Form 9540-1 Import Inspection Application Meat Poultry and Egg Produ

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 0583-0159. The time required to complete this information collection is estimated to average 16 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.

U.S. DEPARTMENT OF AGRICULTURE
FOOD SAFETY AND INSPECTION SERVICE

1. COUNTRY OF ORIGIN

IMPORT INSPECTION APPLICATION

3. EXPORTING ESTABLISHMENT NUMBER

(Meat, Poultry & Egg Products)

5. U.S. PORT OF UNLADING/CBP PORT CODE

4. U.S. PORT OF ENTRY/CBP PORT CODE

6. FSIS ESTABLISHMENT NUMBER

2. INSPECTION CERTIFICATE NUMBER

7. NAME & ADDRESS OF FSIS ESTABLISHMENT

8. NAME , BUSINESS NAME & ADDRESS OF CUSTOMS BROKER OR APPLICANT

8b. FACSIMILE NUMBER

8a. PHONE NUMBER
8c. E-MAIL ADDRESS

9. NAME, BUSINESS NAME & ADDRESS OF CONSIGNEE

10. NAME, BUSINESS NAME & ADDRESS OF IMPORTER OF RECORD

11. BILL OF LADING NUMBER(S)

Blocks 13 through 32 repeat for each lot on the inspection certificate
12. LOT NO.

13. SHIPPING/IDENTIFICATION MARK

16. NET WEIGHT 17. SHIPPING UNIT
OF LOT (pounds) PACKAGE TYPE NAME

18. NUMBER
OF UNITS

22. PROCESSING EST. NO.

14. CUSTOM ENTRY NUMBER(S)

19. IMMEDIATE UNIT
PACKAGE TYPE NAME

15. PRODUCTION DATE(S)
TO:
FROM:
20. NUMBER PER
SHIPPING UNIT

21. SEAL NUMBER(S)

23. SOURCE COUNTRY(S) (if different from block 1)

24. SOURCE EST. NO.

25. HTS CODE (S)

26. PROCESS CATEGORY

27. PRODUCT CATEGORY

28. PRODUCT GROUP

29. SPECIES (Dominant)

29a. ADDITIONAL SPECIES (if applicable)

30. DESCRIPTION OF PRODUCT

31. SUPPLEMENTAL PRODUCT CODES (GTIN, INTENDED USE CODE, UPC)

32. ESTIMATED DATE OF ARRIVAL

12. LOT NO.

15. PRODUCTION DATE(S)
TO:
FROM:

13. SHIPPING/IDENTIFICATION MARK

16. NET WEIGHT 17. SHIPPING UNIT
OF LOT (pounds) PACKAGE TYPE NAME

18. NUMBER
OF UNITS

22. PROCESSING EST. NO.

26. PROCESS CATEGORY

29. SPECIES (Dominant)

14. CUSTOM ENTRY NUMBER(S)

19. IMMEDIATE UNIT
PACKAGE TYPE NAME

20. NUMBER PER
SHIPPING UNIT

21. SEAL NUMBER(S)

23. SOURCE COUNTRY(S) (if different from block 1)

24. SOURCE EST. NO.

25. HTS CODE(S)

27. PRODUCT CATEGORY

28. PRODUCT GROUP

29a. ADDITIONAL SPECIES (if applicable)

31. SUPPLEMENTAL PRODUCT CODES (GTIN, INTENDED USE CODE, UPC)

30. DESCRIPTION OF PRODUCT

32. ESTIMATED DATE OF ARRIVAL

IN CONSIDERATION of the U.S. Director of Customs and Border Protection granting me/us permission to transfer the packages of foreign food product described on this form which are offered for entry
into the United States, I/we agree, under bond filed with said director of Customs and Border Protection and subject to penalties prescribed in laws enacted by Congress and regulations issued there under
by the Secretary of Homeland Security, to hold the said food product intact at the location indicated above until it has been inspected and passed by a food inspector from the Food Safety and Inspection
Service or has been other wise disposed of under the supervision of a U.S. Customs and Border Protection Officer or a FSIS inspector.

33. PRINTED NAME OF CUSTOMS BROKER OR APPLICANT

FSIS FORM 9540-1 (02/26/2014)

34. SIGNATURE

REPLACES FSIS FORM 9540-1 (5/02) WHICH IS OBSOLETE

35. DATE

FSIS Form 9540-1 (continuation sheet)
12. LOT NO.

