DA-201C Cheese Graders Memorandum

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OMB APPROVED – NO. 0581-0126

REPRODUCE LOCALLY Include form number and edition date on all reproductions
U.S. DEPARTMENT OF AGRICULTURE
AGRICULTURAL MARKETING SERVICE

Page
CERTIFICATE NO.

of

CHEESE GRADERS MEMORANDUM
TO: APPLICANT (Name, mailing, and address)

SHIPPER OR SELLER (Name and address)

INSPECTED AT (Name and address)1

INSPECTED BY:

MANUFACTURED BY (Name and address)1

MOISTURE TEST

VAT
NUMBER

RECEIVER OR BUYER (Name and address)

YR__
MFG.
DATE

ANNOUNCEMENT
NO.

DATE INSPECTED

CONDITION OF CONTAINERS

CONTRACT NO.

SAMPLE CONTAINERS STAMPED
WITH USDA LOT NO.

applicable U.S. standards for condition of
food containers
SIZE AND KIND OF CONTAINERS

SEED NO.

NO. SAMPLES TAKEN

STORAGE LOT

SERVICE DATE

DEFECT RATING
NO.
PKGS.

MARKED
WEIGHT

T E S T
SHORTAGE

SIGNATURE OF AGENT FOR APPLICANT

Email address:

NET
WEIGHT

FLAVOR

US GRADE

BODY &
TEX

COLOR

FINISH

NO. OF PACKAGES

U.S.
GRADE

COMMENTS
(S-Slight, D-Definite, P-Pronounced)

FDB

WEIGHT
lbs

INSPECTION

GRADE

lbs

EXPENSE

GRADE

lbs

LABORATOR

GRADE

lbs

TOTAL

BELOW

pH

FEES

GRADE

GRADE

%
H2O

$

$

lbs

DA-201C (06-03) (Destroy previous edition DA-132 dated 01-95 & 12-00)

(See next page for Burden Statement)

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U S DEPARTMENT OF AGRICULTURE
AMS, DAIRY PROGRAMS, DAIRY GRADING BRANCH
BUILDING A, SUITE 370
800 ROOSEVELT ROAD
GLEN ELLYN, IL 60137-5832