The FSIS 7234-1 form is an application used for the approval of labels, markings, or devices for meat, poultry, and egg products. This form is essential for ensuring that your product complies with USDA regulations and is properly labeled for consumer safety. If you need to fill out this form, please click the button below to get started.
The FSIS 7234-1 form is an essential document used for the approval of labels, markings, or devices in the food industry, specifically for poultry, meat, and egg products. This form requires applicants to provide detailed information about their products, including the type of product, establishment number, and specific labeling requirements. It includes sections for the area of the principal display panel and total labeling space, ensuring that all necessary information fits within regulatory guidelines. Applicants must also indicate the type of approval requested, whether it’s a temporary approval or an extension of a previously granted approval. Additionally, the form asks for product formulas, processing procedures, and any special claims or foreign language requirements that may be included on the label. The USDA uses this information to ensure compliance with food safety standards and labeling regulations. Completing the FSIS 7234-1 form accurately is crucial, as it streamlines the approval process and helps maintain the integrity of food products in the marketplace.
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. The valid OMB control number for this information collection is 0583-0092. The time required to complete this information collection is estimated to average 75 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 of information. This form had been approved by OMB for web distribution.
U.S. DEPARTMENT OF AGRICULTURE
FOOD SAFETY AND INSPECTION SERVICE
APPLICATION FOR
APPROVAL OF LABELS,
MARKING OR DEVICE
FSIS has determined that information provided in items 11, 15, and 16 is exempt from mandatory disclosure under the Freedom of Information Act 5 U.S.C. 552(b)(4).
APPLICANT: See Page 5 for instructions.
1.AGENT NAME, ADDRESS, TELEPHONE NO. (If using an Agent, complete this block, otherwise leave blank.)
2. FOR USDA USE ONLY
5a. NAME OF PRODUCT
5b. HACCP PROCESS CATEGORY (Select one)
03J: Slaughter - all species
03B: Raw Product - ground
03C: Raw Product - not ground
03D: Thermally processed - commercially sterile
03E: Not heat treated - shelf stable
6a. TYPE OF APPROVAL REQUESTED
SKETCH TEMPORARY
EXTENSION OF TEMPORARY
6b. WAS THE LABEL PREVIOUSLY APPROVED? YES ►Date of approval:
03F: Heat treated - shelf stable 03G: Fully cooked - not shelf stable
03H: Heat treated but not fully cooked - not shelf stable
03I: Product with secondary inhibitors - not shelf stable
NO
Prior approval number: Number of labels on hand: Number of days requested:
8. Does this label include a "USDA-AMS Child Nutrition Program CN-Logo?
Yes
No
9. (FOR USDA-AMS USE ONLY) CN Identification Number Assigned
10. Are there any special claims, guarantees, or foreign language on the label?
YES
NO (If yes, check all that apply)
Allergen Statements
Other Claims: Specify
Animal Production/Breed/Raising
Grading Terms
Certified/Verified
Guarantees
Environmental/Green
Natural/Organic
Export Only Labels w/deviations from Domestic Requirements
Foreign Language
Nutrition/Health
Geographic/Undefined Style
Religious Exemption
11. NAME AND ADDRESS OF FIRM (Below and between dots)
12. SIGNATURE OF APPLICANT OR AGENT
13. DATE
14. (FOR USDA USE ONLY) CONDITIONS APPLYING TO USE OF LABELS OR DEVICE
FSIS FORM 7234-1 (11/16/2011)
REPLACES FSIS FORM 7234-1 (09/01/2009), WHICH IS OBSOLETE.
FSIS FORM 7234-1 (11/16/2011) page 2
15. PRODUCT FORMULA
PAGE of
PCT
WEIGHT
(No Fractions)
See Continuation Sheet
TOTAL (Percent must total 100%)
FSIS FORM 7234-1 (11/16/2011) page 3
PAGE
of
16. PROCESSING PROCEDURES (Approval of the sketch does not convey approval of the processing procedures)
FSIS FORM 7234-1 (11/16/2011) page 4
CONTINUATION SHEET FOR APPLICATION FOR APPROVAL OF LABELS,
MARKING OR DEVICE (FSIS 7234-1)
PRODUCT NAME:
This sheet is being used for additional information required in Block(s):
INSTRUCTIONS FOR PREPARATION OF FSIS FORM 7234-1
Note: The following instructions should be typed unless otherwise noted.
A.
PREPARATION OF APPLICATION
7b.
Total available labeling space in square inches for entire package.
Application must be typed or it will be returned without evaluation.
8.
