LPS-234 USDA Processed Egg and Egg Products Export Certificate

Regulations Governing the Voluntary Grading of Shell Eggs, Poultry Products, and Rabbit Products--7 CFR Parts 54, 56, 62 and 70

LPS-234_ V Certificate (03-23-17) JoC

Regs Governing the Voluntary Grading of Shell Eggs, Poultry & Rabbit Products, Meat, and QSVP

OMB: 0581-0128

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OMB APPROVED: NO. 0581-0128

U.S. DEPARTMENT OF AGRICULTURE
AGRICULTURAL MARKETING SERVICE
LIVESTOCK, POULTRY, AND SEED PROGRAM

USDA PROCESSED EGG AND EGG PRODUCTS EXPORT CERTIFICATE
NAME AND ADDRESS OF CONSIGNOR/EXPORTER:

CERTIFICATE NUMBER:

COMPETENT AUTHORITY:

NAME AND ADDRESS OF CONSIGNEE/IMPORTER:

STATE OF ORIGIN:

COUNTRY OF DESTINATION:

PLACE OF LOADING:

DECLARED POINT OF ENTRY:

MEANS OF TRANSPORT:

CONDITIONS OF TRANSPORT/STORAGE:

PRODUCER/MANUFACTURER:

DATE OF PACKING:

TYPE OF PACKING:

NAME OF PRODUCTS:

NUMBER OF PACKAGES:

NET WEIGHT:

ATTESTATIONS:

CERTIFICATION
DATE:

PRINTED NAME:
SIGNATURE:

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parental status, religion, sexual orientation, genetic information, political beliefs, reprisal, or because all or part of an individual’s income is derived from any public assistance program (Not all prohibited bases apply to
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and TDD). To file a complaint of discrimination, write to USDA, Director, Office of Civil Rights, 1400 Independence Avenue, S.W., Washington, D.C. 20250-9410, or call (800) 795-3272 (voice) or (202) 720-6382
(TDD). USDA is an equal opportunity provider, employer, and lender.

LPS-234 (12-2016)


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