DA-250 Sanitary Certificate Request (Morocco)

Form
U. S DEPARTMENT OF AGRICULTURE
AGRICULTURAL MARKETING SERVICE

SANITARY CERTIFICATE REqUEST

TYPE

Morocco

I

I raxed

Certificate'

0 Additional

Copies'

'aoortronar cnarBes apprv

that by checking this box that the information provided

CONTACT INFORMATION

is factual and accurate.
MAITING INFORMATION

1. CONTACT NAME

7. COMPANY

2. AMS BILLING ACCT.

8. CONTACT

3. BILLING REFERENCE

9. STREET

4. E-MAIL

10. ctTY

I acknowledge

OMB No.058L-0283

According to the papenrvork reduction act of 1995, an a8ency 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. This
valid OMB control number for this collection is 0581-0283. 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 information.

ADDRESS

5. CONTACT PHONE

11. STATE

6. FAX

t2.ztP

CONSIGNOR

13. NAME
14. ADDRESS
15. CITY/STATE
CONSIGNEE

16. NAME
17. ADDRESS
18. COUNTRY CODE

MA

IDENTIFICATION OF DAIRY PRODUCTS

19. DESCRIPTION OF COMMODITY

+

20. KIND OF HEAT TREATMENT (HTST; PASTEURIZED) *
21. WPE OF PACKAGING *

22. NUMBER OF PACKAGING UNITS *
23. NET WEIGHT*
24. REQUIRED TEMPERATURE DURING STORAGE AND
TRANSPORTATION *

rb

25. DATE PRODUCED*
26.EXPIRATION DATE*
MANUFACTURER

27. PLANT NUMBER
SHIPMENT INFORMATION

28. DEPARTURE PORT

29. ENTRY PORT

30. TRANSPORT TYPE
SIGNATURE (for foxed or moiled copies)

34. DATE

**For fastest processing, please attach this form and a PDF shipping label in an email to [email protected].
DA-2s0 (0u2016)

programoractivityconductedorfundedbyUSDA(notall

basesapplytoall programs) Remediesmdcomplaintfilingdeadlinesvarybyprogramorincident

may be made available in languages other than English

9410: (2)fax:(202)690-'7442;or (3)email: [email protected] USDAisanequal opportunityprovider,employer,mdlender