USDA-AMS Child Nutrition Program Logo. Indicate if the product
Submit two copies for each label application.
includes a USDA-AMS Child Nutrition Program Logo.
B.
TYPE OF APPROVAL REQUESTED
9.
Leave Blank. For USDA-AMS use only.
Sketch: Self explanatory. (See 9 CFR 317.4 & 381.132)
Temporary and Extension of Temporary. Actual label or color litho take off to be used.
10.
Special claims, guarantees, or foreign language. Indicate if there are
are any special claims, guarantees, or foreign language on the label.
C.
FOREIGN LANGUAGE
Check all that apply. If Other Claims is selected, indicate specific claim(s)
Labels printed in foreign languages must be accompanied by English language translation.
in space provided.
D.
ASSEMBLY OF APPLICATION
11.
Name and Address of Firm. Insert Firm's name and mailing
Application Form, Product Formula, Processing Procedures, Continuation Sheet if applicable, Label,
address. Use 2 letter symbol for State. Show postal zip code.
and any Supporting Documentation Staple with one or as few staples as possible. (Do not use paper
12 & 13.
Signature and Date of Applicant or Agent. To be signed and
clips).
dated by the applicant or agent representing the official
E.
MAIL COMPLETED APPLICATION TO:
establishment or plant.
USDA, FSIS, OPPD, LPDD
14.
Labeling Distribution Unit
Leave blank for USDA use only. Conditions Applying to Use of Label or
Stop Code 3786, Patriots Plaza III, 8-168
Device. (Any condition, modification or remarks applied to the application
1400 Independence Avenue, SW
when approved are conditions governing use of the approved devices.)
Washington, DC 20250-3700
The following instructions relate to numbered items on form.
15.
Product Formula. List the ingredients by percent or weight in order of
1.
If using an Agent, provide the company name, address, and telephone number,
their predominance. If product consists of several components, e.g.,
a frozen dinner, list each component separately and indicate the
otherwise leave blank.
percentage or amount of each component in the product. If additional
2 & 3.
Leave blank, for USDA use only.
space is needed, check the box for "Continuation Sheet," and use the
Continuation Sheet. Be sure to include the product name and number
of the block item. Express all ingredients in the same units, i.e., do not
4.
Establishment No./Foreign Country (if applicable) - Self Explanatory.
list some in pounds and others in ounces.
4a.
Type of Product. Select one product type: Egg, Meat, Poultry, or Other (i.e. Exotic Species,
Non-Amenable, Voluntary, etc.)
Check whether weight or percent is used. It is preferred that
5a.
Name of Product. Use common or descriptive product name, i.e., "Frankfurter ,
percentages be used, and the total must equal 100 percent. If weights
are used, show in pounds, kilograms or grams. (No gallons, pints,
Cereal Added" or "Meat Patties in Gravy. (Do not use trade brand names or
cups, teaspoons, etc.) The total must equal the weights of the
coined names, such as "Joe's Corn Dogs" or "Joe's Sloppy Joes.") If coined
individual units. (Example: Crust + Cheese + Sauce + Meat = Total
names such as "Corn Dogs" are used, also show true product name, such as
new weight of unit.)
"Batter Wrapped Wiener."
5b.
Provide HACCP process category for the product. See 9 CFR 417.2(b) (1),
DO NOT use fractions. Express as decimals carried to two places, Example:
Example, Heat Treated - shelf stable, Not heat treated-shelf stable etc. Select one.
1-1/4 lbs., show as 1.25 lbs. Example: 3/4 lbs., show as .75 lbs.
6a & b.
Type of Approval Requested. If temporary approval or extension, insert
number of days requested and number of labels on hand. If previous
approval, attach copy of application and label. Include specific reason(s)
16.
Processing Procedures. Poultry Products provide complete
why requesting a temporary or extension and include information required
in 9 CFR 317.4(f) (1) or 381.132(f) (1) on the continuation sheet.
processing procedures as required in 9 CFR 381.134. Meat
Be sure to include product name and block item.
Products, provide complete processing procedures as required.
Note: Approval of the sketch does not convey approval of the
7a.
Area of Principal Display Panel (PDP). The PDP is the entire side
processing procedures. If additional space is needed, check the box for
"Continuation Sheet," and use the Continuation Sheet.
of the package to which the label is affixed. See 9 CFR 317.2 (d)
Be sure to include the product name and number of the block item.
and 381.116 (b).
Completing the FSIS 7234-1 form is a crucial step in ensuring that your product labels meet USDA requirements. After filling out the form, it must be submitted to the USDA's Food Safety and Inspection Service for evaluation. This process involves providing accurate information regarding your product, its labeling, and any special claims you may wish to include.
