OMB APPROVED: NO. 0581-0113

U.S. DEPARTMENT OF AGRICULTURE

AGRICULTURAL MARKETING SERVICE

LIVESTOCK, POULTRY, AND SEED PROGRAM

REGISTRATION OF SHELL EGG HANDLER

RETURN THIS REPORT TO:

Email: ses@ams.usda.gov

Quality Assessment Division

Livestock, Poultry, and Seed Program, AMS 

U.S. Department of Agriculture

1400 Independence Ave., SW; MAIL STOP 0258

Washington D.C. 20250-0258

No shell egg handler (except a producer -

packer with a flock of 3,000 hens or less) who 

grades and packs eggs for the ultimate 

consumer may start operations until a 

registration form has been properly 

completed and submitted (7 CFR 57.690). 

Instructions: Complete and return the original copy to the address shown in the 

upper middle section. Keep one copy for your records (optional). If more space is 

needed, use the reverse of the form. Please print or type.

FOR USDA USE ONLY

HANDLER NAME: REGISTRATION NUMBER DATE OF REGISTRATION

STATE COUNTY HANDLER

EMAIL:

PHONE NUMBER:

STREET ADDRESS:

CITY, STATE, ZIP CODE: SIGNATURE AND TITLE OF USDA OFFICIAL

REMARKS:

COUNTY IN WHICH BUSINESS IS LOCATED:

PLEASE LIST BELOW IF MAILING ADDRESS DIFFERS FROM STREET ADDRESS: 

MAILING ADDRESS:

CITY, STATE, ZIP CODE:

NATURE OF BUSINESS (Check as appropriate)

 PRODUCER/PACKER with more than 3,000 birds HATCHERY COOKED EGG

 GRADING STATION INEDIBLE COLLECTION/PROCESSING EXEMPT BREAKER

 OTHER (Specify)

YES NO

Do you pack shell eggs in consumer size containers?............................................................................................................

Do you sell eggs directly to consumers on retail egg routes?................................................................................................

Do you sell eggs in consumer size containers to retailers or brokers who in turn sell them to retail distributors?..............

Do you sell eggs directly to institutional type users (i.e., restaurants, schools, hospitals, etc.)?..........................................

CERTIFICATION OF INDUSTRY PERSONNEL PREPARING REPORT

DATE: TITLE: TYPED OR PRINTED NAME: SIGNATURE:

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 0581-0113. The time required to complete this information collection is estimated to average 20 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.

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, employer, and lender. 

LPS-155 (01/2018) (Previous edition dated 01/2015 may be used.)
UNITED STATES DEPARTMENT OF AGRICULTURE

AGRICULTURAL MARKETING SERVICE

1400 INDEPENDENCE AVENUE, SW MAIL STOP 0258

WASHINGTON, DC 20250-0258

NOTICE TO SHELL EGG HANDLERS

Public Law 91-597 enacted by the 91st Congress of the United States referred to as the ''Egg 

Products Inspection Act" places restrictions upon the disposition of certain qualities of shell 

eggs effective July 1, 1972.

Producers having 3,000 or less hens and producers who do not pack eggs for sale to the 

ultimate consumer exclusive of sales direct to consumers on the producer’s premises are 

exempt.

To carry out the provisions of this Act, it is necessary that all persons who pack eggs for 

consumer outlets, including producer-packers that have more than 3,000 hens, persons who 

operate grading stations, and persons who have hatcheries are to complete the attached 

registration form and return it to the address shown in the upper middle section of the form. 

Keep one copy of this form for your records. You will receive a copy of this form showing 

your registration number after it has been assigned.

The Act and the regulations issued pursuant thereto require specific labeling and handling 

for restricted eggs and the maintenance of records of production, bills of sale, inventories (by 

class and quantities of product), receipts, shipments, dates of shipment and receipt, carrier 

names, and shippers and receivers names.

LPS-155 (01/2018) Reverse