5020-2 Registration of Catfish Handlers

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 collection is 0583-XXX. The time required to complete this information collection is
estimated to average 15 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed,
and completing and reviewing the collection of information.

DISTRIBUTION: RETAIN ONE COPY FOR YOUR FILES, AND RETURN
ONE COPY OF THIS REPORT TO:

U.S. DEPARTMENT OF AGRICULTURE
FOOD SAFETY AND INSPECTION SERVICE
OFFICE OF PROGRAM EVALUATION, ENFORCEMENT AND REVIEW

USDA, FSIS, OFO
1400 Independence Ave, South Building, Rm. 3175,
Washington, DC, 20250-3700

REGISTRATION OF
CATFISH HANDLERS

NOTICE TO CATFISH HANDLERS
Unless you operate under Federal Inspection, you are required by law to register with the U.S. Department of Agriculture if you deal in meat, poultry or
catfish product in commerce. (The term "commerce" means commerce between any State, any territory, or the District of Columbia, and any place
outside thereof, or within any territory not organized with a legislative body, or the District of Columbia), or within a State or Territory that has been
designated for 21 U.S.C. 643 and/or 21 U.S.C. 460 because such State or Territory does not operate a program of its own.
INSTRUCTIONS: Complete items 1 through 9 and send two copies to the address in the upper right corner. USDA will return one copy of the
completed registration to the registrant in item 1.
1. NAME AND MAILING ADDRESS OF REGISTRANT (include Zip Code) 2. FORM OF ORGANIZATION (Check or specify)
PARTNERSHIP
INDIVIDUALLY OWNED
INCORPORATED

COOPERATIVE
ASSOCIATION

LIMITED LIABILITY
CORPORATION

OTHER (Specify)

E-MAIL

Phone:

3. NATURE OF BUSINESS (Check all that apply)
MEAT OR MEAT
PRODUCTS

POULTRY OR POULTRY
PRODUCTS

CATFISH AND CATFISH
PRODUCTS

OTHER (Specify)

ANIMAL FOOD
MANUFACTURER

4. CHECK EACH TYPE OF BUSINESS YOU ARE ENGAGED IN
DOMESTIC
BROKER

IMPORT
BROKER

RENDERER

PUBLIC
WAREHOUSEMAN

WHOLESALER

OTHER (Specify)

Buying, selling, transporting, or importing any dead, dying, disabled, or diseased cattle, sheep, swine, goats, horses, mules, equines, poultry,
catfish or parts of the carcasses of any such animals or poultry that died otherwise than by slaughter. (4D Operator)
5. Address(es) of subsidiaries, branches, or divisions or your organization which engage in business of the type identified in Item 4.
Include trade or other names if different from your organization's. (if none, so state)

PHONE:

E-MAIL

HOURS OF OPERATION

CHANGES: If you make any changes in the names, including trade names, or addresses of the place or places where you do business, nature or type
of business, report such changes within 15 days to address in upper right corner.
CERTIFICATION BY FIRM
6. TYPED OR PRINTED NAME

7. TITLE

8. SIGNATURE

9. DATE

NOTICE OF REGISTRATION BY USDA (COMPLETED BY USDA OFFICIAL)
a. REGISTRATION NO.

FSIS FORM 5020-2 (3/10/2011)

b. DATE OF REGISTRATION

c. TITLE OF USDA OFFICIAL d. SIGNATURE OF USDA OFFICIAL

PREVIOUS EDITIONS ARE OBSOLETE

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INSTRUCTIONS FOR FSIS FORM 5020-2,
REGISTRATION OF CATFISH HANDLERS

OFFICIAL OF THE " REGISTRATION OF CATFISH HANDLERS" FIRM REQUIRED TO REGISTER: COMPLETE
BLOCKS 1-9 BEFORE SUBMITTING THE FORM TO FSIS.
Block 1.

Enter the entire name and mailing address of the registering firm, include the phone number and
an E-mail address.

Block 2.

Check the box that describes the "Form of Organization" of the registering firm's organization.

Block 3.

Check all the boxes that best describe the nature of the registrant's business (meat or meat
products, poultry or poultry products, catfish or catfish products, or other).

Block 4.

Check all the boxes that describe the "Type of Business" that the registrant is engaged in
(domestic broker, import broker, renderer, animal food manufacturer, public warehouseman,
warehouseman, wholesaler, 4D operator, or other).

Block 5.

Enter the address or addresses of subsidiaries, branches, or divisions of the registrant's
organization that engage in business of the type checked in block 4. Include any that do business
as names, trade names, or names that are different than the name entered in block 1. Include the
phone number, and E-mail address, and the hours of operation for each subsidiary, branch, or
division. Attach additional sheets if necessary.

Block 6.

Print or type the name of the registering official.

Block 7.

Print or type the title of the registering official.

Block 8.

Enter the signature of the registering official.

Block 9.

Enter the date when the registering official signs the form.

OCIP HEADQUARTERS PERSONNEL: FILL OUT BLOCKS A-D AFTER RECEIVING THE FORM FROM THE
REGISTRANT
Block a.

Choose a unique registration number.

Block b.

Enter the date the form is signed by a FSIS official.

Block c.

Enter the title of the FSIS official signing the form.

Block d.

Enter the signature of the FSIS official registering the firm.