What is the FSIS Form 7234-1?
The FSIS Form 7234-1 is an application used for the approval of labels, markings, or devices related to meat, poultry, and egg products. It ensures that these products meet USDA regulations before they can be marketed.
Who needs to fill out this form?
Any establishment that produces meat, poultry, or egg products and wants to use specific labels or markings must complete this form. This includes both domestic and foreign establishments.
What information is required on the form?
The form requires various details, including:
How long does it take to complete the form?
On average, it takes about 75 minutes to complete the FSIS Form 7234-1. This includes time for reviewing instructions, gathering necessary data, and filling out the form.
What is the significance of the OMB control number?
The OMB control number, which is 0583-0092 for this form, indicates that the information collection has been approved by the Office of Management and Budget. This means that the agency can legally collect this information.
What happens if the form is not filled out correctly?
If the form is incomplete or not filled out correctly, it may be returned without evaluation. It is essential to follow the instructions carefully to avoid delays.
Can I use an agent to submit the form?
Yes, you can appoint an agent to submit the form on your behalf. If you choose to do so, you must provide the agent's name, address, and telephone number in the designated section of the form.
What if I need to make changes after submission?
If you need to make changes after submission, you will likely need to submit a new application. It is best to contact the USDA for guidance on how to proceed with amendments.
Are there any exemptions for disclosure of information?
Yes, certain information provided in items 11, 15, and 16 is exempt from mandatory disclosure under the Freedom of Information Act. This protects sensitive business information from public access.
Where do I send the completed form?
Send the completed FSIS Form 7234-1 to the USDA, FSIS, OPPD, LPDD Labeling Distribution Unit at 1400 Independence Avenue, SW, Washington, DC 20250-3700. Ensure that you include all required documentation and follow mailing instructions.
Filling out the FSIS 7234-1 form can be straightforward, but many people make common mistakes that can lead to delays or rejections. One frequent error is failing to provide complete information in the Agent Name, Address, and Telephone Number section. If an applicant is using an agent, this section must be filled out accurately. Leaving it blank can result in the application being returned.
Another mistake involves the Type of Product selection. Applicants often select the wrong category, such as Egg, Meat, Poultry, or Other. Choosing an incorrect type can lead to significant issues during the approval process. It is essential to carefully review the options and select the one that accurately represents the product.
Many applicants also overlook the requirement to provide a HACCP Process Category. This section is crucial for USDA compliance. Not providing this information or selecting the wrong category can result in the application being deemed incomplete. Applicants should refer to the guidelines and ensure they understand the different categories before making a selection.
Additionally, the Signature and Date section is often filled out incorrectly. Some applicants forget to sign or date the form, which is a critical step in the submission process. Without a signature and date, the form cannot be processed, leading to unnecessary delays.
Another common issue arises with the Product Formula section. Applicants sometimes fail to list ingredients in the correct order or do not ensure that the percentages total 100%. This can lead to confusion and rejection of the application. It is vital to double-check that all ingredients are listed accurately and that their total weight or percentage is correct.
Lastly, applicants frequently neglect to include a Continuation Sheet when necessary. If there is not enough space to provide complete information on the main form, using a continuation sheet is essential. Failing to include this sheet can result in incomplete submissions, further complicating the approval process.
The FSIS 7234-1 form is essential for the approval of labels, markings, or devices in the food industry, particularly for meat and poultry products. Several other forms and documents accompany this application to ensure compliance with various regulations and requirements. Below is a list of these commonly used documents, each serving a specific purpose in the approval process.
Each of these forms and documents plays a crucial role in the approval process, ensuring that products meet the necessary safety and labeling standards. Understanding their purpose and how they relate to the FSIS 7234-1 form can help facilitate a smoother application process.
The FSIS 7234-1 form is essential for the approval of labels, markings, or devices related to food products. Several other documents share similarities with this form, each serving specific purposes in the food safety and labeling process. Here’s a look at six of those documents:
When filling out the FSIS 7234-1 form, attention to detail is crucial. Here are nine important do's and don'ts to ensure your application is processed smoothly.
By following these guidelines, you can help ensure that your FSIS 7234-1 form is completed correctly and efficiently. Timely and accurate submissions are essential for compliance and approval.
Misconceptions about the FSIS 7234-1 form can lead to confusion and errors in the labeling process. Below is a list of nine common misunderstandings, along with clarifications for each.
Understanding these misconceptions can help streamline the application process and ensure that all necessary information is accurately provided.
Key Takeaways for Filling Out and Using FSIS Form 7234-1