13. SHIPPING/IDENTIFICATION MARK

16. NET WEIGHT 17. SHIPPING UNIT
OF LOT (pounds) PACKAGE TYPE NAME

18. NUMBER
OF UNITS

22. PROCESSING EST. NO.

15. PRODUCTION DATE(S)
TO:
FROM:

14. CUSTOM ENTRY NUMBER(S)

20. NUMBER PER
SHIPPING UNIT

21. SEAL NUMBER(S)

23. SOURCE COUNTRY(S) (if different from block 1)

24. SOURCE EST. NO.

25. HTS CODE(S)

26. PROCESS CATEGORY

27. PRODUCT CATEGORY

28. PRODUCT GROUP

29. SPECIES (Dominant)

29a. ADDITIONAL SPECIES (if applicable)

30. DESCRIPTION OF PRODUCT

19. IMMEDIATE UNIT
PACKAGE TYPE NAME

31. SUPPLEMENTAL PRODUCT CODES (GTIN, INTENDED USE CODE, UPC)

32. ESTIMATED DATE OF ARRIVAL

12. LOT NO.

15. PRODUCTION DATE(S)
TO:
FROM:

13. SHIPPING/IDENTIFICATION MARK

16. NET WEIGHT 17. SHIPPING UNIT
OF LOT (pounds) PACKAGE TYPE NAME

22. PROCESSING EST. NO.

18. NUMBER
OF UNITS

14. CUSTOM ENTRY NUMBER(S)

19. IMMEDIATE UNIT
PACKAGE TYPE NAME

23. SOURCE COUNTRY(S) (if different from block 1)

20. NUMBER PER
SHIPPING UNIT

21. SEAL NUMBER(S)

24. SOURCE EST. NO.

25. HTS CODE(S)

26. PROCESS CATEGORY

27. PRODUCT CATEGORY

28. PRODUCT GROUP

29. SPECIES (Dominant)

29a. ADDITIONAL SPECIES (if applicable)

30. DESCRIPTION OF PRODUCT

31. SUPPLEMENTAL PRODUCT CODES (GTIN, INTENDED USE CODE, UPC)

12. LOT NO.

13. SHIPPING/IDENTIFICATION MARK

16. NET WEIGHT 17. SHIPPING UNIT
OF LOT (pounds) PACKAGE TYPE NAME

18. NUMBER
OF UNITS

22. PROCESSING EST. NO.

32. ESTIMATED DATE OF ARRIVAL

15. PRODUCTION DATE(S)

14. CUSTOM ENTRY NUMBER(S)

19. IMMEDIATE UNIT
PACKAGE TYPE NAME

FROM:
20. NUMBER PER
SHIPPING UNIT

21. SEAL NUMBER(S)

23. SOURCE COUNTRY(S) (if different from block 1)

24. SOURCE EST. NO.

25. HTS CODE (S)

26. PROCESS CATEGORY

27. PRODUCT CATEGORY

28. PRODUCT GROUP

29. SPECIES (Dominant)

29a. ADDITIONAL SPECIES (if applicable)

30. DESCRIPTION OF PRODUCT

32. ESTIMATED DATE OF ARRIVAL

31. SUPPLEMENTAL PRODUCT CODES (GTIN, INTENDED USE CODE, UPC)

12. LOT NO.

13. SHIPPING/IDENTIFICATION MARK

16. NET WEIGHT 17. SHIPPING UNIT
OF LOT (pounds) PACKAGE TYPE NAME

18. NUMBER
OF UNITS

14. CUSTOM ENTRY NUMBER(S)

19. IMMEDIATE UNIT
PACKAGE TYPE NAME

15. PRODUCTION DATE(S)
TO:
FROM:
20. NUMBER PER
SHIPPING UNIT

21. SEAL NUMBER(S)

25. HTS CODE (S)

22. PROCESSING EST. NO.

23. SOURCE COUNTRY(S) (if different from block 1)

24. SOURCE EST. NO.

26. PROCESS CATEGORY

27. PRODUCT CATEGORY

28. PRODUCT GROUP

29. SPECIES (Dominant)

29a. ADDITIONAL SPECIES (if applicable)

31. SUPPLEMENTAL PRODUCT CODES (GTIN, INTENDED USE CODE, UPC)

TO:

30. DESCRIPTION OF PRODUCT

32. ESTIMATED DATE OF ARRIVAL

FSIS 9540-1, IMPORT INSPECTION APPLICATION
(Meat, Poultry & Egg Products)

The following is guidance for applicants/custom brokers importing meat, poultry or egg products to the United States. The FSIS form 9540-1 has
been modified to capture more detailed information about shipments.
Block:
1.
2.
3.
4.
5.
6.
7.
8.

9.
10.
11.
12.

13.

