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pdfU.S. DEPARTMENT OF AGRICULTURE
GRAIN INSPECTION, PACKERS AND STOCKYARDS ADMINISTRATION
PACKERS AND STOCKYARDS PROGRAM
OMB Control No. 0580-0015
Response is required by law to ensure compliance with the Packers and Stockyards Act, 1921, as Amended and
Supplemented. Failure to report after notice of default will result in forfeiture to the United States the sum of $100
for each and every day of the continuance of such failure.
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 6 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 inf ormation.
ANNUAL REPORT OF LIVE
POULTRY DEALERS
1. REPORT FOR YEAR ENDED
INSTRUCTIONS: This report must be filed by any individual, partnership, corporation, or
association, as determined by the Secretrary, that is engaged in the business o f a live
poultry dealer as the term is defined in the Packers and Stockyards Act, 1921, and should
be returned not later than April 15 following the calendar year end or 90 days after the
close of fiscal period if business is on other than a calendar year basis. If space provided
in any item is not sufficient, attach additional sheets containing the information and make
reference to the relevant Section and item number.
SEE ENCLOSED INSTRUCTIONS BEFORE COMPLETING THIS REPORT.
2. IF NOT FOR CALENDAR YEAR, INDICATE PERIOD COVERED:
RETURN COMPLETED REPORT TO APPROPRIATE REGIONAL OFFICE, SEE SEPARATE
INSTRUCTIONS FOR INFORMATION.
SECTION 1. GENERAL INFORMATION
4. TYPE OF ORGANIZATION (check one)
3. NAME AND ADDRESS OF POULTRY DEALER
(Include ZIP +4 code)
7. TELEPHONE NUMBER
INDIVIDUAL
CORPORATION
PARTNERSHIP
OTHER (specify) ______________
5. IF A CORPORATION, STATE, IN WHICH
INCORPORATED
9. E-Mail Address
10. DOES THE REPORTING FIRM OPERATE A WEBSITE IN CONJUNCTION WITH ITS POULTRY OPERATIONS?
11. DID ANY CHANGE IN ORGANIZATION TAKE
PLACE DURING THE YEAR?
YES
YES
NO IF YES, PROVIDE DETAILS
12. IF YES, PROVIDE DETAILS
NO
14. DID YOU SELL OR LEASE ANY PLANTS TO
OTHERS DURING REPORTING PERIOD?
13. DID YOU ACQUIRE ANY PLANTS THROUGH PURCHASE,
MERGER, LEASE, ETC., DURING REPORTING PERIOD?
YES
15. ACTIVITIES ENGAGED IN:
8. Fax Number
6. DATE INCORPORATED
NO
YES
Producing poultry under growing
arrangement
Slaughtering
NO
Dealing-selling poultry for slaughter
16. OWNERS, PARTNERS, OFFICERS, AND DIRECTORS
NAME
TITLE
MAILING ADDRESS (Street and No., City, State, and Zip Code)
17. IF REPORTING COMPANY IS OWNED OR CONTROLLED BY ANY CORPORATION OR INDIVIDUAL OTHER THAN THOSE LISTED UNDER LINE 16 ABOVE, GIVE NAME AND ADDRESS
OF SUCH CORPORATION OR INDIVIDUAL:
FORM P&SP-3600
AUGUST 2007
PAGE 1 OF 6
SECTION 1. GENERAL INFORMATION - Continued
18. SUBSIDIARIES AND AFFILIATED COMPANIES WHOSE OPERATIONS AREINCLUDED IN THIS REPORT (Include in all appropriate portions of report TOTAL operations of ALL
subsidiaries and affiliated companies listed in this item.)
