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UNITED STATES DEPARTMENT OF AGRICULTURE
FOOD SAFETY AND INSPECTION Serviced Defense Plan
Security Measures for Food Defense Establishment Name:Establishment Location (city, state):ISIS Establishment
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How to fill out fsis form 5420 5

How to fill out fsis form 5420 5
01
To fill out FSIS Form 5420-5, follow these steps:
02
Start by entering the establishment name, establishment number, and the date the form is being completed.
03
Fill in the product information, including the product name, product code, and the lot or batch number.
04
Provide information on any action taken or anticipated, such as a recall or market withdrawal.
05
Indicate the reason for taking the action, whether it's due to a potential health hazard or a labeling issue.
06
Include details of the distribution of the affected products, such as the states or countries involved.
07
Provide contact information for the responsible party, including the name, title, and phone number.
08
Attach any supporting documentation or official notifications related to the action.
09
Sign and date the form to certify its accuracy and completeness.
10
Submit the filled-out form to the appropriate FSIS district office as soon as possible.
11
Note: It is important to consult the FSIS instructions and guidelines specific to Form 5420-5 for detailed information and requirements.
Who needs fsis form 5420 5?
01
FSIS Form 5420-5 is needed by establishments under the jurisdiction of the Food Safety and Inspection Service (FSIS) of the United States Department of Agriculture (USDA).
02
Specifically, this form is used to report product recalls, market withdrawals, or other actions taken by the establishment to address issues related to the safety or labeling of meat, poultry, or egg products.
03
The responsible party of the establishment, such as the manufacturer, processor, distributor, or importer, is required to fill out and submit this form to the FSIS district office.
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What is fsis form 5420 5?
FSIS form 5420 5 is a form used to report data on imported meat, poultry, and egg products.
Who is required to file fsis form 5420 5?
Importers of meat, poultry, and egg products are required to file FSIS form 5420 5.
How to fill out fsis form 5420 5?
FSIS form 5420 5 can be filled out electronically through the FSIS Import iRP System.
What is the purpose of fsis form 5420 5?
The purpose of FSIS form 5420 5 is to collect data on imported meat, poultry, and egg products for inspection purposes.
What information must be reported on fsis form 5420 5?
Information such as product description, quantity, country of origin, and establishment number must be reported on FSIS form 5420 5.
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