DA-244 Sanitary Certificate Request - Chile

Export Health Certificate Request Forms

DA-244 Sanitary-Chile

Export Certificates

OMB: 0581-0283

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Form approved OMB No. 0581-0283


U. S DEPARTMENT OF AGRICULTURE

AGRICULTURAL MARKETING SERVICE

SANITARY CERTIFICATE REQUEST


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. This valid OMB control number for this collection is 0581-0283. The time required to complete this information collection is estimated to average 12 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 information.

TYPE Faxed Certificate* 0 Additional Copies* *additional charges apply

I acknowledge that by checking this box that the information provided is factual and accurate.

  1. CONTACT NAME

     

MAIL CERTIFICATE TO:

  1. AMS BILLING ACCT.

     

7. COMPANY

     

  1. BILLING REFERENCE

     

8. CONTACT

     

  1. E-MAIL ADDRESS

     

9. STREET

     

  1. CONTACT PHONE

     

10. CITY

     

  1. FAX

     

11. STATE

     

12. ZIP

     

CONSIGNOR

14. NAME

     

15. ADDRESS

     

16. CITY/STATE

     

CONSIGNEE

17. NAME

     

18. ADDRESS

     

19. COUNTRY CODE

CL

IDENTIFICATION OF DAIRY PRODUCTS

20. DESCRIPTION OF COMMODITY

     

21. KIND OF HEAT TREATMENT (HTST; PAST.)

     

22. TYPE OF PACKAGING

     

23. NUMBER OF PACKAGING UNITS

     

24. NET WEIGHT

     

25. REQUIRED TEMPERATURE DURING STORAGE AND TRANSPORTATION

     

     

     

27. EXPIRATION DATE

     

MANUFACTURER

28. PLANT NUMBER

     ;      ;      

SHIPMENT INFORMATION

     

     

30. ENTRY PORT

     

31. TRANSPORT TYPE

     

32. TRANSPORT NAME

     

33. CONTAINER NUMBER

     

34. SEAL NUMBER

     

SIGNATURE (for faxed or mailed copies)


35. DATE

March 30, 2022


**For fastest processing, please attach this form and a PDF shipping label in an email to [email protected].


DA-244 (01/2013)

The U.S. Department of Agriculture (USDA) prohibits discrimination in all its programs and activities on the basis of race, color, national origin, age, disability, and where applicable, sex, marital status, familial status, parental status, religion, sexual orientation, genetic information, political beliefs, reprisal, or because all or part of an individual’s income is derived from any public assistance program. (Not all prohibited bases apply to all programs.) Persons with disabilities who require alternative means for communication of program information (Braille, large print, audiotape, etc.) should contact USDA’s TARGET Center at (202) 720-2600 (voice and TDD).


To file a complaint of discrimination, write to USDA, Director, Office of Civil Rights, 1400 Independence Avenue, S.W., Washington, D.C. 20250-9410, or call (800) 795-3272 (voice) or (202) 720-6382 (TDD). USDA is an equal opportunity provider and employer.


File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorKen Vorgert Chief, Dairy Grading BranchUSDA
File Modified0000-00-00
File Created2022-03-30

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