Warehouse Regulations Under the United States Warehouse Act

Warehouse Regulations Under the United States Warehouse Act

WA0070 E-Gov

Warehouse Regulations Under the United States Warehouse Act

OMB: 0581-0305

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Instructions For WA-70

RECEIPT SIGNATURE AUTHORITY

Warehouse operators licensed under the United States Warehouse Act use this form to record the official signature of persons authorized by the warehouse operator to sign negotiable warehouse receipts.

Submit the original of the completed form in hard copy or facsimile to the Kansas City Commodity Office (KCCO), Warehouse License and Examination Division, STOP 9148, P.O. Box 419205, Kansas City, MO 64141-6205; or FAX 816-926-1774. Customers who have established electronic access credentials with KCCO may electronically transmit this form to KCCO. Features for transmitting the form electronically are available to those customers with access credentials only. If you would like to establish online access credentials with USDA, follow the instructions provided at the USDA eForms web site.

Warehouse operators must complete Items 1 through 6

Items 1 through 6

Fld Name /
Item No.

Instruction

1

License Number

Enter the United States Warehouse Act license number.

2

Date

Enter today’s date (MM-DD-YYYY).

Warehouse Operator

Signature…

This is to certify that the person whose signature, facsimile or electronic signature which appears in Item 4 has been duly authorized to sign warehouse receipts issued under the U.S. Warehouse Act. Type of signature authorized is Original, Facsimile, or an Electronic signature.

3

Name and Address of Licensed Warehouse

Enter the name of the licensed warehouse and the address.


4A and 4B

Signature of Person Authorized to Sign Receipts

A. Enter the signature of the warehouse receipt signer being authorized.

  1. Enter the typed signature or printed signature of the warehouse receipt signer.

5

Name of Licensed Warehouse Operator

Enter the name of the licensed warehouse operator.

Enter the warehouse operator’s full legal name and type of organization:

For a proprietor, enter, for example “Susan Doe” and change “at” to “of” just before (b)

For a corporation, enter, for example, “Does, Inc.”, “a BLANK corporation”, where BLANK is the name of the State of incorporation

For a general partnership, enter, for example “Letitia Doe, Frank Doe, Selma Doe, and James Doe, copartners, trading as Doe Farms” then “under the laws of BLANK” where BLANK is the State under whose laws the partnership is organized.

For a limited partnership, enter, for example “Doe Farms Limited Partnership under the laws of BLANK, Selma Doe, General Partner” where BLANK is the State of organization and under whose laws you operate.

For a limited liability company, enter, for example “Doe Farms, L. L. C., a BLANK limited liability company” where BLANK is the name of the State under which organized)

6

By

Enter the signature of an authorized person who is authorized to approve this signature for the warehouse operator entity.



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