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About FDA
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FDA Forms
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| Form | Date | Food and Drugs Administration Forms | Format | Contact Info |
|---|---|---|---|---|
| 1815 | 02/2006 | Certificate/ Transmittal for an Application | (PDF - 59KB) |
Esther Lazar 301-436-1485 |
| 1993 | 08/2009 | Application for Permit to Ship or Transport Milk and/or Cream into US | (PDF - 672KB) |
Esther Lazar 301-436-1485 |
| 1994 | 08/2009 | Report of Tuberculin Tests of Cattle | (PDF - 405KB) |
Esther Lazar 301-436-1485 |
| 1995 | 08/2009 | Report of Physical Examination of Cows | (PDF - 1088KB) |
Esther Lazar 301-436-1485 |
| 1996 | 04/2009 | Dairy Farm Sanitation Report | (PDF - 560KB) |
Esther Lazar 301-436-1485 |
| 1997 | 02/2006 | Score Card for Sanitation Inspections of Milk Plants | (PDF - 89KB) |
Esther Lazar 301-436-1485 |
| 2359 | 10/2008 | Milk Plant Inspection Report | (PDF - 435KB) |
Robert Hennes 301-436-2175 |
| 2359a | 10/2008 | Dairy Farm Inspection Report | (PDF - 448KB) |
At the warehouse Elizabeth.Sands@fda.hhs.gov |
| 2359b | 10/2008 | Milk Plant Equipment Tests Report | (PDF - 370KB) |
Robert Hennes 301-436-2175 |
| 2359c | 10/2008 | Manufacturing Plant Inspection Report | (PDF - 692KB) |
At the warehouse Elizabeth.Sands@fda.hhs.gov |
| 2359d | 10/2008 | Report of Certification | (PDF - 405KB) |
At the warehouse Elizabeth.Sands@fda.hhs.gov |
| 2359h | 10/2008 | Interstate Milk Shipper Check-Rating Report | (PDF - 558KB) |
At the warehouse Elizabeth.Sands@fda.hhs.gov |
| 2359i | 10/2008 | Interstate Milk Shipper Report | (PDF - 594KB) |
Robert Hennes 301-436-2175 |
| 2359j | 10/2008 | Milk Sanitation Rating Report | (PDF - 431KB) |
At the warehouse Elizabeth.Sands@fda.hhs.gov |
| 2359k | 10/2008 | Status of Raw Milk for Pasteurization | (PDF - 706KB) |
Robert Hennes 301-436-2175 |
| 2359l | 10/2008 | Status of Milk Plants | (PDF - 606KB) |
Robert Hennes 301-436-2175 |
| 2359m | 10/2008 | Milk Plant, Receiving Station or Transfer Station NCIMS HACPP System Audit | (PDF - 443KB) |
Robert Hennes 301-436-2175 |
| 2359n | 10/2008 | NCIMS HACCP System Regulatory Agency Review Report | (PDF - 288KB) |
Robert Hennes 301-436-2175 |
| 2399 | 10/2008 | Dairy Plant Sampling - Raw & Pasteurized Milk | (PDF - 571KB) |
Robert Hennes 301-436-2175 |
| 2399a | 10/2008 | Bulk Milk Hauler/Sampler Evaluation Report | (PDF - 404KB) |
Robert Hennes 301-436-2175 |
| 2399b | 10/2008 | Milk Tank Truck Inspection Report | (PDF - 435KB) |
Robert Hennes 301-436-2175 |
| 2399c | 10/2008 | Farm Bulk Tank Milk Sampling Inspection Record | (PDF - 698KB) |
Robert Hennes 301-436-2175 |
| 2399d | 10/2008 | Dairy Plant - Milk Sample Collector Evaluation Record | (PDF - 459KB) |
Robert Hennes 301-436-2175 |
| 2541 | 10/2008 | Food Canning Registration | (PDF - 378KB) |
LACF Coordinator LACF@FDA.HHS.GOV |
| 2541a | 10/2008 | Food Process Filing For All Methods Except Low-Acid Aseptic | (PDF - 518KB) |
LACF Coordinator LACF@FDA.HHS.GOV |
| 2541a | 10/2008 | Food Process Filing For All Methods Except Low-Acid Aseptic (HTML) | (HTM - 0KB) |
LACF Coordinator LACF@FDA.HHS.GOV |
| 2541c | 10/2008 | Food Process Filing For Low-Acid Aseptic Systems (PDF) | (PDF - 426KB) |
LACF Coordinator LACF@FDA.HHS.GOV |
| 2541c | 08/2005 | Food Process Filing For Low-Acid Aseptic Systems (HTML) | (HTM - 0KB) |
LACF Coordinator LACF@FDA.HHS.GOV |
| 3038 | 03/2007 | Interstate Shellfish Dealer's Certificate | (PDF - 600KB) |
Charlotte Epps 301-436-2154 |
| 3038 | 03/2007 | Interstate Shellfish Dealer's Certificate {Not for public use, only for approved State shellfish officials to log into to set up a shellfish shipper user account to be able to fill out and submit the FDA 3038 electronically} (HTML) | (HTM - 0KB) |
Charlotte Epps 301-436-2154 |
| 3479 | 03/2005 | Notification for a Food Contact Substance Formulation | (PDF - 538KB) |
Mitchell Cheeseman 301- 436-1162 |
| 3480 | 09/2005 | Notification For New Use Of A Food Contact Substance | (PDF - 1031KB) |
Mitchell Cheeseman 301- 436-1162 |
| 3501 | 07/2008 | Domestic Seafood (HACCP) Report | (HTM - 0KB) |
Roshelle King 301-436-1416 |
| 3502 | 01/2001 | Importer Seafood HACCP Report | (PDF - 6KB) |
Roshelle King 301-436-1416 |
| 3503 | 09/2007 | Food Additive Petition Submission | (PDF - 256KB) |
Maribeth LaVecchi 301-436-1211 |
| 3504 | 09/2007 | Color Additive Petition Submission | (PDF - 245KB) |
Maribeth LaVecchi 301-436-1211 |
| 3537 | 11/2008 | Food Facility Registration | (PDF - 537KB) |
FDA Industry Systems Help Desk 800-216-7331 301-575-0156 |
| 3537 | 05/2007 | Food Facility Registration (HTML) | (HTM - 0KB) |
FDA Industry Systems Help Desk 800-216-7331 301-575-0156 |
| 3537a | 11/2008 | Cancellation of Food Facility Registration (HTML) | (HTM - 0KB) |
FDA Industry Systems Help Desk 800-216-7331 301-575-0156 |
| 3537a | 11/2008 | Cancellation of Food Facility Registration | (PDF - 653KB) |
Industry Systems Help Desk 800-216-7331 301-575-0156 |
| 3540 | 05/2007 | Prior Notice Submission | (HTM - 0KB) |
Prior Notice Center 866-521-2297 |
| 3570 | 02/2007 | Model Small Business Food Labeling Exemption Notice | (HTM - 0KB) |
SBusiness 301-436-2375 |
| 3613e | 02/2006 | Food Export Certificate Application | (PDF - 86KB) | Import/Export Team CFSAN 301-436-1130 |
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