DA-242 Sanitary Certificate Request - Argentina

OMB No.0581-0283

Form
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 nilaintaining the data needed, and completing and reviewing
the collection information.

'additionar
raxed certificate0 Additional copies.
I acknowledse that bv checking this box that the information provided is factual and accurate.
MAIL INFORMAT!ON
CONTACT INFORMATION

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Argentina

charses apprv

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1. CONTACT NAME

7. COMPANY

2. AMS BILLING ACCT.

8. CONTACT

3. BILLING REFERENCE

9. STREET

4. E-MAIL

10. ctTY

ADDRESS

5. CONTACT PHONE

11. STATE

6. FAX

12.ZtP

CONSIGNOR

13. NAME
14. ADDRESS

1s. crw/srATE
CONSIGNEE

16. NAME
17. ADDRESS
AR
18. COUNTRY CODE
IDENTIFICATION OF DAIRY PRODUCTS

19. DESCRIPTION OF COMMODITY
20. KIND OF HEAT TREATMENT (HTST; PASTEURIZED)
21. TYPE OF PACKAGING

22. NUMBER OF PACKAGING UNITS
23. NET WEIGHT
24. REQUIRED TEMPERATURE DURING STORAGE AND

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TRANSPORTATION

25. DATE PRODUCEDAND/OR LOTS
26. ANIMAL SPECIES
MANUFACTURER

27. PLANT NUMBER
SHIPMENT INFORMATION

28. DEPARTURE PORT

29. ENTRY PORT

30. TRANSPORT TYPE

31. TRANSIT COUNTRIES

32. CONTAINER NUMBER
33. SEAL NUMBER
SIGNATURE (for foxed or mailed copies)

34. DATE

**Forfastest processing, please attach this form and a PDF shipping label in an emailto DairvsanitaryCerts@ams.usda.gov.
DA-242 (0Ll2O76l

prograrnoractivityconductedorfundedbyUSDA(notallbasesapplytoall

programs) Remediesmdcomplaintfilingdeadlinesvarybyprogramorincident

may be made available in languages other than English

9410. (2) fax: (202)690-7442 or (3) email: orogram.intake@usda.gov USDA is an equal opportunity provider, employer, and lender