United States Department of OMB No. 0581-0125 

Agriculture Exp. 10/31/2026

AGRICULTURAL MARKETING SERVICE, SPECIALTY CROPS PROGRAM 

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. 

Services will be declined if the request is beyond our scope of certification. Once a request has been received, a USDA representative will make contact within 48 

hours (excluding weekends and holidays) of receipt to schedule the audit. 

DATE OF REQUEST: ANTICIPATED DATE OF AUDIT: 

AUDITEE INFORMATION FARM / FACILITY INFORMATION 

Company Name: 

Street Address: Location(s), 

including noncontiguous sites 

and fields: 

(Please list here or 

attach longer list) 

City, State & Zip: 

Phone Number: 

Fax Number: 

E-mail: Total Acres / Total 

Sq. Feet to be 

Contact Person: audited:

APPLICANT INFORMATION (responsible for payment) 

Same as above (please still list Billing Account No.) 

Company Name: 

Phone Number: Commodities to be 

covered by the 

audit (Please list 

here or attach 

longer list): 

Fax Number: 

E-mail:

Contact Person: 

Billing Acct No.: 

AUDIT PROGRAM REQUESTED (Please choose at least one) 

Produce GAPs Harmonized Audit (choose scopes 

below) 

USDA Good Agricultural Practices and Good Handling

Practices (GAP&GHP) Audit (choose scopes below) 

Field Operations & Harvesting Part 1 – Farm Review 

Post-harvest Part 2 – Field Harvest & Field Packing Activities 

Tomato Audit Protocol (choose scopes below) Part 3 – House Packing Facility 

Open-field Production and Harvesting Part 4 – Storage & Transportation 

Packinghouse Part 6 – Wholesale Distribution Center/Terminal Warehouse 

Greenhouse Part 7 – Preventive Food Defense Procedures 

Packing and Distribution Mushroom Specific GAP Audit (M-GAP) 

Harmonized GAP Plus+ Audit (choose scopes below) Non-GAP Audit Services 

Field Operations & Harvesting Food Defense 

Post-harvest Operations Plant Systems Audit 

Tomato Audit Protocol (choose scopes below) 

Open-field Production and Harvesting Other: (please list any additional servics, not already included 

above) 

Packinghouse 

Greenhouse 

Packing and Distribution 

GroupGAP (also choose GAP audit service) 

SC-237A (01/11/2024) Page 1 of 2 
 

 

 

 

 

 

OMB No. 0581-0125 

Exp. 10/31/2026

ADDITIONAL 

REMARKS 

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 2 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. 

Non-Discrimination Policy: In accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, the USDA, its Agencies, offices, and employees, and 

institutions participating in or administering USDA programs are prohibited from discriminating based on race, color, national origin, religion, sex, gender identity (including gender expression), sexual orientation, 

disability, age, marital status, family/parental status, income derived from a public assistance program, political beliefs, or reprisal or retaliation for prior civil rights activity, in any program or activity conducted or 

funded by USDA (not all bases apply to all programs). Remedies and complaint filing deadlines vary by program or incident. 

Persons with disabilities who require alternative means of communication for program information (e.g., Braille, large print, audiotape, American Sign Language, etc.) should contact the responsible Agency or 

USDA’s TARGET Center at (202) 720-2600 (voice and TTY) or contact USDA through the Federal Relay Service at (800) 877-8339. Additionally, program information may be made available in languages other 

than English. 

To file a program discrimination complaint, complete the USDA Program Discrimination Complaint Form, AD-3027, found online at How to File a Program Discrimination Complaint and at any USDA office or write 

a letter addressed to USDA and provide in the letter all of the information requested in the form. To request a copy of the complaint form, call (866) 632-9992. Submit your completed form or letter to USDA by: (1) 

mail: U.S. Department of Agriculture, Office of the Assistant Secretary for Civil Rights, 1400 Independence Avenue, SW, Washington, D.C. 20250-9410; (2) fax: (202) 690-7442; or (3) email: 

program.intake@usda.gov. 

USDA is an equal opportunity provider, employer, and lender. 

SC-237A (01/11/2024) (Previous editions are to be destroyed) Page 2 of 2