Form PY-155 Registration of Shell Egg Handlers

FORM APPROVED -OMB NO. 0581-0113
RETURN THIS REPORT TO:

U.S. DEPARTMENT OF AGRICULTURE
AGRICULTURAL MARKETING SERVICE

Grading Branch
Poultry Programs, AMS
U.S. Department of Agriculture
1400 Independence Ave., SW MAIL STOP 0258
Washington, DC 20250-0258

POULTRY PROGRAMS

REGISTRATION OF SHELL EGG HANDLERS

No shell egg handler (except a producer-packer
with a flock of 3,000 hens or less) who grades
and packs eggs for the ultimate consumer or
hatchery may start operations until a registration
form has been properly completed and
submitted (7 CFR 57.690)

FOR USDA USE ONLY

INSTRUCTIONS: Complete all four copies of this form. Return the
original and two copies to the address shown in the upper middle
section. Keep one copy for your records. If more space is needed, use
the reverse of the form. Please print or type.

REGISTRATION NO.

DATE OF REGISTRATION

STATE

COUNTY

HANDLER

Col. 1-2

Col. 3-5

Col. 6-9

NAME AND ADDRESS OF EGG HANDLER
Col. 10

YES
1

(NAME)

Col. 11-30

NO
2

Plant has resident Grading Service

SIGNATURE AND TITLE OF USDA OFFICIAL
Col. 31-50

(STREET ADDRESS)

Col. 51-70

(CITY, STATE, ZIP CODE)

COUNTY IN WHICH BUSINESS IS LOCATED

NATURE OF BUSINESS (Check as appropriate)

Col. 71
1

PRODUCER/PACKER WITH 3,000 OR MORE HENS

4

OTHER (Specify)

2

GRADING STATION

Col. 72

3

HATCHERY

YES
1

NO
2

Do you pack shell eggs in consumer size containers?
Do you sell eggs directly to consumer on retail egg routes?
Do you sell eggs in consumer size containers to retailers or brokers who in turn sell them to retail distributors?
Do you sell eggs directly to institutional type users (i.e., restaurants, schools, hospitals, etc.)?
Col. 73

REMARKS

CERTIFICATION OF PERSON PREPARING REPORT
DATE

TITLE

TYPED OR PRINTED NAME

SIGNATURE

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 0581-0113. The time required to complete this information collection is estimated to average .33
hours 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.
The U.S. Department of Agriculture (USDA) prohibits discrimination in all its programs and activities on the basis of race, color, national origin, age, disability, and where applicable, sex,
marital status, familial status, 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 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 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 and employer.

PY-155

(04-08)

Previous edition dated 01-04 may be used.

UNITED STATES DEPARTMENT OF AGRICULTURE
AGRICULTURAL MARKETING SERVICE
1400 INDEPENDENCE AVENUE, SW MAIL STOP 0258
WASHINGTON, DC 20250-0258

NOTICE TO SHELL EGG HANDLERS
Public Law 91-597 enacted by the 91st Congress of the United States referred to as the
''Egg Products Inspection Act" places restrictions upon the disposition of certain
qualities of shell eggs effective July 1, 1972.
Producers having 3,000 or less hens and producers who do not pack eggs for sale to the
ultimate consumer exclusive of sales direct to consumers on the producers premises are
exempt.
To carry out the provisions of this Act, it is necessary that all persons who pack eggs for
consumer outlets, including producer-packers that have more than 3,000 hens, persons
who operate grading stations, and persons who have hatcheries are to complete the
attached registration form and return it to the address shown in the upper middle section
of the form. Keep one copy of this form for your records. You will receive a copy of
this form showing your registration number after it has been assigned.
The Act and the regulations issued pursuant thereto require specific labeling and
handling for restricted eggs and the maintenance of records of production, bills of sale,

inventories (by class and quantities of product), receipts, shipments, dates of shipment

and receipt, carrier names, and shippers and receivers names.

PY-155

(04-08)

Previous edition dated 01-04 may be used.