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  • Specialty Crops Inspection Division Request for Inspection

  • Request for:*
  • NOTE: Fill in all blocks with "*". Inspection may be delayed because of incomplete information.

  • Date:*
     - -
  • Time:*
  • Format: (000) 000-0000.
  • Complete this section when different from the Applicant.

  • Is the shipper the same as applicant?
  • Type of Carrier:*
  • Lots Separated by
  • Digital Images Requested:
  • Inspection Requested For (Must select at least one):*
  • Failure to include all information about products may delay inspection.

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  • According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information is 0581-0125. The time required to complete this information collection is estimated to average 2 minutes per response, including the time for reviewing the instruction, searching existing data sources, gathering and maintaining data needed, and completing and reviewing the collection of information.
    Non-Discrimination Policy: In accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, the USDA, Its Agencies, offices, and employees, and institutions participating in or administering USDA programs are prohibited from discriminating based on race, color, national origin, religion, sex, gender identity (including gender expression), sexual orientation, disability, age, marital status, family/parental status, income derived from a public assistance program, political beliefs, or reprisal or retaliation for prior civill rights activity, in any program or activity conducted or funded by USDA (not all bases apply to all programs). Remedies and complaint filing deadlines vary by program or incident. Persons with disabilities who require alternative means of communication for program information (e.g., Braille, large print, audiotape, American Sign Language, etc.) should contact the responsible Agency or USDA's TARGET Center at (202) 720-2600 (voice and TTY) or contact USDA through the Federal Relay Service at (800) 877-8339. Additionally, program information may be made available in languages other than English. To file a program discrimination complaint, complete the USDA Program Discrimination Complaint Form, AD-3027, found online at http://www.asor.usda.gov/complaint filing cust. html and at any USDA office or write a letter addressed to USDA and provide in the letter all of the information requested in the form. To request a copy of the complaint form, call (866) 632-9962. Submit your completed form or letter to USDA by. (1) mait U.S. Department of Agriculture, Office of the Assistant Secretary for Civil Rights, 1400 Independence Avenue, SW, Washington, D.C. 20250-9410, (2) fax (202) 690-7442; or (3) emait program.intake@usda.gov. USDA is an equal opportunity provider, employer, and lender. SC-237 (01/2024) Destroy previous editions. USDA is an equal opportunity provider, employer, and lender.

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