NAME OF COMPANY
LOCATION
(City and State)
NATURE OF BUSINESS
PERCENTAGE OF CONTROL
BY REPORTING COMPANY
19. SUBSIDIARIES AND AFFILIATED COMPANIES WHOSE OPERATIONS ARE NOT INCLUDED IN THIS REPORT
LOCATION
(City and State)
NAME OF COMPANY
NATURE OF BUSINESS
PERCENTAGE OF CONTROL
BY REPORTING COMPANY
20. OWNERS, PARTNERS, OFFICERS, AND DIRECTORS OF REPORTING COMPANY WHO ARE PARTNERS, OFFICERS, OR DIRECTORS IN, OR OWN OR CONTROL, OTHER FIRMS
ENGAGED IN SLAUGHTERING LIVESTOCK OR POULTRY; MANUFACTURING OR PREPARING MEAT, MEAT FOOD, OR POULTRY PRODUCTS; MARKETING OF WHOLESALE OR RETAIL,
MEAT, MEAT FOOD, OR POULTRY PRODUCTS; OPERATING A STOCKYARD, MARKET AGENCY, OR DEALER ORGANIZATION HANDLING LIVESTOCK OR LIVE POULTRY; OR FEEDING
LIVESTOCK OR POULTRY.
NAME
POSITION IN
REPORTING
COMPANY
POSITION AND
OWNERSHIP
INTEREST IN
OTHER COMPANY
NAME OF OTHER COMPANY
LOCATION OF OTHER
COMPANY
(City and State)
NATURE OF BUSINESS OF
OTHER COMPANY
REMARKS:
FORM P&SP-3600
AUGUST 2007
PAGE 2 OF 6
SECTION 2 - POULTRY OPERATIONS (Include your poultry operations and those of the subsidiaries and affiliated companies listed in line 18. Poultry includes chickens, turkeys, ducks,
geese, and all other domestic fowl. Chickens include fryers, broilers, roasters, capons, hens, and roosters.)
LIVE POULTRY SLAUGHTERED FOR YOUR ACCOUNT (Show live
weight):
CHICKENS
HEAD
TURKEYS
LBS.
HEAD
OTHER
LBS.
HEAD
LBS.
21. POULTRY PURCHASED BY YOU OR YOUR EMPLOYEES
(Exclude poultry reported in lines 23 & 24 below.):
22. POULTRY PURCHASED BY OTHERS FOR YOUR ACCOUNT
(Exclude poultry reported in lines 23 & 24 below.):
23. POULTRY RAISED BY YOU
24. POULTRY RAISED FOR YOU BY OTHERS
25. TOTAL SLAUGHTERED (add lines 21 through 24)
26. WAS ANY POULTRY PURCHASED OUTSIDE THE STATE IN
WHICH SLAUGHTERED?
YES
NO
27. POULTRY RAISED (include only poultry removed from
production for slaughter or sold during reporting period):
LIVE POULTRY RAISED BY YOU: (Show live weight)
Name and Location of Establishment
28. TOTAL
29. POULTRY SLAUGHTERED OR PROCESSED (show dressed
weight):
POULTRY SLAUGHTERED OR PROCESSED IN
ESTABLISHMENTS OWNED OR OPERATED BY YOU
Name and Location of Establishment
FSIS
Estabishment
Type of
Inspection
30. TOTAL
31. TOTAL POULTRY CUSTOM SLAUGHTERED OR PROCESSED
FOR YOU BY OTHERS:
32. TOTAL POULTRY CUSTOM SLAUGHTERED OR PROCESSED BY
YOU FOR OTHERS:
33. TOTAL LIVE POULTRY SOLD:
34. WAS ANY LIVE POULTRY SOLD OUTSIDE THE STATE IN WHICH PRODUCED?
FORM P&SP-3600
YES
AUGUST 2007
NO
PAGE 3 OF 6
SECTION 3. FINANCIAL INFORMATION (Complete this Section as of the end of the reporting period including financial information for all subsidiaries and affiliated companies listed in
line 18. IN ADDITION, complete this Section for EACH subsidiary and affiliated companies engaged in slaughtering poultry).
NOTE: A copy of financial statements or audit report, if available for the period covered by this report, may be furnished in lieu of the Balance Sheet and Statement of Income
information below, PROVIDED information requested herein but not shown in such statements or reports is furnished under this section.
SUBSIDIARY NAME (if applicable):
Fiscal Year Ending:
1. STATEMENT OF INCOME
A
SALES:
Gross Sales Less Sales Returns and Allowances:
Live Poultry and Poultry Products (include all edible products and byproducts)
Other (Include all other sales) _____________________________________________ _____
$_____________________________ 35.
