Form FDA-2541

FORM APPROVED: OMB No. 0910-0037; EXPIRATION DATE: 8-31-2011. (See burden statement on page 2.)

DEPARTMENT OF HEALTH AND HUMAN SERVICES
Food and Drug Administration

TYPE OF SUBMISSION

FOR FDA USE ONLY

FOOD CANNING ESTABLISHMENT REGISTRATION

Initial Registration
Relocation (new registration required)
Change of Registration Information

FCE No.

Date Received by FDA

Enter Current FCE: (If applicable)
Enter Current FCE: (If applicable)

Specify Type of Change:

FOOD PROCESSING PLANT LOCATION

PREFERRED MAILING ADDRESS

Establishment
Name

Establishment
Name

Number and
Street
City and State
or Province
(or other Subdivision)
Zip (or other
Postal Code)

Number and
Street
City and State
or Province
(or other Subdivision)
Zip (or other
Postal Code)

Country (if other
than U.S.)

Telephone No.

Country (if other
than U.S.)

Telephone No.

Telefax No.

Telefax No.

PLEASE NOTE THE FOLLOWING:

LOW ACID AND/OR ACIDIFIED FOODS PROCESSED AT THIS LOCATION
Food Product Name, Form or Style, and Packing Medium
Listing products produced at this location is not a process filing.
(Do not list meat and poultry foods under the jurisdiction of the Food Safety and Inspection Service of the U.S.
Department of Agriculture.)

Same as Plant Location

(Check One)
Low-Acid Acidified

The requester hereby presents and acknowledges that the company is aware that
in making this request the company is subject to the terms and provisions of Title
18, Section 1001, United States Code which makes it a criminal offense to falsify,
conceal, or cover up a material fact; make any false, fictitious, or fraudulent
statement or representation; or make or use any false writing or document knowing
the same to contain any materially false, fictitious, or fraudulent statement or entry.
Subject to the terms of 21 CFR 108.25 (c)(1) and (2) and 108.35 (c)(1) and (2), no
commercial processor shall engage in the processing of low-acid or acidified foods
until the completed forms FDA 2541 and 2541a or 2541c have been filed with the
FDA within the applicable time frames specified in these regulations.
Forms, Instructions, regulations, and information can be secured online at http://
www.cfsan.fda.gov/~comm/lacf-toc
For more information contact the LACF Registration Coordinator by e-mail at
[email protected]

Food and Drug Administration
LACF Registration Coordinator (HFS-303)
Center for Food Safety & Applied Nutrition
5100 Paint Branch Parkway
College Park, Maryland 20740-3835
FACILITY CONTACT PERSON
Name of Contact and Business Address:
Position Held at Plant Location:

FAX Number:

FORM FDA 2541 (9/11)

Owner

Technologist

Manger

Director

Email Address:
PREVIOUS EDITION IS OBSOLETE

President/Vice President

Signature:

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Phone Number:
Date:
PSC Publishing Services (301) 443-6740

EF

Public reporting burden for this collection of information is estimated to average .17 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. Send comments regarding this burden estimate or any other aspect of this collection of
information, including suggestions for reducing this burden to: Department of Health and Human Services, Food and Drug
Administration, Office of Chief Information Officer, 1350 Piccard Drive, Room 400, Rockville, MD 20850.
An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it
displays a currently valid OMB control number.

FORM FDA 2541 (9/11)

PREVIOUS EDITION IS OBSOLETE

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