DA-230-S (Supplement sheet to DA-230) Supplement Page 1 of 3

Office 

Use Company Name Physical Address Contact Name

Plant 

Id Plant Name Mailing Address Telephone Number Question 2 Question 3 Question 4

[Interviewer Note: In the Question Answer Log - For each plant listed in the supplement with reportable products, answer questions 2, 3 and 4 listed below.]

2. Does your office have full access to (insert Plant Name of each entry) weekly sales data (i.e. all ledgers, contracts,

 invoices, and cash receipts)? If "No" or "Unknown", please explain in the comment box.

3. Does (insert Plant Name of each entry) produce and/or market products outside of the information you can provide to AMS (i.e. cheese is

 reported through your office but the plant listed above sells dry whey using a different office)? If "Yes" or "Unknown", please explain in the comment box.

4. Does (insert Plant Name of each entry) market products of the same type outside of information you can provide to AMS (i.e. the plant

 listed above may have cash sales you cannot access)? If "Yes" or "Unknown", please explain in the comment box.

[After completion of the supplement return to the Annual Validation Worksheet in Section 1, Question 2.]

OMB No. 0581-0274

Supplement - Multiple Plants Reporting Screening Table

Note: This supplement is required for all operations answering "YES" to Question 1 in Section 1 of the Annual Validation.

Question Answer Log 

(For plants with reportable products, answer 

questions in the boxes below)

1. Please list your company's headquarters location, all dairy plant locations, any plants/companies owned or partially owned producing or selling dairy 

products, plants/companies with whom you have tolling agreements, or plants/companies with whom you have exclusive marketing agreements.

List ALL Dairy Products 

Produced at Plant

(Check the box ONLY if ALL PRODUCTS LISTED 

are NOT REPORTABLE )

 Interviewer Note: List Company Name, Plant Name, Physical Address, Mailing Address, Contact, Telephone, and Dairy Products Produced for each location.

HQ

P1

P2

5. Comment Box: 

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DA-230-S (Supplement sheet to DA-230) Supplement Page 2 of 3

Office 

Use Company Name Physical Address Contact Name

Plant 

Id Plant Name Mailing Address Telephone Number Question 2 Question 3 Question 4

Question Answer Log 

(For plants with reportable products, answer 

questions in the boxes below)

List ALL Dairy Products 

Produced at Plant

(Check the box ONLY if ALL PRODUCTS 

LISTED are NOT REPORTABLE )

 Interviewer Note: List Company Name, Plant Name, Physical Address, Mailing Address, Contact, Telephone, and Dairy Products Produced for each location.

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P4

P7

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P9

P8

P11

P10

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DA-230-S (Supplement sheet to DA-230) Supplement Page 3 of 3

Office 

Use Company Name Physical Address Contact Name

Plant 

Id Plant Name Mailing Address Telephone Number Question 2 Question 3 Question 4

Question Answer Log 

(For plants with reportable products, answer 

questions in the boxes below)

P14

 Interviewer Note: List Company Name, Plant Name, Physical Address, Mailing Address, Contact, Telephone, and Dairy Products Produced for each location.

List ALL Dairy Products 

Produced at Plant

(Check the box ONLY if ALL PRODUCTS LISTED 

are NOT REPORTABLE )

P15

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P19

P18

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