P&SP 3003 Annual Report of Market Agency - SOC

					For P&SP Use Only									P&SP Bar Code Only
U.S. Department of Agriculture					ANNUAL REPORT OF MARKET AGENCY - SOC
Grain Inspection,
Packers and Stockyards
Administration
Packers and					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.
Stockyards
Program
										GENERAL INFORMATION - SECTION 1
101			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
107			City, State, Zip
108			Contact Name
109			Telephone Number
110			Fax Number
										ORGANIZATIONAL STRUCTURE - SECTION 2
			List owners, officers, partners, and managing members in control of this business
			a. Name									b. Title							c. Percentage Ownership
201
202
203
204
205
206			Type of organization:		Individual			Partnership			Corporation			L.L.C.		L.L.P.	Co-op		Association			Other
207			Is this the same organization type reported last year?									Yes		No
208			Is this business owned or controlled by another business entity?									Yes		No
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?												Yes		No
			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
211
212
213
214
Your response to this form is required under the Packers and Stockyards Act of 1921 (9 CFR 201.97 and 7 U.S.C. 181-229). 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 control number for this information is 0580-0015. The time required to complete this information collection is estimated to average 2 hour per response, including the time to review instructions, search existing data resources, gather the data needed, and complete and review the information collection.
										SOC ACTIVITY (CLAUSE 1 BOND) - SECTION 3
301			Number of public sale days covered by this report
			Livestock Sold at Market					a. Cattle & Calves			b. Hogs			c. Sheep & Goats			d. Horses & Mules			e. Total (a+b+c+d)
302			Livestock consigned by others to your market (number of head)
303			Livestock consigned by you to your market (number of head)
304			Total livestock consigned to your market (number of head)
305			Gross value of livestock sold on commission					$			$			$			$			$
									DEALER OPERATIONS (CLAUSE 2 BOND) - SECTION 4
			Livestock Dealer Activity					a. Cattle & Calves			b. Hogs			c. Sheep & Goats			d. Horses & Mules			e. Total (a+b+c+d)
401			Cost of livestock purchased on a dealer basis for registrant's account					$			$			$			$			$
402			Number of head of livestock purchased on a dealer basis for registrant's account
			Livestock Bought on Commission					a. Cattle & Calves			b. Hogs			c. Sheep & Goats			d. Horses & Mules			e. Total (a+b+c+d)
403			Cost of livestock bought on commission for the account of others regardless of who paid for the livestock.					$			$			$			$			$
404			Number of head of livestock bought on commission for the account of others regardless of who paid for the livestock.
405			What was the dollar value of livestock dealer and BOC purchases in your highest quarter?
									CLEAREE AND CLEAROR DESIGNATIONS - SECTION 5
501			Are you a clearee (cleared by another business for your livestock purchases)?											Yes		No
502			If you checked yes in item 501, provide the name of the clearing agent:
503			Are you a clearor (provide clearing services for clearees)?										Yes		No	If yes provide information for lines 504-512
			Clearee's Name as Registered											Gross Value of Livestock Purchased
504														505	$
506														507	$
508														509	$
510														511	$
			Total Livestock Purchases of all Clearees											512	$
							ANALYSIS OF CUSTODIAL BANK ACCOUNT FOR SHIPPERS' PROCEEDS - SECTION 6
601			Balance per Bank Statement as of (Date):										602	$
			Deposits in Transit (in mail or bank, but not on statement)										603	$
			CD's and Savings Accounts designated as Custodial Funds										604	$
			Proceeds on Hand										605	$
			Proceeds Receivables										606	$
			Total Debits															607	$
			Outstanding Checks and Drafts which have not Cleared Bank										608	$
			Proceeds Due Consignors of Livestock for which no Checks were issued										609	$
			Expense Items incident to Sales remaining in Account										610	$
			Total Credits															611	$
			Overage in account (Debits exceed Credits) - Enter on line 702															612	$
			Shortage in account (Credits exceed Debits) - Enter on line 719															613	$
										BALANCE SHEET - SECTION 7
			Include values only for the reporting entity.
