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UNITED STATES DEPARTMENT OF AGRICULTURE
AGRICULTURAL MARKETING SERVICE
COTTON AND TOBACCO PROGRAM
DATE:
ORDER #
DO NOT WRITE IN THIS SPACE
Standardization & Engineering Division
3275 Appling Rd.
Memphis, TN 38133
Telephone: (901) 384-3030
Fax: (901) 384-3032
E-mail: [email protected]
PAID BY CHECK NO.
AMOUNT
RECEIVED BY
DATE
International Calibration Cotton Standard Order Form
Stelometer
ITEM
E3
E11
E12
DESCRIPTION
1/8" Gage
Elongation
Grams/Tex
(Percent)
C - XX
American Upland
XX.X
X.X
L-X
American Upland
XX.X
X.X
M-X
American Pima
XX.X
X.X
Fibrograph
2.5%
50%
DOLLAR
AMOUNT
Micronaire QUANTITY
Span Length, in. Span Length, in.
X.XX
X.XX
X.XX
$
TOTALS
$
Check Here To Be Included in the Semi-Annual ICCS Check Test
Exact test values for each calibration cotton are shown on the label of each sample. These values are established by designated laboratories.
The samples are blended card web.
PRICES: The price of each 1/2 pound sample includes packaging, handling and delivery where stated. Fumigation (if needed) is a
minimum of $X.XX per order. Phytosanitary Certificate (if needed) is $XX.XX.
PAYMENT MUST BE SUBMITTED WITH ORDER. WE DO NOT ACCEPT LETTERS OF CREDIT.
CHECK MUST BE DRAWN ON A U.S. BANK PAYABLE TO: USDA, AMS, COTTON AND TOBACCO PROGRAM.
CHECK
VISA
MC
ACCT.NO.
EXPIRES
UNITED STATES
FOB Memphis...
Surface Delivered...
SIGNATURE
EXPORT
$XX.XX
$XX.XX
Request Quote for Air Freight Pre-Paid
SHIP TO (print or type)
CONTACT NAME
COMPANY NAME
STREET ADDRESSS (necessary)
POSTAL BOX
CITY
PHONE
STATE, COUNTRY, AND ZIP CODE
E-MAIL ADDRESS
FAX
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 0581-0008. The time required to
complete this information collection is estimated to average 3 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.
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.
CN-383-H (12-06)
File Type | application/pdf |
File Title | CN-383H_2017.xls |
Author | SRiva |
File Modified | 2017-02-03 |
File Created | 2017-02-03 |