______________________________________________________________________________

Distribution:

Originating Office:

File Maintenance 

Instructions:

EM, FM, FPM, HQ, CM

Office of the Chief

Place in Office Directives File

United States Department of Agriculture 

Agricultural Marketing Service 

Fruit and Vegetable Programs

 Fresh Products Branch Directive

FPB 706

3/2/2011

FV-237A REQUEST FORM FOR AUDIT SERVICES

I. PURPOSE To announce and release Form FV-237A, a request form specific to

Fresh Products Branch audit based services. 

II. AUTHORITY Title 7 of the Code of Federal Regulations, Part 51 (7CFR 51.7) Form of 

Application.

III. POLICY The FV-237A, Request for Audit Services form (Exhibit A) allows for 

the efficient collection of required data needed to plan, schedule and 

perform Fresh Products Branch audit based services. These include the 

Good Agricultural Practices & Good Handling Practices (GAP&GHP) 

audit verification program, commodity specific GAP&GHP audit 

programs, the Identity Preservation Program as well as other audit based 

services the Branch may offer in the future. 

• When a federal or federal-state field office receives a call from 

an applicant requesting audit based services, the FV-237A form 

shall be used to document the request. Applicants may submit 

the FV-237A via fax or email to the appropriate field office or 

headquarters staff.

• Upon receipt of an FV-237A form, the local field office shall 

make contact with the applicant within 48 hours to verify and 

schedule the audit.

• Any audits not shown on the FV-237A form which are 

conducted by the Branch shall be noted under “Other, Specify” 

and the type of audit listed in the space provided. (i.e., 

Harmonized GAP Audit, PIQ audit, etc.).
 ______________________________________________________________________________

Distribution:

Originating Office:

File Maintenance 

Instructions:

EM, FM, FPM, HQ, CM

Office of the Chief

Place in Office Directives File

FPB 706

3/2/2011

Page 2

POLICY

Continued

• Offices shall keep the FV-237A form on file in the office of 

record for a period of three fiscal years after the year the form 

was received in accordance with Branch retention policy as 

outlined in FPB Directive 104 dated April 23, 1993. 

• Field Offices may reproduce this form as needed.

Cheri Courtney

Assistant Branch Chief

Attachments: FV-237A
FORM APPROVED BY OMB No. 0581-0125

UNITED STATES DEPARTMENT OF AGRICULTURE 

Agricultural Marketing Service 

Fruit and Vegetable Programs 

Fresh Products Branch

REQUEST FOR AUDIT SERVICES 

(This is the only acceptable form for fax or electronic submission to USDA for audit requests) 

NOTE: Fill in all appropriate blocks. Requested services may be delayed because of incomplete information. Type of service 

 requested must be selected below.

DATE OF REQUEST: ANTICIPATED DATE OF AUDIT: 

AUDITEE INFORMATION FARM / FACILITY INFORMATION 

Company Name: Location: 

Street Address: 

City, State & Zip: Total Acres /

Total Sq Feet 

to be audited:

Phone Number: 

Contact Person: 

APPLICANT INFORMATION COMMODITIES TO BE COVERED BY AUDIT (Please List)

Company Name 

Phone Number: 

Fax Number: 

E-mail: 

Contact Person: 

TYPE OF AUDIT SERVICES REQUESTED 

Type of Audit(s) Requested (Please choose at least one)

□ Good Agricultural Practices & Good Handling Practices 

 (GAP&GHP) (Select Audit Scopes) 

□ Mushroom Specific GAP Audit (M-GAP) 

□ Tomato Audit Protocol (T-GAP) 

□ Leafy Greens Audit (LGMA) 

□ Identity Preservation Audit (IP) 

□ Other, Specify: __________________________________ 

Scope of GAP&GHP Audit (Please choose all that apply) 

□ Part 1 – Farm Review 

□ Part 2 – Field Harvest & Field Packing Activities 

□ Part 3 – House Packing Facility 

□ Part 4 – Storage & Transportation 

□ Part 6 – Wholesale Distribution Center / 

 Terminal Warehouse 

□ Part 7 – Preventative Food Defense Procedures 

ADDITIONAL 

REMARKS

To download a copy of the USDA Good Agricultural Practices & Good Handling Practices audit checklist, please visit the USDA 

website at http://www.ams.usda.gov/gapghp. 

Once a request has been received, a USDA representative will make contact within 48 hours of receipt to schedule the audit. 

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 0581-0125. The time required to complete this information 

collection is estimated average .02 hours 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. 

The U.S. Department of Agriculture (USDA) prohibits discrimination in all its programs and activities on the basis of race, color, national origin, age, disability, and where 

applicable, sex, marital status, familial status, parental status, religion, sexual orientation, genetic information, political beliefs, reprisal or because all or part of an 

individual’s income is derived from any public assistance program. (Not all prohibited bases apply to all programs.) Persons with disabilities who require alternative 

means for communication of program information (Braille, large print, audiotape, etc.) should contact USDA’s TARGET Center at (202)720-2600 (voice and TDD). To file a 

complaint of discrimination, write to USDA, Director, Office of Civil Rights, 1400 Independence Avenue, S.W., Washington, D.C. 20250-9410, or call (800)795-3272 (voice) 

or (202)720-6382 (TDD). USDA is an equal opportunity provider and employer. 

FV-237A (10-10)