FGIS 960 Official Grain Weight Certificate

FORM FGIS-960
JAN 07

Approved OMB No. 0580-0013

UNITED STATES DEPARTMENT OF AGRICULTURE
FEDERAL GRAIN INSPECTION SERVICE

U.S. GRAIN STANDARDS ACT
ORIGINAL

OFFICIAL GRAIN WEIGHT CERTIFICATE

US-NOFO-1-00352

US CLASS X WEIGHTS

IDENTIFICATION:
M/V GRAND VOYAGE

NOT NEGOTIABLE

ISSUED AT:
DESTREHAN, LA

DATE OF SERVICE:
February 01, 2007

LOCATION:
Elevator B
New Orleans, LA

NET WEIGHT:
11,456,370 Pounds

START TIME:
7:00

FINISH TIME:
11:00

TYPE OF MOVEMENT:
Export
START DATE:
February 01, 2007

KIND:

Corn

REMARKS:
Stowage: Holds 1 & 2

I CERTIFY THAT THE SERVICES SPECIFIED ABOVE WERE PERFORMED WITH THE RESULTS STATED.

APPLICANT NAME: A & B Exporters
ISSUING OFFICE:

NAME OR SIGNATURE: Diane K Palecek

FGIS - New Orleans Field Office

This certificate is issued under the authority of the United States Grain Standards Act, as amended (7 U.S.C. 71 et seq.), and the regulations thereunder (7 CFR 800.0 et seq.). It is issued to show the kind, class, grade, quality, condition, or
quantity of grain; or the condition of a carrier or container for the storage or transportation of grain; or other facts relating to grain as determined by official personnel. The statements on the certificate are considered true at the time and place the
inspection or weighing service was performed. The certificate shall not be considered representative of the lot if the grain is transshipped or is otherwise transferred from the identified carrier or container or if grain or other material is added to or
removed from the total lot. If this certificate is not canceled by a superseding certificate, it is receivable by all officers and all courts of the United States as prima facie evidence of the truth of the facts stated therein. This certificate does not
excuse failure to comply with the provisions of the Federal Food, Drug, and Cosmetic Act or other Federal law.
WARNING: Any person who shall knowingly falsely make, issue, alter, forge, or counterfeit this certificate, or participate in any such actions, or otherwise violate provisions in the U.S. Grain Standards Act, the U.S. Warehouse
Act, or related Federal laws is subject to criminal, civil, and administrative penalties. The conduct of all services and the licensing of personnel under the regulations governing such services shall be accomplished without
discrimination as to race, color, religion, sex, national origin, age, or handicap.
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 0580-0013. The time
required to disclose this recordkeeping requirement is to average 3.74 hours per recordkeeper annually, including the time to retain such records, and to notify, disclose, and report to third parties such recordkeeping requirements.