FV-251 Imported Pistachios - Rework & Failed Lot Disposition Re

REPRODUCE LOCALLY – Include form number and date on all republications

OMB No. 0581-NEW

USDA – Fruit and Vegetable Programs
Marketing Order Administration Branch
1400 Independence Avenue SW, Stop 0237
Washington, D.C. 20250-0237
Phone: (202) 720-2491; Fax: (202) 720-5698

Form FV-251 – Imported Pistachios – Rework & Failed Lot Disposition Report
Section A: Importers should complete and submit the following information for the failed lot within 10 days after
rework or other disposition is completed. Send the original to the U.S. Customs and Border Protection office
overseeing importation of this lot, send one copy to the Marketing Order Administration Branch, and retain a copy
for your records.

Customs entry number: ____________________________
Lot description: ______________________ Lot ID marks: ___________________________
Weight: _________________ Lbs.

Container size/description: _______________________

Importer name: ______________________________________________________________
Address: ______________________ City: _____________ State:_____ Zip code: ________
Aflatoxin Certificate number: ___________________ Date: __________________________
Is this an inshell lot? (circle one): Yes or No
If answer is yes, has it failed aflatoxin testing more than once? (circle one): Yes or No
Note: Inshell lots can be reworked only once for aflatoxin. Upon second rejection they must be shelled, sold as
export, or sold for non-human consumption.

Section B – Rework: Complete this section if rework of the failed lot is elected.

Total Pounds Reworked:_________ Pounds Accepted:_________ Pounds Rejected:_________
Location of rework: _____________________________________________________________
Address: ______________________ City:_____________ State:_____ Zip code:__________
Description of rework process:_____________________________________________________
New lot description:_________________________ New lot ID:_________________________
New container / size description:___________________________________________________
If reworked for aflatoxin, did the lot pass retest? (Circle one): Yes or No Cert #:___________
Aflatoxin Results: Test 1:______ppb Test 2:______ppb

Average of Tests 1 and 2:______ppb

Section C – Shelling: Complete this section if shelling was performed prior to reworking.

Pounds shelled:_________________ Name of sheller:_________________________________
Address:______________________ City:_______________ State:_____ Zip code:_________

FV-251 (June 2011)

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REPRODUCE LOCALLY – Include form number and date on all republications

OMB No. 0581-NEW

Form FV-251 – Imported Pistachios – Rework & Failed Lot Disposition Report (continued)
Section D - Non-Human Consumption: Complete this section if the failed lot was shipped to a non-human
consumption outlet.

Pounds shipped:________________ BOL #:_______________________
Product Shipped To:____________________________ Phone #: _______________________
Address:_______________________ City: _____________ State: _____ Zip code:_________
Description of use:_____________________________________________________________
Section E - Export: Complete this section if the failed lot was exported.

Pounds shipped:________________ BOL #:_______________________
Customer:___________________________ Country:________________________________
Address:_____________________________________________________________________
Section F – Destroyed: Complete this section if the failed lot, or a portion of the failed lot, was destroyed.

Pounds destroyed:___________________
Method of destruction:___________________________________________________________
Location of destruction:__________________________________________________________
Verified by:_____________________________________ Of (Agency):__________________

Importer Signature: _______________________________ Date:_________________________
Name:__________________________________________ Title:_________________________

The making of any false statements or representations in any matter within the jurisdiction of any agency of the United States,
knowing it to be false, is a violation of Title 18, Section 1001, United States Code, which provides for a penalty of a fine for
individuals and for organizations or imprisonment, or both.
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-NEW. The time required to complete this information collection is estimated to average 12
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.
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.
FV-251 (June 2011)

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