______________________________ 36.
NET SALES 37.
B
$_________________________
COST OF SALES:
Opening Inventory
_______________________________
38.
Live Poultry Purchases
_______________________________
39.
Poultry Growouts
_______________________________ 40.
Other Purchases (include poultry products)
_______________________________ 41.
_______________________________ 42.
Less: Closing Inventory
_______________________________ 43.
TOTAL COST OF SALES
GROSS INCOME
44. _________________________
45._________________________
C. OPERATING EXPENSES:
Manufacturing
_______________________________ 46.
Advertising
_______________________________
Sales Promotion
_______________________________
48.
Sales Brokerage
_______________________________
49.
Selling (other than above)
_______________________________
50.
Delivery
_______________________________
51.
General and Administrative
_______________________________ 52.
Depreciation and Amortization
_______________________________
Interest
_______________________________ 54.
Other
_______________________________ 55.
TOTAL OPERATING EXPENSE
47.
53.
66 _________________________
OPERATING INCOME (LOSS) 57 _________________________
D. OTHER INCOME:
Interest
_______________________________
58.
Other (specify)________________________________________________________________
_______________________________
59.
_________________________________________________________________
_______________________________
TOTAL OTHER INCOME
60_________________________
TOTAL INCOME 61 _________________________
E. DEDUCTIONS:
(specify)
_______________________________
_________________________________________________________________________
_______________________________
______________________________________________________________________________
TOTAL DEDUCTIONS
62.
63. _________________________
INCOME (LOSS) BEFORE INCOME TAXES 64.________________________
F. EXPENSE INCOME TAXES:
Current_______________________________________________________________________
_______________________________ 65.
Deferred ______________________________________________________________________
_______________________________ 66.
TOTAL INCOME TAX 67________________________
NET INCOME (LOSS) 68_________________________
G. Retained Earnings/Owners' Capital at Beginning of Period
69. _________________________
Additions to Owners' Capital -- if unincorporated or net income if incorporated
_______________________________ 70.
Dividends Declared/Owners' Withdrawals
_______________________________ 71.
Other Deductions (specify) ____________________________________________________ __
_______________________________ 72.
NET ADJUSTMENT 73.________________________
Retained Earnings/Owners' Capital at End of Period
FORM P&SP-3600
74._________________________
AUGUST 2007
PAGE 4 OF 6
SECTION 3. FINANCIAL INFORMATION (continued)
SUBSIDIARY NAME (if applicable):
Fiscal Year Ending:
1. BALANCE SHEET -- ASSETS
A.
CURRENT ASSESTS:
Cash on Hand and in Banks
$_____________________________
75
(enter overdraft on next page under Current Liabilities)
Temporary Cash Investments (marketable securities,
_______________________________ 76
certificates of deposit, commercial paper, etc.)
Accounts Receivable:
From Trade
77
_________________________
78
_________________________
From Others (owners, officers, employees, subsidiaries,
and affiliated companies)
_________________________
Less Allowance for Doubtful Accounts
79
_________________________
Due from Subsidiaries and Affiliated Complanies
81
________________________
Due from Owners, Directors, Officers, Stockholders
82
_________________________
Due from Others
83
_________________________
Live Poultry
85
_________________________
Poultry Products
86
_________________________
Other Inventories
87
_________________________
_______________________________ 80
Notes and Loans Receivable (due within 1 year):
_______________________________ 84
Inventories:
Advances Made on Live Poultry
89
Prepaid Expenses (rent, insurance, etc.)
90
Other Current Assets
91
_______________________________
88
_______________________________ 92
TOTAL CURRENT ASSETS 93
B.
$___________________
_____________________
INVESTMENTS:
Subsidiaries and Affiliated Companies (line 22
only)
_______________________________ 94
Other
_______________________________ 95
TOTAL INVESTMENTS 96
C.
FIXED ASSETS:
______________________________
Land
Buildings, Equipment, and Other Fixed Assets
Less Accumulated Depreciation
98
_______________________
99
________________________
97
_______________________________ 100
NET FIXED ASSETS 101
D.
