P&SP 5000 Reparation Complaint

Instructions to Complete
Reparation Complaint
Form P&SP-5000
If you believe that you have been harmed by the actions of any person or firm subject to the Packers and Stockyards
Act, 1921, as amended and supplemented, then you may file a reparation complaint, in writing, within 90 days after
you determine there is cause for action. This form is provided to you, as the complainant, to file the complaint, in
writing.
Mail four copies of the completed form, with accompanying, supporting documentation, to the appropriate regional
office of the Packers and Stockyards Program as listed below; retain a copy for your files. The states covered by
each regional office are listed below its address.
Regional Offices of the Packers and Stockyards Program
Grain Inspection, Packers and Stockyards Administration
Eastern Regional Office
Western Regional Office
Midwestern Regional Office
Suite 230
3950 Lewiston St., Suite 200
Room 317
75 Spring Street
Aurora, CO 80011-1556
210 Walnut Street
Atlanta, GA 30303-3308
Telephone: (303) 375-4240
Des Moines, IA 50309-2110
Telephone: (404) 562-5840
FAX: (303) 371-4609
Telephone: (515) 323-2579
FAX: (404) 562-5848
E-mail:
FAX: (515) 323-2590
E-mail:
[email protected]
E-mail:
[email protected]
[email protected]
States Covered
States Covered
States Covered
AL, AR, CT, DC, DE, FL, GA, LA,
AK, AZ, CA, CO, HI, ID, KS, MT,
IA, IL, IN, KY, OH, MI, MO, MN,
MA, MD, ME, MS, NC, NH, NJ,
NM, NV, OK, OR, TX, UT, WA, WY
ND, NE, SD, WI
NY, PA, RI, SC, TN, VA, VT, WV
If you have questions regarding completion of ANY portion of the reparation claim form, please contact the
Regional Office in the area which you reside for assistance.
The claimant(s) must complete lines 1 through 8 and must sign line 9.

Line
No.
1
2

Subject

Instruction

Name and Address of
Complainant
Name and Address of
Respondent

Enter the name(s) and street, city, state, and zip code of each of
the complainants wishing to file a complaint of reparation.
Enter the name(s) and street, city, state, and zip code of the
person(s) or firm(s) the complaint is being filed against.

3

Date of Transaction

4
5

Amount Claimed
Location of Transaction

6

Description of
Transaction

7

Itemize Amount Claimed

8

Date

P&SP-5000i

If you are naming more than one respondent, prepare an
additional copy for each respondent.
Enter the date of the transaction upon which you based your
complaint.
Enter the amount you are claiming as damages.
Enter the name and street, city, state, and zip code where the
transaction took place.
Give a brief description of the events involving the transaction,
including the alleged violation. All supporting documentation
must be attached to the complaint.
Itemize the transaction(s) and give an explanation of how you
calculated the amount of damages that you are claiming.
Enter the date you sign the complaint.

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Line
No.
9

Subject

Instruction

Signature of
Complainants

Each of the complainants must sign the complaint.

Sections 308 and 309 of the
Packers and Stockyards Act, 1921, as Amended and Supplemented
In Relevant Part
Section 308. Liability to individuals for violations; enforcement generally.1
(a) If any person subject to this Act violates any of the provisions of this Act, or
of any order of the Secretary under this Act, relating to the purchase, sale, or
handling of livestock, the purchase or sale of poultry, or relating to any poultry
growing arrangement or swine production contract, he shall be liable to the person
or persons injured thereby for the full amount of damages sustained in
consequence of such violation.
(b) Such liability may be enforced either (1) by complaint to the Secretary as
provided in section 309, or (2) by suit in any district court of the United States of
competent jurisdiction; but this section shall not in any way abridge or alter the
remedies now existing at common law or by statute, but the provisions of this Act
are in addition to such remedies. (7 U.S.C. 209)
Section 309. Proceedings before Secretary for violations.
(a) COMPLAINT; RESPONSE; SATISFACTION OR INVESTIGATION. Any person
complaining of anything done or omitted to be done by any stockyard owner,
market agency, or dealer (hereinafter in this section referred to as the
“defendant”) in violation of the provisions of sections 304, 305, 306, or 307, or of
an order of the Secretary made under this title, may, at any time within ninety
days after the cause of action accrues, apply to the Secretary by petition which
shall briefly state the facts, whereupon the complaint thus made shall be
forwarded by the Secretary to the defendant, who shall be called upon to satisfy
the complaint, or to answer it in writing, within a reasonable time to be specified
by the Secretary. If the defendant within the time specified makes reparation for
the injury alleged to be done he shall be relieved of liability to the complainant
only for the particular violation thus complained of. If the defendant does not
satisfy the complaint within the time specified, or there appears to be any
reasonable ground for investigating the complaint, it shall be the duty of the
Secretary to investigate the matters complained of in such manner and by such
means as he deems proper. (7 U.S.C. 210)

1

Amended by acts of Congress, approved Sept. 13, 1976, Nov. 23, 1987, and May 13, 2002. NOTE: The full text
of the Packer and Stockyards Act, 1921, as amended and supplemented is available on the USDA GIPSA web site
(http://www.usda.gov/gipsa/lawsandregs/law/p&s_act.pdf).

P&SP-5000i

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OMB CONTROL NO. 0580-0015
Expires: xx/xx/20xx

U.S. DEPARTMENT OF AGRICULTURE

Grain Inspection, Packers and
Stockyards Administration
Packers and Stockyards
Program

REPARATION COMPLAINT
BEFORE THE SECRETARY OF AGRICULTURE

This form may be used to file complaint for reparation within 90 days after cause of action accrued in accordance
with Section 309(a) of the Packers and Stockyards Act, 1921, as amended and supplemented (7 U.S.C. 210(a)).

1. Name(s) and Address(s) of Complainant(s)

v.

2. Name(s) and Address(s) of Respondent(s)

The following complaint is filed pursuant to section 309(a) of the Packers and Stockyards Act, 1921, as amended
and supplemented. (7 U.S.C. 210(a)).
3. Date of Transaction: __________________

4. Amount Claimed: $__________________

5. Name of Business and Address where transaction occurred:

6. Briefly describe the transaction involved, including the terms of the contract(s) or agreement(s) and the alleged
violation(s). Attach all supporting documents and evidence.

7. Itemize and explain how you calculated amount claimed.

8. Date: _______________

9. Signature(s) of Complainant(s): _____________________________

If space is insufficient, continue on separate paper and attach.
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 0580-0015. The time
required to complete this information collection is estimated to average 1 hour 30 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.
Form P&SP-5000

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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) 7206382 (TDD). USDA is an equal opportunity provider and employer.

Form P&SP-5000

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