Warehouse Regulations Under the United States Warehouse Act

Warehouse Regulations Under the United States Warehouse Act

WA0490 E-Gov

Warehouse Regulations Under the United States Warehouse Act

OMB: 0581-0305

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Instructions For WA-490

FARM SERVICE AGENCY PROVIDER AGREEMENT TO ELECTRONICALLY FILE AND MAINTAIN OTHER ELECTRONIC DOCUMENTS

Used by authorized providers to contract with FSA to provide services to users of the provider’s electronic storage and transfer system.


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 816-926-1548. 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.

Providers complete Page 1 and Page 12.


Fld Name /
Item No.

Instruction

(a)

Name of Provider

Enter complete name of Provider, on page 1.

(a)

Name of Provider

Enter complete name of Provider, on page 12.

(b)

Signature

of Provider

Enter signature of Provider’s authorized person, on page 12.

(c)

Title of

Provider

Enter title of Provider’s authorized person, on page 12.

(d)

Date

Enter date of signature of Provider’s authorized person, on page 12.

Page 12 (e) Deputy Administrator for Commodity Operations” and (f) Date” is for FSA use only.

Page 1 of 1

File Typeapplication/msword
File TitleInstructions For WA-490
AuthorPreferred Customer
Last Modified ByJoanne.shaw
File Modified2011-11-08
File Created2011-11-08

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