SC-357 Notification of Entry

OMB No. 0581-0125

INITIAL INSPECTION REQUEST FOR REGULATED IMPORTED COMMODITIES
8e IMPORT PRODUCTS AND FRESH FRUITS, VEGETABLES, NUTS AND SPECIALTY CROPS
* denotes required information

APPLICATION
*PRODUCT LOCATION and AVAILABILITY for INSPECTION

DATE:

TIME:

DATE:

TIME:

*COMPANY NAME
*ADDRESS
*PHONE

FAX

*CITY

*EMAIL

*STATE

*ZIP

*CONTACT PERSON

SECTION 8e IMPORT PRODUCT INSPECTION – QUALITY AND CONDITION (SIZE INCLUDED WHEN APPLICABLE)
☐ OTHER: _________________________________________________________________
☐ FRESH ☐ CANNED ☐ FROZEN ☐ DRIED ☐ DEHYDRATED
IMPORTER/BROKER
*IMPORTER OF RECORD

BROKER’S REFERENCE No.

*ENTRY DATE

FCE NUMBER

*PORT OF ENTRY

PORT OF EXPORT

*NAME OF VESSEL/VOYAGE
NUMBER

COUNTRY OF ORIGIN

*CUSTOMS ENTRY NUMBER

*CONTAINER NUMBER(S)

BILL OF LADING NUMBER
FRESH FRUITS, VEGETABLES OR NUTS: ☐ INSPECTION ☐ RE-INSPECTION ☐ APPEAL INSPECTION
☐ QUALITY AND CONDITION ☐ CONDITION ONLY ☐ SIZE ☐ NET WEIGHT ☐ DIGITAL IMAGES ☐ OTHER: _______________________________________
☐ SHIPPER

*APPLICANT
*COMPANY NAME

☐ RECEIVER

☐ BUYER

*COMPANY NAME

*ADDRESS 1

ADDRESS 1

ADDRESS 2

ADDRESS 2

*CITY

*CITY

*STATE

*ZIP

*STATE

ZIP

*COUNTRY
*CONTACT PERSON

CONTACT PERSON

*PHONE

*FAX

PHONE

EMAIL

FAX

EMAIL
PRODUCTS TO BE INSPECTED

LOT/PO/PLI
NUMBER

*PRODUCT

*HTS CODE

*QUANTITY

*NET WT (LBS)

CONTAINER TYPE

*SIZE

*TYPE/VARIETY

CODE MARKS
CODE MARKS
CODE MARKS
CODE MARKS
CODE MARKS
CODE MARKS
CODE MARKS
SEND CERTIFICATE AND FEE BILL TO: (CERTIFICATES FOR PROCESSED PRODUCTS WILL BE EMAILED UNLESS OTHERWISE SPECIFIED)
☐ APPLICANT ☐ OTHER: _______________________________________________________________________________________________________________________
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 is 0581-0125. The time required to complete this information collection is estimated to average five
minutes per response, including the time for reviewing the instruction, searching existing data sources, gathering and maintaining data needed, and completing and reviewing the
collection of information.
SC-357 (6-2017)

Non-Discrimination Policy: 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.

SC-357 (6-2017)