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.    

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The forms are displayed by OMB Number, AMS Forms Number, Title, and File Authority.

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COTTON PROGRAM

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DAIRY PROGRAM

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. 

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FRUIT AND VEGETABLE PROGRAM

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)

 

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LIVESTOCK, POULTRY AND SEED PROGRAM

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

 

 

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NATIONAL ORGANIC PROGRAM

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

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TOBACCO PROGRAM

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

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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