OMB No. 0581-0125

Exp. 10/31/2026

SPECIALTY CROPS PROGRAM 

SPECIALTY CROPS INSPECTION DIVISION 

ORDER FORM FOR EQUIPMENT AND MISCELLANEOUS ITEMS 

Complete form, call 650-552-9073 for shipping cost, total all items and email, fax, or mail to: 

USDA, AMS, SCP, SCI Division, Equipment & Forms Depot, 100 Riverside Parkway, Suite 101, Fredericksburg, VA 22406

Phone: 650-552-9073 Fax: 650-552-9147 Email: SCSupplyDepot@ams.usda.gov

Bill to: Ship to: 

Name: Name: 

Company: Company: 

Address: Address: 

City, State, Zip: City, State, Zip: 

Phone: Fax: Phone: Fax: 

Item Description Quantity Price Per Item Total Cost 

Check here for overnight delivery (additional charges apply) 

Subtotal 

Shipping 

Total 

Payment Information (all international and first-time customers must pay with a credit card): 

Check enclosed (Payable to: USDA-AMS) 

Visa MasterCard American Express Discover 

Card Number: Expiration Date: CVV Code: 

Mailing Address for Card: 

Name on Card: Signature: 

Products not sold by USDA should be ordered directly from the manufacturer. 

For Internal Use: 

Industry Federal Federal-State Check Credit FV-218 Reimbursement Invoice 

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 is 0581-0292. The time required to complete this information collection is estimated to average five 

minutes per response, including the time for reviewing the instruction, searching existing data sources, gathering and maintaining 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 

http://www.ascr.usda.gov/complaint_filing_cust.html 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-380 (1-2024) USDA is an equal opportunity provider, employer, and lender.