This form is completed by an inspector designated by the USDA. The form is split up into 3 main sections. The top part of the form indicates when the inspection started and was completed and provides the applicant's name and address, and the inspection point. The middle part of the form is for describing the product including the number and size of containers and the origin, size, brand, variety, and grade of the product. The bottom part of the form is for additional remarks, the inspector to detail the fees associated with the issuance of the form (including the estimated total cost) and to sign the form.