Fsis 7234 1 Template

Fsis 7234 1 Template

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.

Table of Contents

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.

Fsis 7234 1 Sample

7a. AREA OF PRINCIPAL DISPLAY PANEL (Square Inches)
7b. TOTAL AVAILABLE LABELING SPACE FOR ENTIRE PACKAGE (Square inches):
Poultry
Other
Egg
Meat
4a. TYPE OF PRODUCT
3. FOR USDA USE ONLY
PAGE of
4. ESTABLISHMENT NO. / FOREIGN COUNTRY (If applicable)

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)

See Continuation Sheet

FSIS FORM 7234-1 (11/16/2011) page 4

PAGE

 

of

 

 

 

 

 

 

 

 

 

 

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).

 

 

 

FSIS FORM 7234-1 (11/16/2011)

 

Document Attributes

Fact Name Details
Form Purpose The FSIS 7234-1 form is used to apply for the approval of labels, markings, or devices for meat, poultry, and egg products.
Governing Laws This form is governed by regulations outlined in the Federal Meat Inspection Act and the Poultry Products Inspection Act.
OMB Control Number The valid OMB control number for this information collection is 0583-0092, as required by the Paperwork Reduction Act of 1995.
Completion Time It is estimated that completing this form will take about 75 minutes, including gathering necessary information and reviewing instructions.
Labeling Space Section 7a and 7b of the form require details about the area of the principal display panel and total available labeling space in square inches.
Child Nutrition Program Logo Applicants must indicate whether the label includes a USDA-AMS Child Nutrition Program logo, which is important for compliance.
Exempt Information Information provided in items 11, 15, and 16 is exempt from mandatory disclosure under the Freedom of Information Act.

Fsis 7234 1: Usage Instruction

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.

  1. Obtain the FSIS 7234-1 form. Ensure you have the most recent version of the form for your application.
  2. Fill out the applicant section. If you are using an agent, provide their name, address, and telephone number. Otherwise, leave this section blank.
  3. Complete the establishment information. Enter the establishment number and, if applicable, the foreign country.
  4. Specify the type of product. Choose from options such as Poultry, Meat, Egg, or Other.
  5. Provide the product name. Use a common or descriptive name for your product, avoiding trade brand names.
  6. Select the HACCP process category. Choose the appropriate category that describes your product's processing.
  7. Indicate the type of approval requested. Specify whether it is a temporary approval or an extension of a previous approval.
  8. Answer questions about previous approvals. If applicable, provide the date of the previous approval and the number of labels on hand.
  9. Detail the area of the principal display panel. Measure and enter the area in square inches.
  10. Provide total available labeling space. Measure the entire package's labeling space and enter the square inches.
  11. Check for special claims. Indicate if there are any special claims, guarantees, or foreign language on the label.
  12. List the product formula. Detail the ingredients by percent or weight, ensuring the total equals 100 percent.
  13. Outline the processing procedures. Provide complete processing procedures as required for your product category.
  14. Sign and date the application. The applicant or agent must sign and date the form.
  15. Submit the application. Mail two copies of the completed form and any supporting documents to the USDA address provided.

Frequently Asked Questions

  1. 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.

  2. 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.

  3. What information is required on the form?

    The form requires various details, including:

    • Name and address of the applicant or agent
    • Type of product (e.g., poultry, meat, egg)
    • HACCP process category
    • Details about the label, including any special claims or foreign language
    • Product formula and processing procedures

  4. 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.

  5. 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.

  6. 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.

  7. 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.

  8. 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.

  9. 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.

  10. 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.

Common mistakes

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.

Documents used along the form

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.

  • FSIS Form 7200-1: This form is used to apply for a waiver of inspection requirements for certain products. It outlines the specifics of the product and the reason for the waiver request.
  • FSIS Form 7200-2: This document is utilized for the submission of a Hazard Analysis and Critical Control Point (HACCP) plan. It details the steps taken to ensure food safety during production.
  • Product Formula Sheet: This sheet lists all ingredients used in the product, along with their respective percentages or weights. It ensures transparency in product formulation.
  • Processing Procedures Document: This document outlines the specific methods used in processing the product. It is crucial for verifying that all safety standards are met.
  • Continuation Sheet: This additional sheet is used when more space is needed to provide information related to the FSIS 7234-1 form. It should be clearly labeled and submitted with the main application.
  • Labeling Specifications: This document provides detailed guidelines on how labels should be formatted and what information they must contain, ensuring compliance with federal regulations.
  • USDA-AMS Child Nutrition Program Documentation: If a product includes a Child Nutrition Program logo, this documentation verifies compliance with specific nutritional standards.
  • Foreign Language Labeling Requirements: This document outlines the requirements for labeling products in foreign languages, including the necessity for English translations.
  • Special Claims Documentation: If the product label includes any special claims (e.g., organic, natural), this document provides the necessary evidence to support those claims.
  • Approval Notification Letter: Once the FSIS 7234-1 form is reviewed, this letter communicates the outcome of the application, detailing any conditions or modifications that apply.

