P&SP 3200 Annaul Report of Clearing Agency

OMB Control No. 0580-0015

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

Response is required in order to determine if packer is subject to bonding provision of the Packers and
Stockyards Act, 1921, as Amended and Supplemented (7 U.S.C. 204). Information held confidential (9 CFR
201.96).
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 for reviewing instruction, searching existing data sources, gathering and
maintaining the data needed, and completing and reviewing the collection of inf ormation.

ANNUAL REPORT OF CLEARING
AGENCY

1. DOES THE FIRM OPERATE ON A FISCAL YEAR BASIS?
IF YES, LIST FIRM'S FISCAL YEAR:

INSTRUCTIONS: This report must be completed by every person operating as a dealer or
market agency providing clearing services for (an)other registrant(s) operating subject to
the Packers and Stockyards Act, 1921, as Amended and Supplemented. If the repo rting
registrant operates on a calendar year basis, this report must be returned no l ater than
April 15 following the calendar year end . If the reporting registrant operates on a fiscal
year basis, this report must be filed no later than 90 days after the close of the fiscal year.
If the space provided for any Item is insufficient, attach additional pages containing the
required information and referring to the appropriate section and item number.

YES

NO

2. LIST PERIOD COVERED BY THIS REPORT:

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

SECTION 1. GENERAL INFORMATION
3. NAME AND ADDRESS OF REPORTING FIRM (Include ZIP + 4 code).

4. TELEPHONE NUMBER

5. Fax Number

6. E-Mail Address

8a. DID THE REPORTING FIRM OPERATE A WEBSITE IN
CONJUNCTION WITH ITS LIVESTOCK OPERATIONS?
YES
NO

8b. IF "YES,"PROVIDE DETAILS

9a. DID ANY CHANGES IN THE FIRM'S ORGANIZATION
OCCUR DURING THE REPORTING YEAR?
YES
NO

9b. IF "YES," PROVIDE DETAILS

10. OWNERS, PARTNERS, OFFICERS, AND DIRECTORS
a. NAME

b. TITLE

c. PERCENT OF OWNERSHIP

d. SOCIAL SECURITY NUMBER*

The Privacy Act of 1974 requires this Agency to inform application that disclosures of social security numbers are optional and that the information sought on this form is required by 9
CFR 201.97. The sole use of the social security number(s) sought on this form is to distinguish between individuals that have identical or similar names. As this Agency maintains a large
volume of names, clearing agencies are encouraged to supply social security numbers.
SECTION 2 - CLEAREES
11. LIST EVERY INDIVIDUAL FOR WHOSE LIVESTOCK OBLIGATIONS REPORTING FIRM WAS FINANCIALLY RESPONSIBLE, NUMBER OF WEEKS CLEARED, AND GROSS VALUE OF ALL
LIVESTOCK PURCHASED BY EACH CLEAREE DURING THE PERIOD COVERED BY THIS REPORT. ATTACH ADDITIONAL PAGES IF NECESSARY.
a. CLEAREE'S NAME (AS REGISTERED)

b. NO. OF WEEKS CLEARED

c. GROSS VALUE OF LIVESTOCK

TOTAL $
FORM P&SP 3200

AUGUST 2007

PAGE 1 OF 3

NOTE: A copy of financial statement or audit report, if available for the period covered by this report, may be furnished in lieu of the Balance Sheet and Statement of Operations;
PROVIDED, information requested herein but not shown in such statement or reports is furnished under Sections 3 and 4.
SECTION 3 - BALANCE SHEET AS OF CLOSE OF REPORTING PERIOD
ASSETS
A.

CURRENT ASSETS
Cash
On Hand

$___________________ 12.

In Bank (per book)

_____________________13.

Inventories
Livestock

_______________________14.

Other

_______________________15.

Marketable Securities: U.S. Government Bonds and Others

_______________________16.

Accounts Receivable
One Year or Less

_______________________17.

More than One Year Old

_______________________18.

Subtotal (17 and 18)

_______________________19.

Less Allowance for Doubtful Account

(

Notes Receivable Due within One Year (including current portion, due within
one year, of long-term notes)

)20.

_______________________21.

Other Current Assets
Prepaid Expenses
Interest Receivable
Other (specify) ___________________________________________________________ _______
_________________________________________________________________________

_______________________24.

TOTAL CURRENT ASSETS

B.

$ __________________25.

OTHER ASSETS
Investments

______________________26.

Fixed Assets
Land

______________________27.

Buildings, Structures, and Equipment

$________________________28.

Less Allowance for Depreciation

_________________________29._______________________30.

Long-term Notes Receivable not Due within One Year (excluding portion
included in item A5 above)

______________________31.

Other

_______________________32.

Total Other Assets

C.

TOTAL ASSETS

D.

CURRENT LIABILITIES

___________________33.

____________________34.

LIABILITIES AND NET WORTH

Bank Overdraft (per book)

____________________35.

Payables, Accruals, ad other Current Liabilities
Due to Trade

_____________________36.

Due to Affiliates and Subsidiaries

____________________37.

Due to Officers

____________________38.

Due to Employees

____________________39.

Advances and Deposits on Livestock

____________________40.

Taxes

____________________41.

Demand Notes Payable

____________________42.

Notes, Mortgages, and Bonds due within One Year (including payments
___________________43.

on long-term debts due within one year)
Other

___________________ 44.

___________________46.

Total Current Liabilities
FORM P&SP 3200

____________________45.

AUGUST 2007

PAGE 2 OF 3

SECTION 3 - BALANCE SHEET (continued)
E.

LONG - TERM LIABILITIES
Long-term Notes, Mortgages, and Bonds Payable (excluding payments due
within one year, included in item line 46)

$_________________47.

Other (specify) _______________________________________________________________ __
_______________________________________________________________________________

__________________48.

Total Long-Term Liabilities

F.

TOTAL LIABILITIES

G.

NET WORTH

_______________49.

_______________50.

If Incorporated:
Capital Stock

__ _____________51.

Retaining Earnings

__________________52.

If Unincorporated:
Owner's Capital

__________________53.

Undivided Profits (+) or Less (-)

__________________54.

Total Net Worth

H.

_______________55.

TOTAL LIABILITIES AND NET WORTH

SECTION 4 - STATEMENT OF OPERATIONS
A.

INCOME
Clearing Fees

$_________________57.

Interest Received

__________________58.

Bonuses, Profits, or Salary Received from Others

__________________59.

Other Income

__________________60.

Total Income

B.

______________61.

EXPENSES
Salaries and Bonuses of Owners and Officers

__________________62.

Salaries and Bonuses Paid to Employees

__________________63.

Rent

__________________64.

Taxes

__________________65.

Interest Paid

__________________66.

Split or Profits, Bonuses, etc., Paid to Others (specify) _________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________ __________________67.
Other

___________________68.

Total Expenses

C.

_______________69.

_______________70.

NET PROFIT (+) OR LOSS (-)

SECTION 5 - CERTIFICATION: I certify that this report has been prepared by me or under my direction, and that to the best of my
knowledge and belief, this report correctly reflects the operations of the repo rting firm.
71. DATE

FORM P&SP 3200

72. TITLE (Owner, Partner, Officer)

73. SIGNATURE

AUGUST 2007

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