Foreign Buyers List Registration/Update Form

Foreign Buyers List Registration/Update Form
Post Name
Post Address
Post Phone / Fax / E-mail / Web site

1. Firm Name _____________________________________________________________
2. Contact Name and Title: ___________________________________________________
3. Street Address: __________________________________________________________
4. City: ___________________________________________________________________
5. Province: _______________________________________________________________
6. Country: ________________________________________________________________
7. Phone: _________________________________________________________________
8. Fax: ___________________________________________________________________
9. E-mail Address: ___________________________________________________________
10. Firm Type (circle your selection):
Importer - Wholesaler - Retailer - Other (explain) ________________________________

11. Agricultural/Food Products You Wish To Import:

According to the Paperwork 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 number for this information collection is 0551-0031. The time required to
complete this information collection is estimated to average 8 minutes per response, including the time for reviewing instructions, searching
existing data sources, gathering & maintaining data needed for completing & reviewing the collection of information.
The U.S. Department of Agriculture (USDA) prohibits discrimination in all its programs and activities on the basis of race, color, national origin, sex,
religion, age, disability, political beliefs, sexual orientation, and marital or family status. (Not all prohibited bases apply to all programs.) Persons with
disabilities who require alternative means for communication of program information (Braille, large print, audiotape, etc.) should contact USDA’s
TARGET Center at (202) 720-2600 (voice and TDD).
To file a complaint of discrimination, write USDA, Director, Office of Civil Rights, Room 326-W, Whitten Building, 14th and Independence Avenue, SW,
Washington DC 20250-9410 or call (202) 720-5964 (voice and TDD). USDA is an equal opportunity provider and employer.
March 2008, OMB 0551-0031