DA-230-S Supplement Sample

Dairy Products Mandatory Sales Reporting

DA-230-S_Supplement Sample

Dairy Mandatory Sales Reporting

OMB: 0581-0274

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******S A M P L E******

Supplement - Multiple Plants Screening Table

Note: This supplement is required for all operations answering "YES" to Question 1 in Section 1 of the Annual validation.
1. Please list all plants affiliated with this firm that produce any dairy products:

Interviewer Note: List Plant Name, Address, Telephone, and Dairy Products Produced for all company locations.
Answer Codes

Office Use
ST ID

PLANT ID

PP

Plane Name

Location

Telephone Number

(

)____________

(

)____________

(

)____________

(

)____________

(

)____________

(

)____________

(

)____________

Products Produced

YES = 1 / NO = 3 / DNK = 7
Question Question Question
2
3
4

2. Does this firm have full access to all weekly sales data for (insert Plant Name of each entry) reported above (i.e. all ledgers, contracts,
invoices, and cash receipts)?[If no or DNK, skip Questions 3 & 4.]
1 = YES

3 = NO

7 = DNK

3. Does (insert Plant Name of each entry) produce and/or market products outside of the information your firm provides to AMS (i.e. cheese is
reported through your firm but the plant makes and sells dry whey)?
1 = YES

3 = NO

7 = DNK

4. Does (insert Plant Name of each entry) market products of the same type outside of the information provided by your firm to AMS (i.e. the
plant has walk-in cash sales)?
1 = YES

3 = NO

7 = DNK

[After plants have been completed of the supplement return to the Annual Validation Worksheet in Section 1, Question 2.]
DA-230-S (Supplement sheet to DA-230)

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Additional Table - Interviewer Note: List Plant Name, Address, Telephone, and Dairy Products Produced for all company locations.
Answer Codes

Office Use
ST ID

PLANT ID

PP

Plane Name

DA-230-S (Supplement sheet to DA-230)

Location

Telephone Number

(

)____________

(

)____________

(

)____________

(

)____________

(

)____________

(

)____________

(

)____________

(

)____________

(

)____________

(

)____________

(

)____________

(

)____________

(

)____________

(

)____________

(

)____________

(

)____________

Products Produced

YES = 1 / NO = 3 / DNK = 7
Question Question Question
2
3
4

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