Assets
	Current Assets
		Cash on Hand and in Non-Custodial Bank Accounts (Enter overdrafts under Current Liabilities - line 718)																	701	$
		Overage in Analysis of Custodial Bank Account (From Line 612)																	702	$
		Temporary Cash Investments (Marketable Securities, Certificates
			of Deposit, Commercial Paper, etc.)																703	$
		Accounts Receivable (Due in 1 Year or Less)
			From Sources Not Related to Company											704	$
			From Sources Related to Company											705	$
		Total Accounts Receivable																	706	$
		Notes and Loans Receivable (Portion due in 1 Year or Less)																	707	$
		Inventory
			Livestock											708	$
			Other Inventory											709	$
		Total Inventory																	710	$
		Other Current Assets																	711	$
	Total Current Assets																		712	$
	Long-Term Assets
		Investments												713	$
		Property, Plant & Equipment (Net of Depreciation and Amortization)												714	$
		Other Long-Term Assets												715	$
	Total Long-Term Assets																		716	$
Total Assets																			717	$
Liabilities and Net Worth
Liabilities
	Current Liabilities
		Bank Overdraft in Non-Custodial Bank Accounts																	718	$
		Shortage in Analysis of Custodial Bank Account (from line 613)																	719	$
		Accounts Payable
			Livestock Payables											720	$
			Other Payables to Sources Not Related to Company											721	$
			Other Payables to Sources Related to Company											722	$
		Total Accounts Payable																	723	$
		Notes and Loans Payable (demand notes and portion of long-term notes due in 1 year or less)																	724	$
		Other Current Liabilities																	725	$
	Total Current Liabilities																		726	$
	Long-Term Liabilities (Due after 1 Year)																		727	$
Total Liabilities																			728	$
Total Net Worth																			729	$
Total Liabilities and Net Worth (Equals Total Assets)																			730	$
									INCOME STATEMENT - SECTION 8
Income Statement
	Selling Commissions of Market																		801	$
	Gross Dealer Profit (+) or Loss (-)																		802	$
	Buying Commission																		803	$
	Other Income																		804	$
Total Income																			805	$
Total Expenses																			806	$
Net Profit (+) or Loss (-) before Income Taxes																			807	$
										CERTIFICATION - SECTION 9
Under the Packers and Stockyards Act any person who willfully makes, or causes any false entry or statement of fact in this report shall be deemed guilty of offense against the United States, and be subject to a fine of $1,000 to $5,000, or to imprisonment for a term of not more than 3 years, or to both fine and imprisonment.
I certify that this report has been prepared by me or under my direction, and to the best of my knowledge and belief correctly reflects reporting entity operations.
901 Print Name												902 Signature (Must be signed by a person listed on 201-205)
903 Phone Number								904 Date				905 Title
Submitted information is confidential (9 CFR 201.96). Failure to report will result in forfeiture to the United States $110 per day until report receipt 7 (U.S.C. 222).
The U.S. Department of Agriculture (USDA) prohibits discrimination in all its programs and activities on the basis of race, color, national origin, age, disability, and where applicable, sex, marital status, familial status, parental status, religion, sexual orientation, genetic information, political beliefs, reprisal, or because all or part of an individual’s income is derived from any public assistance program. (Not all prohibited bases apply to all programs.) Persons with disabilities who require alternative means for communication of program information (Braille, large print, audiotape, etc.) should contact USDA’s TARGET Center at (202) 720-2600 (voice and TDD). To file a complaint of discrimination, write to USDA, Director, Office of Civil Rights, 1400 Independence Avenue, S.W., Washington, D.C. 20250-9410, or call (800) 795-3272 (voice) or (202) 720-6382 (TDD). USDA is an equal opportunity provider and employer.