Country of Origin. Enter the name of the country that issued the inspection certificate for the export of the product.
Inspection Certificate Number. Enter the serial number, including dashes/slashes, from the foreign country inspection contained on the
inspection certificate.
Exporting Establishment Number. Enter the official number of the foreign facility that the product was exported from the
inspection certificate.
U.S. Port of Entry/CBP Port Code1. This is the name of the port of entry and the associated CBP port code designation where the entry
is filed with U.S. Customs and Border Protection (CBP). Example: When the entry is filed at the Port of Philadelphia for merchandise
unladed at Long Beach, CA, enter “Philadelphia, PA – 1101” as the U.S. Port of Entry and Port Code.
U.S. Port of Unlading/CBP Port Code. This is the name of the U.S. port of entry and the associated CBP port code for merchandise
unladed at Long Beach, CA, enter “Los Angeles/Long Beach, CA – 1104” as the U.S. Port of Unlading and Port Code.
FSIS Establishment Number. This is the official number assigned by FSIS to the establishment where the product will move for FSIS
import inspection.
Name and Address of FSIS Establishment. The name and address of the FSIS establishment where the product is to be moved for
FSIS import inspection.
Name (first/last), Business Name and Address of Customs Broker or Applicant, as applicable (including zip code). Self explanatory
(NOTE: the name of a responsible person is required, in addition to the name of the business).
8a. Phone Number. Self explanatory.
8b. Facsimile Number. Self explanatory.
8c. E-Mail Address. The email address for refused entry notifications and communication with the applicant.
Name (first/last), Business Name and Address of Consignee (including zip code): The name and address, including zip code, of the
company or person to which the product is consigned (NOTE: the name of a responsible person is required, in addition to the name of
the business).
Enter Name (first/last), Business Name and Address of Importer of Record (IR) (including zip code). The name and address of the Importer of
Record as declared to Customs when the entry is filed (NOTE: the name of a responsible person is required, in addition to the name of
the business).
Bill of Lading Number(s). Enter the applicable bill of lading numbers for this application.
Lot No. The lot number of each line item of product identified on the foreign inspection certificate. Start with 1 and continue with 2, 3,
etc.
NOTE: Blocks 13 through 32 repeat for each lot on an inspection certificate. FSIS expects that each line item
on the inspection certificate is one (1) lot on the form 9540-1.
Shipping/Identification Mark. Enter the unique number from the inspection certificate that links the product in the lot to the inspection
certificate. Include slashes/dashes as appropriate.

14. Custom Entry Number(s). Enter each applicable 11 digit custom entry number associated with the shipment. For locations where the
custom entry number is not 11 characters long, enter enough zeros at the beginning to make an eleven digit number.
15. Production Date(s). Enter the range of production dates from the inspection certificate for each lot when applicable.
16. Net Weight of Lot. Enter the net weight of each lot in pounds from the inspection certificate.
17. Shipping Unit Package Type Name. Enter the type of shipping unit.
18. Number of Units. Enter the number of shipping units from the inspection certificate.
19. Immediate Unit Package Type Name. Enter the type of immediate container packaging.
20. Number per Shipping Unit. Enter the number of immediate containers contained in a shipping unit. When the amount is not standard in
each shipping container, enter an average/approximate number.
21. Seal Number(s). Enter the conveyance seal number(s) from the inspection certificate (egg products, red meat carcass shipments, etc).
22. Processing Est. No. Enter the foreign establishment number from the inspection certificate of the foreign plant that produced the product
(e.g., last processed the product).
23. Source Country(s). Enter each country, other than the exporting country, from which product was sourced to produce the product in this
lot.
24. Source Est. No. Enter each establishment, other than an establishment in the exporting country, from which product was sourced to produce the
product in this lot.
25. HTS Code(s): Enter the 10 number Harmonized Tariff Schedule code(s) for the product(s) in the lot.
26. Process Category. Enter the process category from the inspection certificate.
27. Product Category. Enter the product category from the inspection certificate.
28. Product Group. Enter the product group from the inspection certificate.
29. Species (dominant:) Enter one of the following species that the product predominantly contains: Beef, Veal, Goat, Lamb, Mutton,
Pork, Horse, Equine other than horse, Chicken, Duck, Goose, Guinea, Squab, Turkey, Emu, Ostrich, or Rhea.
29a. Additional Species (if applicable).
Enter the less predominant additional species from the inspection certificate, when
applicable. Refer to #29 for the applicable entries.

30. Description of the Product. Enter the name or description of the product from the inspection certificate. For example, lamb legs,
beef short loin, etc.
31. Supplemental Product Code. Enter the GTIN, Intended Use Code, UPC, or other product code that is used in commerce for the
product.
32. Estimated Date of Arrival. Enter the date that the product is expected to arrive at the FSIS establishment for import inspection.
33. Printed Name of Customs Broker or Applicant. Enter actual name of person signing this application.
34. Signature. Signature of person filing this application.
35. Date. Enter the date the application is completed.
1/ For American Samoa, enter either Pago Pago, AS Seaport - 0001 or Pago Pago, AS Airport - 0002