Alleged Violation and Detention Notice

The following statements are made in accordance with the Privacy Act of 1974 (5 USC 552a). The authorities for
requesting the information to be supplied on this form and any supplements are the Egg Products Inspection Act (21
USC 1031-1056) to provide a mandatory inspection program & the Agricultural Marketing Act of 1946 (7 USC
1621-1627) to provide a voluntary grading program. This form is used to report alleged violation(s) of the EPIA (Secs.
5,8,10,11,19, and 20) or the AMS (Sec. 203(h)) & as a notice & record of detention of product in noncompliance with
these Acts. 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 .25 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-518-1 (11-07)

(Previous edition dated 01-99 may be used.)