FSA-751 End-Use Certificate Program Canadian Wheat Consumption a

Form Approved - OMB No. 0560-0151
FOR INTERNAL USE ONLY

U.S. DEPARTMENT OF AGRICULTURE
Farm Service Agency

FSA-751
(07-01-03)

Date (MM-DD-YYYY):

END-USE CERTIFICATE PROGRAM
CANADIAN WHEAT CONSUMPTION AND RESALE REPORT
NOTE:

Initials:

The following statement is made in accordance with the Privacy Act of 1974 (5 USC 552a) and the Paperwork Reduction Act of 1995, as amended. The authority for requesting the following information
is 7 CFR Part 782. The Information will be used to verify compliance by the importer, end user or subsequent buyer of imported wheat with the provisions of 7 CFR Part 782. Furnishing the requested
information is mandatory. Failure to comply with the regulations governing the End-Use Certificate Program may result in the assessment of penalties in accordance with 7 CFR Part 782 against the
non-complying party. This information maybe provided to other agencies, IRS, Department of Justice or other State and Federal law enforcement agencies, and in response to a court magistrate or
administrative tribunal. The provisions of criminal and civil fraud statutes, including 18 USC 286, 287, 371, 651, 1001, 15 USC 714m, and 31 USC 3729, are applicable to the information provided.
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. The valid OMB control number for this information collection is 0560-0151. The time required to complete this information collection is estimated to average 10 minutes 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. RETURN THE ORIGINAL OF

THIS COMPLETED FORM TO THE KANSAS CITY COMMODITY OFFICE, Contract Reconciliation Division, P.O. BOX 419205, KANSAS CITY, MO 64141-6205.
PART A - GENERAL INFORMATION
1. Filer's Name and Address (Include Street, City, State , ZIP code)

2. Filer's Telephone Number (Include Area Code)

4. Importer's Name and Address (Include Street, City, State, ZIP Code) 5. End-Use Certificate for Wheat Serial No.

3. Storage Location of the Wheat

6. Class of Wheat

8. Quantity Received in Net Metric Tons

7. Date of Receipt (MM-DD-YYYY)

PART B - CERTIFICATION BY END USERS AND EXPORTERS (Must be filed quarterly)

I certify that:
• I have personal knowledge concerning the consumption or export of the wheat described above.
• The wheat has been fully or partially consumed at my facility, or exported in accordance with provisions in 7 CFR Part 782.
• I will continue to provide the U.S. Department of Agriculture's Kansas City Commodity Office, Contract Reconciliation Division, P.O. Box 419205, Kansas City,
MO 64141-6205, with Wheat Consumption and Resale Reports until the wheat is fully consumed at my facility or exported.
• The wheat was consumed or exported as described below.
9. Quantity Consumed or Exported (report in net metric tons)

10. Quantity Remaining (report in net metric tons)

11. Use (mark all applicable items):
Milling for Animal Feed
Milling for Human Consumption

Manufacturing
Brewing or Malting

Distilling
Other (Please specify below):

12A. Signature of Authorized Representative

Export (enter destination):

12B. Date (MM-DD-YYYY)

PART C - CERTIFICATION BY SUBSEQUENT BUYERS AND IMPORTERS (Must be filed within 15 workdays of sale)

I certify that:
• I have personal knowledge concerning the wheat described above.
• I preserved the identity of the wheat in accordance with the provisions at 7 CFR Part 782 until the wheat was loaded onto a conveyance for direct delivery to the end
user or foreign country.
• I provided a copy of the applicable form FSA-750, End-Use Certificate for Wheat, to each subsequent buyer or end user.
• I will continue to report each individual sale to the U.S. Department of Agriculture, Kansas City Commodity Office, Contract Reconciliation Division, P.O. Box 419205,
Kansas City, MO 64141-6205, until the wheat is fully resold.
• The following wheat was sold as described below.
13. Quantity Resold (report in net metric tons)

14. Name, Address and Telephone Number of the Buyer (Include Street, City, State and Zip code
and Area Code for Telephone Number)

15B. Date (MM-DD-YYYY)

15A. Signature of Authorized Representative

The U.S. Department of Agriculture (USDA) prohibits discrimination in all its programs and activities on the basis of race, color, national origin, gender, religion, age, disability, political beliefs, sexual orientation,
and marital or family status. (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 USDA, Director, Office of Civil Rights, Room 326-W, Whitten Building, 1400
Independence Avenue, SW, Washington, D. C. 20250-9410 or call (202) 720-5964 (voice or TDD). USDA is an equal opportunity provider and employer.

End User's and Exporters must file this report quarterly to report consumptions and exports. This report must be filed within 15 workdays following March 31,
June 30, September 30, and December 31, until the wheat is fully consumed or exported.
Subsequent Buyers and Importers must file this report for each individual resale of imported Canadian wheat. This report must be filed within 15 workdays
following the date of sale.
Kansas City Commodity Office's Copy (Original)

Filer's Copy

FSA-751 (07-01-03) (Page 2)

GENERAL INFORMATION
A

The United States Department of Agriculture (USDA) provides End-Use Certificate for Wheat (FSA-750) for
persons required to submit these certificates for the importation of Canadian-produced wheat into the United
States.

B

Regulations governing the End-Use Certificate Program can be found at 7 CFR Part 782.

C

Wheat covered by an End-Use Certificate for Wheat must be stored identity preserved until such time as the
wheat is loaded onto a conveyance for delivery to an end user or foreign country.

D

Copies of FSA-751, Canadian Wheat Consumption and Resale Report, can be obtained from the Kansas
City Commodity Office, Contract Reconciliation Division, P.O. Box 419205, Kansas City, MO 64141-6205.

E

FSA-751, Canadian Wheat Consumption and Resale Report must be filed by each end user, subsequent
buyer, exporter, and importer.

F

All filers must complete Part A, General Information.

G

In Item 5, enter the serial number from the FSA-750, End-Use Certificate for Wheat, that was filed when the
Canadian wheat was imported.

H

End users and exporters must:
(1) complete Part B, Certification by End Users and Exporters.
(2) file form FSA-751 to report quarterly consumption and exports. Reports are due from end users and
exporters within 15 workdays following March 31, June 30, September 30, and December 31.

I

Subsequent buyers and importers must:
(1) complete Part C, Certification by Subsequent Buyers and Importers.
(2) file form FSA-751 for each individual sale. Reports are due from subsequent buyers and importers
within 15 workdays following the date of the sale.