_____________________
_____________________
OTHER ASSETS:
Notes Receivable (due after 1 year)
_______________________________ 102
Goodwill, Patents, Trade-marks
_______________________________ 103
Other Assets (specify)
_______________________________ 104
______________________________________________________ _______________
_______________________________________________________________________________ ___
FORM P&SP-3600
AUGUST 2007
_______________________________
TOTAL OTHER ASSETS 105
_____________________
TOTAL ASSETS 106
_____________________
PAGE 5 OF 6
SECTION 3. FINANCIAL INFORMATION (continued)
SUBSIDIARY NAME (If applicable):
Fiscal Year End ing:
2. BALANCE SHEET - LIABILITIES AND OWNERS' EQUITY
A. CURRENT LIABILITIES:
Bank Overdraft (per books)
$______________________________ 107
Accounts Payable -Poultry (purchases and growout contracts)
_______________________________ 108
Accounts Payable - Other
_______________________________ 109
Notes and Loans Payable (due within 1 year):
Due to Banks, Financing and Lending Companies
110
$________________________
Due to Subsidiaries and Affiliated Companies
111
_________________________
Due to Owners, Directors, Officers, Stockholders
112
_________________________
Due to Others
113
_________________________
_______________________________ 114
Accrued Liabilities
_______________________________ 115
Accrued Federal and Other Income Taxes
_______________________________ 116
Accrued Other Taxes
_______________________________ 117
Other Current Liabilities
_______________________________ 118
TOTAL CURRENT LIABILITIES 119
$______________________
B. LONG-TERM LIABILITIES (Due after 1 year):
Due to Subsidiaries and Affiliated Companies
_______________________________ 120
Due to Owners, Directors, Officers, Stockholders
_______________________________ 121
Due to Others
________________________________ 122
TOTAL LONG-TERM LIABILITIES
123
______________________
TOTAL LIABILITIES
124
______________________
125
______________________
C. DEFERRED INCOME TAXES
D. OWNERS' EQUITY:
If Incorporated:
Capital Stock - Preferred and Common
_______________________________ 126
_______________________________ 127
Additional Paid-In Capital
Retained Earnings
Less Cost of Treasury Stock
128
________________________
129
_________________________
Total Retained Earnings
_______________________________ 130
If Unincorpoated:
Owners' Capital - - Net of Withdrawals
______________________________ 131
TOTAL EQUITY 132
_____________________
133
_____________________
TOTAL LIABILITY AND EQUITY
137 CONTINGENT LIABILITIES (attach explanation)
SECTION 4. ACCOUNTS RECEIVABLE AND/OR INVENTORY FINANCING ARRANGEMENTS
135. As of the end of the reporting period, were Accounts Receivable and/or Inventories,
or any part thereof, pledged, assigned, or hypothecated as collateral under a financing or
loan agreement? (If answer is "YES", complete questions 136 through 145.)
YES
NO
YES
NO
136. Names and addresses of financial lending institutions having security interests:
(If the answer is YES, fully explain)
137. Are Inventories collateralized under the agreement?
139. Enter borrowing limit under the agreement:
138. Are Accounts Receivable collateralized under the agreement?
YES
140. Enter borrowing payable as of the end of the reporting period:
$
141. Are any Company owners, directors, officers, or stockholders named as
a guarantor under the agreement?
YES
NO
$
142. If Company is a subsidiary of another, is the Parent Company named as a guarantor
under the agreement?
NO
YES
NO
NOT APPLICABLE
Restrictions and covenants under financing or loan agreement:
143.
Minimum cash balance to be maintained on deposit
$__________________
144.
Minimum working capital ratio to be maintained (give ratio)
___________________
145.
Others (describe)
146. Name and location of banks used for poultry payments (Attach list if additional space is needed):
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, said report correctly reflects the operations of the repo rting poultry dealer.
147. DATE
FORM P&SP-3600
148. TITLE
149. SIGNATURE (sole proprietor, partner, or officer responsible if a corporation)
AUGUST 2007
PAGE 6 OF 6
| File Type | application/pdf |
| File Title | e:\newrev~1\psp3600.wpf |
| Author | camcduffie |
| File Modified | 2007-07-30 |
| File Created | 2006-12-05 |