Form FV-357 Notification of Entry

OMB 0581-NEW

Agricultural Marketing Service, Fruit & Vegetable Program

NOTIFICATION OF ENTRY

8e IMPORT PRODUCTS and FRESH FRUITS, VEGETABLES, NUTS and SPECIALTY CROPS

NOTE:  Items with an “*” must be completed

APPLICATION

Date:

Time:

PRODUCT LOCATION and AVAILABILITY for INSPECTION

Date:

Time:

Company Name:

Address:

Ph.:

Fax:

City:

State:

E-mail:

Contact Person:

SECTION 8e IMPORT PRODUCT INSPECTION – Quality and Condition (size included when applicable)

 FRESH  CANNED   FROZEN  DRIED     DEHYDRATED     OTHER

Importer of Record		Broker’s Reference No.
Arrival Date		FCE No.
Port of Entry		Port of Export
Name of Vessel/Voyage No.		Country of Origin
Customs Entry No.		Container No(s).
Bill of Lading No.

FRESH FRUITS, VEGETABLE OR NUTS:  INSPECTION  Re-INSPECTION  APPEAL INSPECTION

 Quality and Condition  Condition only  Size  Net Weight  Digital Images  Other (specify)

APPLICANT

 SHIPPER  RECEIVER  BUYER

*Company Name

Company Name

*Address 1

Address 1

Address 2

Address 2

*City

City

*State

*Zip

State

Zip

*Contact Person

Contact Person

*Phone

*Fax

Phone

Fax

E-mail

E-mail

Lot No., PO No.

or PLI No.

PRODUCTS TO BE INSPECTED

PRODUCTS

*HTS CODE

*QUANTITY

LOT WEIGHT

TYPE CONTAINER

SIZE

TYPE/VARIETY

Code Marks

Code Marks

Code Marks

Code Marks

Code Marks

Code Marks

Code Marks

SEND CERTIFICATE AND FEE BILL TO:  APPLICANT  OTHER (Specify) (Certificates for processed products will be e-mailed unless specified below)

Remarks:

_______________________________________________________________________________________________________________________________ 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 five 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.

FV-357 (10-2015)

In accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, the USDA, its Agencies, offices, and employees, and institutions participating in or administering USDA programs are prohibited from discriminating based on race, color, national origin, religion, sex, gender identity (including gender expression), sexual orientation, disability, age, marital status, family/parental status, income derived from a public assistance program, political beliefs, or reprisal or retaliation for prior civil rights activity, in any program or activity conducted or funded by USDA (not all bases apply to all programs). Remedies and complaint filing deadlines vary by program or incident. Persons with disabilities who require alternative means of communication for program information (e.g., Braille, large print, audiotape, American Sign Language, etc.) should contact the responsible Agency or USDA’s TARGET Center at (202) 720-2600 (voice and TTY) or contact USDA through the Federal Relay Service at (800) 877-8339. Additionally, program information may be made available in languages other than English.

To file a program discrimination complaint, complete the USDA Program Discrimination Complaint Form, AD-3027, found online at http://www.ascr.usda.gov/complaint_filing_cust.html and at any USDA office or write a letter addressed to USDA and provide in the letter all of the information requested in the form. To request a copy of the complaint form, call (866) 632-9992. Submit your completed form or letter to USDA by:

1. mail: U.S. Department of Agriculture Office of the Assistant Secretary for Civil Rights 1400 Independence Avenue, SW Washington, D.C. 20250-9410;

2. fax: (202) 690-7442; or

3. email: [email protected].

USDA is an equal opportunity provider, employer, and lender.

FV-357 (10-2015)