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About FDA
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FDA Forms
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| Form | Date | Food and Drug Administration Forms | Format | Contact Info |
|---|---|---|---|---|
| 1815 | 12/2010 | Certificate/ Transmittal for an Application | (PDF - 294KB) |
Esther Lazar 240-402-1485 |
| 1993 | 08/2009 | Application for Permit to Ship or Transport Milk and/or Cream into US | (PDF - 672KB) |
Esther Lazar 240-402-1485 |
| 1994 | 08/2009 | Report of Tuberculin Tests of Cattle | (PDF - 404KB) |
Esther Lazar 240-402-1485 |
| 1995 | 08/2009 | Report of Physical Examination of Cows | (PDF - 1.1MB) |
Esther Lazar 240-402-1485 |
| 1996 | 04/2009 | Farm Inspection Report | (PDF - 554KB) |
Esther Lazar 240-402-1485 |
| 1997 | 08/2009 | Score Card for Sanitation Inspections of Milk Plants | (PDF - 370KB) |
Esther Lazar 240-402-1485 |
| 2359 | 09/2008 | Milk Plant Inspection Report | (PDF - 435KB) |
Robert Hennes 240-402-2175 |
| 2359a | 09/2008 | Dairy Farm Inspection Report | (PDF - 448KB) |
Robert Hennes 240-402-2175 |
| 2359b | 10/2011 | Milk Plant Equipment Tests Report | (PDF - 387KB) |
Robert Hennes 240-402-2175 |
| 2359c | 10/2008 | Manufacturing Plant Inspection Report | (PDF - 692KB) |
Robert Hennes 240-402-2175 |
| 2359d | 10/2010 | Report of Certification | (PDF - 431KB) |
Robert Hennes 240-402-2175 |
| 2359h | 10/2011 | Interstate Milk Shipper Check-Rating Report | (PDF - 589KB) |
Robert Hennes 240-402-2175 |
| 2359i | 10/2011 | Interstate Milk Shipper Report | (PDF - 607KB) |
Robert Hennes 240-402-2175 |
| 2359j | 10/2011 | Milk Sanitation Rating Report | (PDF - 477KB) |
Robert Hennes 240-402-2175 |
| 2359k | 10/2008 | Status of Raw Milk for Pasteurization | (PDF - 703KB) |
Robert Hennes 240-402-2175 |
| 2359l | 10/2011 | Status of Milk Plants | (PDF - 614KB) |
Robert Hennes 240-402-2175 |
| 2359m | 10/2011 | Milk Plant, Receiving Station or Transfer Station NCIMS HACPP System Audit | (PDF - 469KB) |
Robert Hennes 240-402-2175 |
| 2359n | 10/2011 | NCIMS HACCP System Regulatory Agency Review Report | (PDF - 337KB) |
Robert Hennes 240-402-2175 |
| 2359o | 10/2010 | Permission for Publication Interstate Milk Shipper’s Listing | (PDF - 405KB) |
Robert Hennes 240-402-2175 |
| 2359p | 10/2011 | NCIMS Aseptic Processing and Packaging Program Critical Listing Elements | (PDF - 387KB) |
Robert Hennes 240-402-2175 |
| 2399 | 09/2008 | Dairy Plant Sampling - Raw & Pasteurized Milk | (PDF - 571KB) |
Robert Hennes 240-402-2175 |
| 2399a | 10/2011 | Bulk Milk Hauler/Sampler Evaluation Report | (PDF - 428KB) |
Robert Hennes 240-402-2175 |
| 2399b | 10/2008 | Milk Tank Truck Inspection Report | (PDF - 427KB) |
Robert Hennes 240-402-2175 |
| 2399c | 10/2011 | Farm Bulk Tank Milk Sampling Inspection Record | (PDF - 713KB) |
Robert Hennes 240-402-2175 |
| 2399d | 10/2008 | Dairy Plant - Milk Sample Collector Evaluation Record | (PDF - 457KB) |
Robert Hennes 240-402-2175 |
| 2400 | 03/2001 | Cultural Procedures - General Requirements | (PDF - 8KB) |
William Northeimer, PhD 708-728-4137 |
| 2400a | 03/2001 | Milk Laboratory Evaluation Form: Standard Plate Count, Coliform, and Simpl | (PDF - 8KB) |
William Northeimer, PhD 708-728-4137 |
| 2400a-1 | 03/2001 | Milk Laboratory Evaluation Form: Spiral Plate Count Methods | (PDF - 85KB) |
William Northeimer, PhD 708-728-4137 |
| 2400b-1 | 03/2001 | MLEF Detection of Inhibitory Substances in Milk Bacillus Stearothermophilus | (PDF - 8KB) |
William Northeimer, PhD 708-728-4137 |
| 2400b-3 | 03/2001 | MLEF Detection of Inhibitory Substances in Milk Delvotest 5 Pack | (PDF - 8KB) |
William Northeimer, PhD 708-728-4137. |
| 2400d | 03/2001 | MLEF Direct Microscopic Somatic Cell Count | (PDF - 8KB) |
William Northeimer, PhD 708-728-4137. |
| 2400h | 03/2001 | Optical Somatic Cell Count | (PDF - 8KB) |
William Northeimer, PhD 708-728-4137. |
| 2400h-1 | 03/2001 | MLEF Electronic Somatic Cell Count Foss 250/300/360/400 | (PDF - 8KB) |
William Northeimer, PhD 708-728-4137. |
