CN-383-F HVI Check Test Program - Domestic Order Form

REPRODUCE LOCALLY
UNITED STATES DEPARTMENT OF AGRICULTURE
AGRICULTURAL MARKETING SERVICE
COTTON & TOBACCO PROGRAM
						DATE			ORDER #
Standardization & Engineering Division						DO NOT WRITE IN THIS SPACE
3275 Appling Road
Memphis, TN 38133
Telephone: (901) 384-3030
Fax: (901) 384-3039
E-Mail: cotton.standards@ams.usda.gov
HVI Check Test Program - Domestic Order Form
P	ITEM			DESCRIPTION		UNIT PRICE		QUANTITY		DOLLAR AMOUNT
1	Complete Program			12 Months		$XXX.XX				$
1	Pro-rated Program			1 Month		$XX.XX
	First Year Participation			Shipping		Amount based on destination
Type of HVI Instrument						TOTALS				$
The cost of the program to new domestic participants is free the first year, (excluding shipping). After you return this order form to us, we will notify you of the shipping charges.
The official cost of the program is $XXX.XX for the check test period of August through July . The $XXX.XX must be paid in advance in U. S. dollars with the check drawn on a U. S. bank, payable to USDA AMS Cotton and Tobacco Program. If participation starts after August, the cost will be pro-rated at $XX.XX per month. Payment can also be made by credit card. Letters of credit are not accepted.
		ACCT NO.				EXPIRES
		SIGNATURE
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