No Form Number BEEF--Certification of Non-Producer Status (re-seller)

CERTIFICATION OF NON-PRODUCER STATUS (FOR THE RESELLER)
Failure to pay the beef checkoff is a violation of federal law. This form must be properly completed and signed to be valid. You may by law be fined up to $10,000, imprisoned up to 5
years, or both, for knowingly or willfully making false statements within this document (18 U.S.C. §1001).

I CLAIM NON-PRODUCER STATUS ON

HEAD OF CATTLE WHICH I AM RESELLING ON
(number)

TO:
(date)

BUYER’S NAME/ADDRESS
I certify upon reselling these cattle in compliance with 7 CFR §1260.314 that I have purchased these cattle to
facilitate the transfer of ownership of these cattle to a third party and I am reselling these cattle no later than
10 days from the date I purchased them; or that I have purchased these cattle and upon transfer shall
receive only a sales commission or a service fee which was established prior to my purchase of the cattle.

I (the reseller) further certify that I purchased these cattle on

and:
(date(s))

(Check only one box)
OMB 0581-0093
1. I collected $1.00 per head; or
2. I received a Certification of Non-Producer Status from the person I purchased these cattle from; or
3. I purchased these cattle in a transaction in which I was not responsible for collecting the $1 per head
(Auction Market or Brand Inspector).
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 0581-0093. The
time required to complete this information collection is estimated to average 2 minutes per
response, including the time for reviewing instructions, searching existing data sources,
gathering and maintain the data needed, and completing and review the collection of
information.

(Rev. 04/17)

Person who owns these cattle at the time of sale and is
claiming Non-Producer status.

RESELLER’S NAME:

TAX ID #:

ADDRESS:

CITY:

STATE/ZIP:

SIGNATURE OF RESELLER:

In accordance with Federal civil rights law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, the USDA, its Agencies,
offices, and employees, and institutions participating in or administering USDA programs are prohibited from discriminating based on race, color,
national origin, religion, sex, gender identity (including gender expression), sexual orientation, disability, age, marital status, family/parental status,
income derived from a public assistance program, political beliefs, or reprisal or retaliation for prior civil rights activity, in any program or activity
conducted or funded by USDA (not all bases apply to all programs). Remedies and complaint filing deadlines vary by program or incident.
Persons with disabilities who require alternative means of communication for program information (e.g., Braille, large print, audiotape, American
Sign Language, etc.) should contact the responsible Agency or USDA’s TARGET Center at (202) 720-2600 (voice and TTY) or contact USDA
through the Federal Relay Service at (800) 877-8339. Additionally, program information may be made available in languages other than English.
To file a program discrimination complaint, complete the USDA Program Discrimination Complaint Form, AD-3027, found online at
http://www.ascr.usda.gov/complaint_filing_cust.html and at any USDA office or write a letter addressed to USDA and provide in the letter all of the
information requested in the form. To request a copy of the complaint form, call (866) 632-9992. Submit your completed form or letter to USDA by:
(1) mail: U.S. Department of Agriculture, Office of the Assistant Secretary for Civil Rights, 1400 Independence Avenue, SW., Washington, D.C.
20250-9410; (2) fax: (202) 690-7442; or (3) email: [email protected]. USDA is an equal opportunity provider, employer, and lender.

The following statements are made in accordance with the Privacy Act of 1974 (U.S.C. 522a) and the Paperwork Reduction Act of 1995, as amended. The
authority for requesting this information to be supplied on the form is the Beef Promotion and Research Act of 1985 (7 U.S.C. 2901-2911). Furnishing the
requested information is necessary for the administration of this program. Submission of the Tax Identification Number (TIN) or Employer Identification
Number (EIN) is mandatory, and will be used to determine affiliation or entity identity.
(rev. 04/17)

ABOUT THIS FORM
Get a Dollar or Get a Document! This expression has been used by the Beef Industry as a simple answer to an often asked
question. Every buyer is responsible for getting either a dollar or a document from a seller. We all understand that when
ownership of a bovine animal changes, a $1 is due for beef promotion and research. In some instances, however, a document
is accepted in place of the $1. This document is the “Certification of Non-Producer Status” form.
The “Certification of Non-Producer Status” form is to be used only by someone RESELLING cattle that they have purchased
and held not longer than 10 days. This RESELLER is considered to be a non-producer, and, therefore, exempt from the
checkoff on this transaction. This form is used to certify the number of head sold and whether or not the reseller was required
to collect a checkoff $1 when he/she purchased these cattle.
As the RESELLER you are responsible for filling in this form with the number of head of cattle being resold, the actual date
of the sale, your name or company name, tax ID number, your complete address. Completed information on the buyer
should also be filled in. Check the appropriate box certifying that when you purchased the cattle, you either collected the
checkoff $1, received a non-producer status form, or bought cattle in a transaction in which you were not responsible for
collecting the checkoff (auction market or brand inspector collected). For the form to be acceptable to the buyer, ALL of this
information must be completed and the form must be signed.

THIS FORM MUST BE SIGNED BY THE RESELLER IN ORDER TO BE VALID.

(rev. 04/17)

THIS BOOK ISSUED TO:
NAME/COMPANY:
ADDRESS:
CITY:
(rev. 04/17)

STATE:

ZIP:

INSTRUCTIONS
1.

Certificate must be filled out correctly and completely. When completed, it must then be given to the purchaser of your
cattle, otherwise the purchaser is required under Federal Law to deduct the $1 per head.

2.

A NON-PRODUCER is one who:
{a} received only a commission, handling fee, or other service fee from the proceeds of the cattle sale;
{b} acquired title of cattle to facilitate the transfer of ownership of such cattle from the seller to a third party, and resold
such cattle no later than 10 days from the date on which the person acquired ownership; and
{c} has proof from the Bill of Sale or other documentation that the $1-per-head assessment was collected on the
previous sale of these cattle.

PENALTIES
You may by law, be fined up to $10,000, imprisoned up to 5 years, or both for knowingly or willfully making false statements
within this document. {18 U.S.C. §1001).
(rev. 04/17)