P&SP 3110 Supplemental Balance Sheet - Packers

U.S. DEPARTMENT OF AGRICULTURE
GRAIN INSPECTION, PACKERS AND STOCKYARDS ADMINISTRATION
PACKERS AND STOCKYARDS PROGRAM

SUPPLEMENTAL BALANCE SHEET
PACKERS
2. NAME AND ADDRESS (Include Zip+ 4 Code)

OMB Control No. 0580-0015
Response is required by law to ensure compliance with the Packers and Stockyards Act 1921, as amended and
supplemented (9 CFR 201.97 and (7 U.S.C. 222). Failure to report after notice of default will result in forfeiture to
the United States the sum of $10 for each and every day of the continuance of such failure (7 U.S.C 222).
According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of
information unless it displays a valid OMB control number. The valid OMB contr ol number for this information
collection is 0580-0015. The time requested to complete this information is estimated to average 1 hour per
response, including the time to review instructions, search existing data resources, gather the data needed, and
complete and review the information. collection.

1. BALANCE SHEET AS OF (Give date)

RETURN COMPLETED FORM TO THE APPROPRIATE REGIONAL OFFICE; SEE SEPARATE
INSTRUCTIONS FOR INFORMATION.

The Packers and Stockyards Act provides in part that: " Any person who shall willfully make, or cause to be made, any false entry or statement of fact in any report required to be made
under this Act... shall be deemed guilty of any offense against the United States, and shall be subject, upon conviction in any court of the United States of competent jurisdiction, to a fine
of not less than $1,000 nor more than $5,000, or to imprisonment."
SECTION 1 - ASSETS
A.

CURRENT ASSETS:
Cash on Hand and in Banks

$ _________________

201

________________

202

_________________

207

________________

211

________________

215

Advances made on Livestock and Meat

________________

216

Prepaid Expenses (rent, Insurance, etc)

________________

217

________________

218

(enter overdraft on the reverse under Current Liabilities)
Temporary Cash Investments (marketable securities, certificates of
deposit, commercial paper, etc.)
Accounts Receivable:
From Trade

203

$________________

From Others (owners, officers, employees, subsidiaries and affilaed compan ies)

204

_________________

Total accounts receivable before allowance

205

_________________

Less Allowance for Doubtful Accounts

206

_________________

Due from Subsidiaries and Affiliated Companies

208

_________________

Due from Owners, Directors, Officers, Stockholders

209

_________________

Due from Others

210

_________________

Livestock

212

_________________

Meat and Meat Food Products

213

_________________

Other Inventories

214

_________________

Notes and Loans Receivable (due within 1 year)

Inventories:

Other Current Assets
B.

C.

TOTAL CURRENT ASSETS

219

Subsidiaries and Affiliated Companies (section 1, Item 8 only)

_________________

220

Other

_________________

221

TOTAL INVESTMENTS

222

_________________

223

____________________

FIXED ASSETS:
Land
Buildings, Equipment, and Other Fixed Assets
Less Accumulated Depreciation and Amortization

D.

$__________________

INVESTMENTS:

224

_________________

225

_________________

________________

226

NET FIXED ASSETS

227

Notes Receivable (due after 1 year)

________________

228

Goodwill, Patents, Trademarks

________________

229

Other Assets (specify)_____________________________________________________

________________

230

___________________________________________________________________________

________________

231

____________________

OTHER ASSETS:

FORM P&SP-3110

TOTAL OTHER ASSETS

232

____________________

TOTAL ASSETS

233

____________________

AUGUST 2007

Print Form

Save Form

Clear Form

PAGE 1 OF 2

Close Form

Next Page

SECTION 2 - LIABILITIES AND OWNER'S EQUITY

A.

CURRENT LIABILITIES:
Bank Overdraft (per books)

$_______________ 301

Accounts Payable - Livestock Purchases (do not include meat)

________________ 302

Accounts Payable - Meat and Other

________________ 303

Notes and Loans payable (due within 1 year):
Due to Banks, Financing and Lending Companies

304

$_______________

Due to Subsidiaries and Affiliated Companies

305

________________

Due to Owners, Directors, Officers, Stockholders

306

________________

Due to Others

307

_________________ ________________ 308

Accrued Liabilities

___________________ 309

Accrued Federal and Other Income Taxes

________________ 310

Accrued Other Taxes

________________ 311

Other Current Liabilities

________________ 312
TOTAL CURRENT LIABILITIES

B.

313

$________________

LONG-TERM LIABILITIES (due after 1 year):
Due to Banks, Financing and Lending Companies

________________ 314

Due to Subsidiaries and Affiliated Companies

________________ 315

Due to Owners, Directors, Officers, Stockholders

________________ 316
________________ 317

Due to Others

TOTAL LONG-TERM LIABILITIES 318
TOTAL LIABILITIES

C.

DEFERRED ITEMS.

D.

OWNER'S EQUITY

___________________

319

___________________

320

__________________

If Incorporated:
Capital Stock - Preferred and Common

________________ 321

Additional Paid-In Capital

________________ 322

Retained Earnings
Less Cost of Treasury Stock

323

$_______________

324

________________

Total Retained Earnings

_______________ 325

If Unincorporated:
Owner's Capital-Net of Withdrawls

3.

________________ 326
TOTAL OWNER'S EQUITY 327

___________________

TOTAL LIABILITIES AND OWNER'S EQUITY 328

____________________

CONTINGENT LIABILITIES (explain below)

REMARKS:

SECTION 3 - CERTIFICATION: I certify that this balance sheet has been prepared by me or under my direction, and that to the best of my knowledge and belief, said balances sheet currently
reflects the assets and liabilities of the reporting firm.
329. DATE

331. SIGNATURE (owner, partner, or responsible officer, if a corporation)

330. TITLE

FORM P&SP-3110

AUGUST 2007

Print Form

Save Form

Clear Form

PAGE 2 OF 2

Close Form

Previous Page