaf Tobacco Stocks,
Stems, and Sheet as Required by the Tobacco Statistics Act (7 U.S.C.
502). Data Used for Calculation of Domestic Usage Of Tobacco |
83700000 |
0581-0004 |
TB-39
|
Quarterly Report on
Manufacture and SALE OF Snuff, Smoking and Chewing
Tobacco. |
Dealers and Manufacturers |
To Collect Statistics for Publication
of National Totals for the Manufacture and Sales of Snuff, Smoking,
and Chewing Tobacco as Requested by the Industry |
83800000 |
Customers
IMPORTANT: You must be using Adobe
Acrobat 6.0.1 or later, Reader or full version.
ALL POP-UP
BLOCKERS MUST BE DISABLED FOR THIS SITE TO FUNCTION
TRANSPORTATION AND
MARKETING PROGRAM
|
OMB Number |
Form Number |
Title |
Users |
Purpose |
Authority |
0581-0169 |
TM-6
|
Farmer’s Market
Questionnaire |
Farmer's Market Managers |
To Receive Information Regarding
Farmers Markets |
|
|