Information Collection

Reporting and Recordkeeping Requirements - State, Local, Tribal

IC 182961 under ICR 201804-0581-003 · OMB 0581-0309.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0581-0309 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form FGIS 4 Reporting and Recordkeeping Requirements - State, Local, Tribal	Form and Instruction
FGIS 4 Application and Agreement for Contract Service fgis-4.pdf www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-100 Conflict of Interest Questionnaire fgis-100.pdf htt://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-904 Laboratory Scale Test fgis-904.xls www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-905 Official Sample-Lot Inspection Certificate fgis-905.pdf www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landilng	Form and Instruction
FGIS-907 Application for Inspection and Weighing Services Revised fgis-907 030415.pdf www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=lalnding&topic=landing	Form and Instruction
FGIS-909 Official Export Grain Inspection Certificate fgis-909.pdf www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-913 Warehouseman's Sample-lot Inspection fgis-913.pdf www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-914 Submitted Sample Inspection fgis-914.pdf www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-915 Official Stowage Examination Certificate fgis-915.pdf www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-921-2 Inspection Report - Insects in Grain fgis-921-2-v3.doc www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-921 Inspection Log fgis-921.pdf www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-922 Inspection and Weighing Report fgis-922(1).pdf www.gipsa.usda.gov/GIPSA/wepp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-923 Moisture Meter Test fgis-923.xls www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-924 Barley Pearler and Sieve Test fgis-924.xls www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-925 Rice Checklist Form fgis-925.xls www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-927 Testweight Checktest fgis-927.xls www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-928 Dockage Checklist fgis-928.xls www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-930 AMA Output Report FORM 930 - Revision.xls www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-931 Approved Label for Inspected Machinery fgis-931.pdf www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-936 Sampler Condition Report fgis-936.xls www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-938 Report of Grain Inspected and Weighed for Export fgis-938_f.pdf www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-941 Request for Waiver of Inspection fgis-941.pdf www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-942 Application for Designation fgis-942.pdf www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-944 Application for License Under the USGSA and/or the AMA o fgis-944_f.pdf www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-945 Application for Registration fgis-945.doc www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-950 Warehouseman's Sample-Lot Inspection Service Contract fgis-950.pdf www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-952-1 Sanitation Inspection Report (Beans, Peas, and Lentils) fgis-952-1.xls www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-952-2 Sanitation Inspection Report (Overpacker) fgis-952-2.xls www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-952 Sanitation Inspection Report (Processed Products) fgis-952.xls www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-956 Rice Inspection Services Certificate fgis-956.pdf www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-960 Official Grain Weight Certificate fgis-960.pdf www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-963 Scale Record Log FGIS-963_OMB.pdf www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-964 Supervision of Weight Certificate fgis-964.pdf www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-965-1 Scale Test Report (Railroad Track) fgis-965-1.xls www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-965-2 Scale Test Report (Vehicle) fgis-965-2.xls www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-965 Scale Test Report (Hopper) fgis-965.xls www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-968 Weight Loading Log fgis-968.pdf www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-980 Authorization to Use Mechanical Sampler fgis-980.doc www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-983 Contract Service Agreement fgis-983_f.pdf www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-992 Services Performed Report fgis-992.pdf www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-993 Commodity Inspection Certificate fgis-993.pdf www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-994 Commodity Inspection Certificate - Submitted Sample fgis-994.pdf www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-998 Questionnaire for Proposed Diverter Type Mechanical Samp fgis-998.xls www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-1001 Application for Approval to Operate as a Weighing Facili fgis-1001.pdf www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-9601 Repair/Modification Notice FGIS9601.doc www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS 907 Application for Inspection and Weighing Services - Mark 20150313153031150.pdf www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS 930 AMA Output Report - Mark up 20150313153117840.pdf www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction

Information Collection (IC) Details

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IC Title:

Reporting and Recordkeeping Requirements - State, Local, Tribal

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	FGIS 4	Application and Agreement for Contract Service	fgis-4.pdf	http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Yes	No	Fillable Printable
Form and Instruction	FGIS-100	Conflict of Interest Questionnaire	fgis-100.pdf	htt://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Yes	No	Fillable Printable
Form and Instruction	FGIS-904	Laboratory Scale Test	fgis-904.xls	http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Yes	No	Fillable Printable
Form and Instruction	FGIS-905	Official Sample-Lot Inspection Certificate	fgis-905.pdf	http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landilng	Yes	No	Fillable Printable
Form and Instruction	FGIS-907	Application for Inspection and Weighing Services	Revised fgis-907 030415.pdf	http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=lalnding&topic=landing	Yes	No	Fillable Printable
Form and Instruction	FGIS-909	Official Export Grain Inspection Certificate	fgis-909.pdf	http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Yes	No	Fillable Printable
Form and Instruction	FGIS-913	Warehouseman's Sample-lot Inspection	fgis-913.pdf	http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Yes	No	Fillable Printable
Form and Instruction	FGIS-914	Submitted Sample Inspection	fgis-914.pdf	http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Yes	No	Fillable Printable
Form and Instruction	FGIS-915	Official Stowage Examination Certificate	fgis-915.pdf	http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Yes	No	Fillable Printable
Form and Instruction	FGIS-921-2	Inspection Report - Insects in Grain	fgis-921-2-v3.doc	http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Yes	No	Fillable Printable
Form and Instruction	FGIS-921	Inspection Log	fgis-921.pdf	http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Yes	No	Fillable Printable
Form and Instruction	FGIS-922	Inspection and Weighing Report	fgis-922(1).pdf	http://www.gipsa.usda.gov/GIPSA/wepp?area=forms&subject=landing&topic=landing	Yes	No	Fillable Printable
Form and Instruction	FGIS-923	Moisture Meter Test	fgis-923.xls	http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Yes	No	Fillable Printable
Form and Instruction	FGIS-924	Barley Pearler and Sieve Test	fgis-924.xls	http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Yes	No	Fillable Printable
Form and Instruction	FGIS-925	Rice Checklist Form	fgis-925.xls	http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Yes	No	Fillable Printable
Form and Instruction	FGIS-927	Testweight Checktest	fgis-927.xls	http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Yes	No	Fillable Printable
Form and Instruction	FGIS-928	Dockage Checklist	fgis-928.xls	http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Yes	No	Fillable Printable
Form and Instruction	FGIS-930	AMA Output Report	FORM 930 - Revision.xls	http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Yes	No	Fillable Printable
Form and Instruction	FGIS-931	Approved Label for Inspected Machinery	fgis-931.pdf	http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Yes	No	Fillable Printable
Form and Instruction	FGIS-936	Sampler Condition Report	fgis-936.xls	http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Yes	No	Fillable Printable
Form and Instruction	FGIS-938	Report of Grain Inspected and Weighed for Export	fgis-938_f.pdf	http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Yes	No	Fillable Printable
Form and Instruction	FGIS-941	Request for Waiver of Inspection	fgis-941.pdf	http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Yes	No	Printable Only
Form and Instruction	FGIS-942	Application for Designation	fgis-942.pdf	http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Yes	No	Fillable Printable
Form and Instruction	FGIS-944	Application for License Under the USGSA and/or the AMA of 0946	fgis-944_f.pdf	http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Yes	No	Fillable Printable
Form and Instruction	FGIS-965-2	Scale Test Report (Vehicle)	fgis-965-2.xls	http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Yes	No	Fillable Printable
Form and Instruction	FGIS-965	Scale Test Report (Hopper)	fgis-965.xls	http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Yes	No	Fillable Printable
Form and Instruction	FGIS-968	Weight Loading Log	fgis-968.pdf	http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Yes	No	Fillable Printable
Form and Instruction	FGIS-980	Authorization to Use Mechanical Sampler	fgis-980.doc	http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Yes	No	Fillable Printable
Form and Instruction	FGIS-983	Contract Service Agreement	fgis-983_f.pdf	http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Yes	No	Fillable Printable
Form and Instruction	FGIS-945	Application for Registration	fgis-945.doc	http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Yes	No	Fillable Printable
Form and Instruction	FGIS-950	Warehouseman's Sample-Lot Inspection Service Contract	fgis-950.pdf	http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Yes	No	Fillable Printable
Form and Instruction	FGIS-952-1	Sanitation Inspection Report (Beans, Peas, and Lentils)	fgis-952-1.xls	http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Yes	No	Fillable Printable
Form and Instruction	FGIS-952-2	Sanitation Inspection Report (Overpacker)	fgis-952-2.xls	http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Yes	No	Fillable Printable
Form and Instruction	FGIS-952	Sanitation Inspection Report (Processed Products)	fgis-952.xls	http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Yes	No	Fillable Printable
Form and Instruction	FGIS-956	Rice Inspection Services Certificate	fgis-956.pdf	http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Yes	No	Fillable Printable
Form and Instruction	FGIS-960	Official Grain Weight Certificate	fgis-960.pdf	http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Yes	No	Fillable Printable
Form and Instruction	FGIS-963	Scale Record Log	FGIS-963_OMB.pdf	http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Yes	No	Fillable Printable
Form and Instruction	FGIS-964	Supervision of Weight Certificate	fgis-964.pdf	http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Yes	No	Fillable Printable
Form and Instruction	FGIS-965-1	Scale Test Report (Railroad Track)	fgis-965-1.xls	http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Yes	No	Fillable Printable
Form and Instruction	FGIS-992	Services Performed Report	fgis-992.pdf	http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Yes	No	Fillable Printable
Form and Instruction	FGIS-993	Commodity Inspection Certificate	fgis-993.pdf	http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Yes	No	Fillable Printable
Form and Instruction	FGIS-994	Commodity Inspection Certificate - Submitted Sample	fgis-994.pdf	http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Yes	No	Fillable Printable
Form and Instruction	FGIS-998	Questionnaire for Proposed Diverter Type Mechanical Sampler Installation	fgis-998.xls	http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Yes	No	Fillable Printable
Form and Instruction	FGIS-1001	Application for Approval to Operate as a Weighing Facility	fgis-1001.pdf	http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Yes	No	Fillable Printable
Form and Instruction	FGIS-9601	Repair/Modification Notice	FGIS9601.doc	http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Yes	No	Fillable Printable
Form and Instruction	FGIS 907	Application for Inspection and Weighing Services - Mark up	20150313153031150.pdf	http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Yes	No	Fillable Printable
Form and Instruction	FGIS 930	AMA Output Report - Mark up	20150313153117840.pdf	http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Yes	No	Fillable Printable

Federal Enterprise Architecture Business Reference Module

Line of Business: Natural Resources

Subfunction: Agricultural Innovation and Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 842

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Previously Approved
Annual Number of Responses for this IC	129,215	129,215
Annual IC Time Burden (Hours)	16,784	16,784
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.