| 2400h-2 | 03/2001 | MLEF Electronic Somatic Cell Count Bentley Somacount 150/300/500 | (PDF - 8KB) |
William Northeimer, PhD 708-728-4137. |
| 2400h-3 | 03/2001 | MLEF Electronic Somatic Cell Count Fossmatic 5000 | (PDF - 8KB) |
William Northeimer, PhD 708-728-4137. |
| 2400i | 03/2001 | Pasteurized Milk Containers | (PDF - 8KB) |
William Northeimer, PhD 708-728-4137. |
| 2400j | 03/2001 | Phosphatase Test | (PDF - 8KB) |
William Northeimer, PhD 708-728-4137. |
| 2400k | 03/2001 | MLEF Flat Lid Methods | (PDF - 68KB) |
William Northeimer, PhD 708-728-4137. |
| 2400l | 03/2001 | MLEF Disintegration Method for Paper, etc. | (PDF - 45KB) |
William Northeimer, PhD 708-728-4137. |
| 2400m | 03/2001 | MLEF Dairy Waters | (PDF - 8KB) |
William Northeimer, PhD 708-728-4137. |
| 2541 | 11/2010 | Food Canning Registration (HTML) | (HTM - 0KB) |
LACF Coordinator 301/436-2411 |
| 2541 | 12/2010 | Food Canning Registration (Instructions) | (HTM - 0KB) |
LACF Coordinator LACF@FDA.HHS.GOV |
| 2541 | 04/2012 | Food Canning Registration | (PDF - 400KB) |
LACF Coordinator LACF@FDA.HHS.GOV |
| 2541a | 03/2010 | Food Process Filing For All Methods Except Low-Acid Aseptic (HTML) | (HTM - 0KB) |
LACF Coordinator LACF@FDA.HHS.GOV |
| 2541a | 03/2012 | Food Process Filing For All Methods Except Low-Acid Aseptic | (PDF - 520KB) |
LACF Coordinator LACF@FDA.HHS.GOV |
| 2541c | 03/2010 | Food Process Filing For Low-Acid Aseptic Systems (HTML) | (HTM - 0KB) |
LACF Coordinator LACF@FDA.HHS.GOV |
| 2541c | 03/2012 | Food Process Filing For Low-Acid Aseptic Systems (PDF) | (PDF - 711KB) |
LACF Coordinator LACF@FDA.HHS.GOV |
| 2591 | 08/2001 | Inspection Summary Equipment Evaluation | (PDF - 378KB) |
Bruce Kummer 240-402-2142 |
| 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 240-402-2154 |
| 3038 | 07/2010 | Interstate Shellfish Dealer's Certificate | (PDF - 373KB) |
Charlotte Epps 240-402-2154 |
| 3479 | 09/2009 | Notification for a Food Contact Substance Formulation | (PDF - 505KB) |
Francis Lin 240-402-1215 |
| 3480 | 08/2010 | Notification For New Use Of A Food Contact Substance | (PDF - 1.4MB) |
Francis Lin 240-402-1215 |
| 3502 | 01/2001 | Importer Seafood HACCP Report | (HTM - 0KB) |
Roshelle King 301-436-1416 |
| 3503 | 06/2011 | Food Additive Petition Submission | (PDF - 1.3MB) |
Berhane G. Girmay, Ph.D 240-402-1194 |
| 3503 | 06/2011 | Food Additive Petition Submission (Instructions) | (PDF - 39KB) |
Berhane G. Girmay, Ph.D. 240-402-1194 |
| 3519 | 03/2011 | FDA National Registry Report | (PDF - 418KB) |
Glenda Lewis 240-402-2150 |
| 3520 | 03/2011 | Release Record and Agreement - Permission to Publish in National Registry | (PDF - 387KB) |
Glenda Lewis 240-402-2150 |
| 3537 | 08/2011 | Food Facility Registration | (PDF - 555KB) |
FDA Industry Systems Help Desk 800-216-7331 301-575-0156 |
| 3537 | 02/2011 | 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 | 08/2011 | Cancellation of Food Facility Registration | (PDF - 403KB) |
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 | 01/2011 | Model Small Business Food Labeling Exemption Notice | (HTM - 0KB) |
SBusiness 240-402-2375 |
| 3613d | 02/2012 | Office of Cosmetics and Colors "Certificate" Export Application | (PDF - 709KB) |
Export Team 240-402-1178 |
| 3613e | 02/2012 | Food Export Certificate Application | (PDF - 454KB) |
Export Team 240-402-1178 |
| 3665 | 02/2012 | Final Consultation for Food Derived From a New Plant Variety (Instructions) | (PDF - 28KB) |
Dr. Mary Ditto 240-402-1165 |
| 3665 | 02/2012 | Final Consultation for Food Derived From a New Plant Variety (Biotechnology Final Consultation) | (PDF - 812KB) |
Dr. Mary Ditto 240-402-1165 |
| 3733 | 10/2011 | Shell Egg Producer Registration | (PDF - 2.1MB) |
Nancy Bufano 240-402-1493 |
| 3733 | 05/2010 | Shell Egg Producer Registration (HTML) | (HTM - 0KB) |
Nancy Bufano 240-402-1493 |
| 3757 | 07/2010 | Menu and Vending Machine Labeling Voluntary Registration | (PDF - 73KB) |
Felicia Billingslea 240-402-2371 |
| 3800 | 08/2011 | FDA Safety Reporting Portal | (HTM - 0KB) |
Debra Street 240-402-1817 |
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