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.

Similar forms

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:

  • FSIS Form 7200: This form is used for the application of labels for meat and poultry products. Like the FSIS 7234-1, it requires information about the product, establishment details, and the type of approval requested, ensuring compliance with USDA regulations.
  • FSIS Form 7234-2: This is a continuation sheet for the FSIS 7234-1 form, allowing applicants to provide additional information about their labeling requests. It shares the same structure and purpose, focusing on product details and compliance.
  • FSIS Form 2000-1: This form is utilized for the approval of new food products under the USDA. Similar to the FSIS 7234-1, it requires detailed product information and is part of the USDA's regulatory framework to ensure food safety.
  • FSIS Form 10,000-1: This document is for the notification of labeling changes. It is akin to the FSIS 7234-1 in that it facilitates the approval process for any modifications made to existing labels, ensuring transparency and compliance.
  • USDA AMS Form 1000: This form is used for the approval of organic labeling. Like the FSIS 7234-1, it requires comprehensive details about the product and its ingredients, ensuring that claims made on labels are accurate and verifiable.
  • FSIS Form 9400: This form is for the application of export certification for meat and poultry products. It parallels the FSIS 7234-1 in that both require detailed product descriptions and compliance with federal regulations, ensuring safe trade practices.

Dos and Don'ts

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.

  • Do type your application. Handwritten forms may be returned without evaluation.
  • Do provide accurate contact information for your agent, if applicable.
  • Do specify the product type clearly, selecting from the available categories.
  • Do ensure that all percentages in the product formula total 100%.
  • Do include any special claims or guarantees on the label, checking all that apply.
  • Don't leave any required fields blank. Incomplete applications can cause delays.
  • Don't use trade names or coined names for the product. Stick to common or descriptive names.
  • Don't mix units of measurement. Use consistent units throughout your application.
  • Don't forget to sign and date the application. Missing signatures can lead to rejection.

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

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.

  • It is not necessary to provide a signature. Many believe that a signature is optional, but it is essential for validating the application.
  • Only one copy of the application is needed. Some applicants think that submitting a single copy suffices. However, two copies are required for each label application.
  • All information is mandatory. While most fields require completion, certain sections are designated for USDA use only and do not need to be filled out by the applicant.
  • The form can be handwritten. A common misconception is that handwriting is acceptable. In fact, the application must be typed to avoid being returned without evaluation.
  • Labels can include any claims without prior approval. Many assume that they can make any claims on their labels. However, special claims require careful indication and may need additional documentation.
  • There is no need to specify the product type. Some applicants overlook the importance of identifying the product type. This classification is crucial for proper processing and approval.
  • All ingredients can be listed in different units. It is a misconception that varying units are acceptable. Ingredients must be expressed in consistent units, either by weight or percentage, to ensure clarity.
  • Previous approvals guarantee future approvals. Some believe that past approvals automatically apply to new applications. Each application is evaluated independently, and prior approval does not guarantee acceptance.
  • Labeling space is not important. Many applicants underestimate the significance of accurately calculating the available labeling space. This information is essential for compliance with regulations.

Understanding these misconceptions can help streamline the application process and ensure that all necessary information is accurately provided.

Key takeaways

Key Takeaways for Filling Out and Using FSIS Form 7234-1

  • The form is essential for obtaining approval for labels, markings, or devices related to food products.
  • Ensure that all information is typed, as handwritten submissions may be returned without evaluation.
  • Clearly indicate the type of product you are submitting, such as poultry, meat, or eggs, in the appropriate sections.
  • Provide accurate measurements for labeling space and product formula, ensuring totals are correct and in consistent units.
  • Include any special claims or foreign language requirements on the label, checking all applicable boxes.
  • Submit two copies of the completed form along with any necessary supporting documents to the USDA address specified in the instructions.