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Get USDA 3003 2021-2024

The valid OMB control number for this information is 0580-0015. The time required to complete this information collection is estimated to average 2 hours 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. Form 3003 Expires 11/30/2017 Page 1 of 4 SELLING ON COMMISSION OPERATION CLAUSE 1 BOND - SECTION 3 Livestock Sold at Market b. Business Entity ID Number For P SP Use Only U*S* Department of Agriculture Grain Inspection Packers and Stockyards Administration P SP Bar Code Only ANNUAL REPORT OF MARKET AGENCY SELLING ON COMMISSION Indicate your preference to submit forms electronically or by paper copy Electronic Filing Manual Filing Packers and Stockyards Program All items with an asterisk following them must be completed before submitting the form to PSP. If the items are not completed when the form is received the form will be returned for completion by the reporting firm* Instructions If an item s value is zero enter 0. If an item does not apply enter NA. Upon completion please verify that all items have been answered* Return completed form to the P SP Central Reporting Unit. See instructions for information about this report. GENERAL INFORMATION - SECTION 1 Reporting Period mm/dd/yy a* from b. to 102 Legal Business Name 103 Business Name dba 104 Mailing Address 105 City State Zip 106 Physical Address 108 Contact Name 109 Telephone Number Fax Number 111 E-Mail Address Web Address ORGANIZATIONAL STRUCTURE - SECTION 2 List owners officers partners and members in control of this business a* Name b. Title c* Percentage Ownership 206 Type of organization Individual Partnership Corporation L*L*C. 207 Is this the same organization type reported last year Yes No 208 Is this business owned or controlled by another business entity Co-op Association Other 209 If line 208 is yes identify the owner/controlling business name and address. 210 Does this business own or control other businesses within the livestock-meat sector If line 210 is yes then provide the names of businesses that you own or control and percentage of control in items 211-214 a* Name of Business b. Percentage of Control 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. Hogs a* Cattle Livestock consigned by others to your market number of head Total livestock consigned to your market c* Sheep Goats d. Horses Mules e. Total a b c d 304 Gross value of livestock sold on commission 305 Number of Public Sales days covered by this report DEALER AND BUYING ON COMMISSION OPERATION CLAUSE 2 BOND - SECTION 4 Livestock Dealer Purchases Cost of livestock purchased on a dealer basis for registrant s account dealer basis for registrant s account Livestock Bought on Commission 403 the account of others regardless of who paid for the livestock.

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