P&SP 1200 Stockyard Information

OMB Control No. 0580-0015

U.S. Department of Agriculture Grain Inspection, Packers and Stockyards Administration Packers and Stockyards Program

Information to be Supplied in Connection with Posting Stockyards

1. Name of stockyard __________________________________________________________________________

2. Physical location of stockyard __________________________________________________________________

_____________________________________________________________________________________________

3. Type of organization:  Individual  Partnership  Corporation  Association  LLC  LLP

4. Names of Owners (individuals or partners) or corporate officers:

_____________________________________________________________________________________________

_____________________________________________________________________________________________

5. Does the stockyard consist of pens, or other enclosures, and their appurtenances, in which live cattle, sheep, swine, horses, mules, or goats are received, held, or kept for sale or shipment?

 Yes  No

6. Is livestock sold at the stockyard (a) which has been shipped to the stockyard from another state, or (b) which is shipped to another state, or (c) which is shipped to packers within the state who ship products resulting from the slaughter of such livestock to points outside the state?

 Yes  No

7. Are the services and facilities of the stockyard available for use by the general public?

 Yes  No

This notice is given in compliance with section 302 of the Packers and Stockyards Act, 1921, as amended and supplemented.

I represent all information on this form to be true and correct to the best of my knowledge and belief.

8. Signed:______________________________________________________

9. Title:________________________________________________________

10. Date: _______________________________________________________

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 collection is estimated to average 10 minutes per response, including the time to review instructions, search existing data resources, gather the data needed, and complete and review the information collection.

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.

Form P&SP-1200 August 2007 Page 2 of 2