LS-115 Live Cattle Weekly Report (Forward Contract & Packer-Own

FORM APPROVED. - OMB NO. 0581-0186
UNITED STATES DEPARTMENT OF AGRICULTURE
AGRICULTURAL MARKETING SERVICE

LIVE CATTLE WEEKLY REPORT
(Forward Contract and Packer-Owned)
PRIOR WEEK SLAUGHTERED CATTLE HEAD COUNTS

1. IDENTIFICATION NUMBER

(Data in this block to be entered once per weekly submission.)
2. COMPANY NAME

3. PLANT STREET ADDRESS

18. DOMESTIC, FORMULA ARRANGEMENT

Head Count

19. IMPORTED, FORMULA ARRANGEMENT

Head Count

20. DOMESTIC, NEGOTIATED

Head Count

21. IMPORTED, NEGOTIATED

Head Count

22. DOMESTIC, NEGOTIATED GRID

Head Count

23. IMPORTED, NEGOTIATED GRID

Head Count

24. DOMESTIC, FORWARD CONTRACT

Head Count

25. IMPORTED, FORWARD CONTRACT

Head Count

4. PLANT CITY

5. PLANT STATE

6. PLANT ZIP CODE

7. CONTACT NAME

8. PHONE NUMBER (include area code)

9. REPORTING DATE (mm/dd/yyyy)

10. REPORTING TIME (1 = 10:00 a.m.; 2 = 2:00 p.m.)

(NOT APPLICABLE)

SLAUGHTERED PACKER-OWNED CATTLE
11. LOT IDENTIFICATION
12. SOURCE (1 = Domestic; 2 = Imported)
13. HEAD COUNT

NOTE: 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 0581-0186. The time
required to complete this information collection is estimated to average 15 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.
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.

FORWARD CONTRACT PURCHASED CATTLE

14. ACTUAL AVERAGE CARCASS WEIGHT
15. AVERAGE DRESSING PERCENTAGE

26. LOT IDENTIFICATION

16. % YIELD GRADE 3 OR BETTER

27. HEAD COUNT

17. % QUALITY GRADE CHOICE OR BETTER

28. BASIS LEVEL ($/cwt.)
29. DELIVERY MONTH (abbreviated)
30. DELIVERY YEAR (yyyy)
31. BASIS LEVEL MONTH (abbreviatied)

LS-115 (05/13) Destroy previous edition