Form LS-128 Boxed Lamb Report (Importers)

FORM APPROVED. - OMB NO. 0581-0186
UNITED STATES DEPARTMENT OF AGRICULTURE
AGRICULTURAL MARKETING SERVICE

BOXED LAMB DAILY REPORT

SALE TYPE CODE

DELIVERY PERIOD CODE

CLASSIFICATION CODE

1 = NEGOTIATED
2 = FORMULA MARKETING ARRANGEMENT
3 = FORWARD CONTRACT

1 = 0-21 DAYS
2 = 22-60 DAYS
3 = 61-90 DAYS
4 = 91/UP DAYS

1 = PRIME
2 = CHOICE
3 = PRIME/CHOICE
4 = GOOD
5 = UNGRADED

1. IDENTIFICATION NUMBER

2. COMPANY NAME

3. PLANT STREET ADDRESS

4. PLANT CITY
QUALITY
5. PLANT STATE

BRANDED PRODUCT CODE
YIELD

1 = PRIME
2 = CHOICE

1 = YIELD GRADE 2 or BETTER
2 = YIELD GRADE 1-3
3 = YIELD GRADE 4

6. PLANT ZIP CODE

NOTE: 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 0581-0186. The time required to complete this information collection is estimated to average . 0 8 4 0 h o u r s f o r
i mp o r t e r s a n d . 1 6 7 0 f o r d o m e s t i c p a c k e r s 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.

7. CONTACT NAME

8. PHONE NUMBER (include area code)

9. REPORTING DATE (mm/dd/yyyy)

10. REPORTING TIME

(NOT APPLICABLE)

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.202509410, or call (800) 795-3272 (voice) or (202) 720-6382 (TDD). USDA is an equal opportunity provider and employer.

11. LOT IDENTIFICATION OR PURCHASE ORDER NUMBER

18. WEIGHT (1=Light; 2=Medium; 3= Heavy; 4=Mixed)

12. SOURCE (1 = Domestic; 2 = Imported)

19. TOTAL PRODUCT WEIGHT (pounds)

13. SALE TYPE CODE

20. FOB PLANT PRICE ($/cwt.)

14. DELIVERY PERIOD CODE

21. USDA CERTIFIED SCHEDULE CODE (if applicable)

15. REFRIGERATION (1 = Fresh; 2 = Frozen)

16. CLASSIFICATION CODE

17a. LAMB CUT - IMPS Code

17b. LAMB CUT - Description (if IMPS not applicable)

LS-128 (05/13) Destroy previous edition

22a. BRANDED PRODUCT CODE - Quality

22b. BRANDED PRODUCT CODE - Yield