Register FDA | Prior Notice Filing Form

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Please provide general shipment information
- Sea (via ship)
- Land (via truck, train, or car)
- Baggage (on an airplane)
- Mail (via postal service)
Country from which the Article is Shipped:*
How many different food products are included in your shipment?
(Note: Each variety of product should be counted as different product. Also, each packaging size should be counted as a different product.)
Shipping to U.S. State:*
Port Name:*
Port Codes (Optional)
Port Codes - NORTHEAST REGION
Port Codes - NEW YORK REGION
Port Codes - NORTH CENTRAL REGION
Port Codes - SOUTHEAST REGION
Port Codes - SOUTH CENTRAL REGION
Port Codes - SOUTHWEST REGION
Port Codes - PACIFIC REGION

Submitter Information
Name*
First Last
Phone:*
Email Address:*
- Click if Same as Shipper
- Click if Same as Consignee
Importer Information
Company Name:*
Physical Address:*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Food Facility Registration Number:
Contact Name:*
First Last
Phone:*
Email Address:*
Carrier Information
Mode of Transportation*
Standard Carrier Alpha Code (SCAC):*
Carrier Name:*
Vessel Name:*
Bill of Lading - Master:*
Container Numbers:*
Expected Date of Arrival in the U.S.:*
MM
DD
YYYY
Expected Time of Arrival in the U.S.:*

: HH

MM

Product Information
Detailed Product Description:*
Upload Product Information (optional):
Drop files here or
Number of Base Units:*
Measure of Base Units:*
Largest Package:*
Largest Package Type*
Next Size Package:*
Next Size Package Type*
Smallest Size Package:*
Smallest Size Package Type*
Total Quantity:*
Manufacturer:
Address*
Street Address Address Line 2 City ZIP / Postal Code Country
FDA Registration Number:*
Has the product listed above ever been refused entry to another country?*
- No, this product has never been refused entry to another country?
- Yes, this product has been refused from:
In country:*
Country
Comments:
Certification Statement*
By submitting this form to register-FDA, or by authorizing an individual to submit this form to register-FDA, the owner or operator in charge of the facility certifies that the above information is true and accurate. The owner or operator in charge of the facility also authorizes register-FDA to submit the Prior Notice on the facility's behalf.
- I agree

Prior Notice Form