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pdfU.S. Department Of Agriculture
Agricultural Marketing Service
Fair Trade Practices Program
Packers and Stockyards Division
TERMINATION OF TRUST AGREEMENT OR
TRUST FUND AGREEMENT
Part I – Termination
To be completed by the Regional Office of the Packers and Stockyards Division
1. Name of Registrant or Packer and Address
(Street, City, State, Zip+4, and Phone)
2. Name and Address of Trustee (Street, City,
State, Zip+4, and Phone)
Agreement Identification
3. Trust Agreement No.: ____________ OR 4. Trust Fund Agreement No.:_____________
5. Value of Collateral $_____________
7. Termination Date:
6. Original Effective Date: __________________
______________________________________________________
Part II – Statement of Obligations for Livestock Purchased or Sold On Commission
Your agreement is terminated thirty (30) days following the date of receipt of your request with
Packers and Stockyards Division.
The trustee is prohibited from releasing the collateral until a satisfactory showing has been made to the
Deputy Administrator, Agricultural Marketing Service, Fair Trade Practices Program, Packers and
Stockyards Division, that all obligations arising under the terms of the agreement have been satisfied.
Do Not complete this report until on or after the termination date listed on line 7. Then return this
form to the regional office handling your state.
8. Does the registrant or packer named in Part I, line 1 owe or have any outstanding obligations for
livestock purchased, or sold on commission, (including checks or drafts which have been issued in
payment for livestock which have not been presented for payment or actually paid) during the period in
which the agreement was in effect?
NO
YES
(If yes, please attach a list of livestock sellers to whom payment has not been made and the amount owed
each seller. List the amount and date of each check and draft that has been issued in payment for
livestock that has not been presented for payment and actually paid.)
Form PSD 2500
Expires 02/28/2021
Page 1 of 4
CERTIFICATION: With my signature, I certify the information provided on this form is true
and correct to the best of my knowledge and belief, I am an owner, officer, or member
authorized to certify this report.
9a.
Name of Registrant or Packer
9b.
Signature of Registrant or Packer
10. ____________________________________________________________
Date signed (must be on or after the termination date listed on line 7)
Return report to appropriate regional office; see separate instructions for information.
Part III – Collateral - TO BE COMPLETED BY PSD
Because the registrant or packer has certified that all obligations arising under the terms of
the agreement have been paid, we now authorize the trustee to release the collateral
pledged.
11. Date
12. Name of Supervisor
13. Signature of Supervisor
Execution of special report is required to insure all livestock sellers have received payment before collateral held under the trust
agreement or trust fund agreement will be released (9 CFR 201.34 (c)). Information held confidential (9 CFR 201.96).
The Packers and Stockyards Act, 1921, as amended and supplemented provides in part that: “Any person who shall willfully
make, or cause to be made, any false entry or statement of fact in any report required to be made under this Act ... shall be
deemed guilty of an offense against the United States, and shall be subject, upon conviction in any court of the United States of
competent jurisdiction, to a fine of not less than $1,000 nor more than $5,000, or to imprisonment for a term of not more than
three years, or to both such fine and imprisonment.”
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 is 0581-0308. The time required to complete this information collection is estimated to average 2.25 hours 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.
In accordance with Federal law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, this institution
is prohibited from discriminating on the basis of race, color, national origin, sex, age, disability, and reprisal or retaliation for
prior civil rights activity. (Not all prohibited bases apply to all programs.) 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 State or local Agency that administers the program 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 is also
available in languages other than English.
To file a complaint alleging discrimination, complete the USDA Program Discrimination Complaint Form, AD-3027, found
online at http://www.ascr.usda.gov/complaint_filing_cust.html, or 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: (a) mail: U.S. Department of Agriculture, Office of the Assistant Secretary
for Civil Rights, 1400 Independence Avenue, SW, Washington, D.C. 20250-9410; (b) fax: (202) 690-7442; or (c) email:
[email protected]
Form PSD 2500
Expires 02/28/2021
Page 2 of 4
Instructions to Complete
Termination of Trust Agreement or
Trust Fund Agreement
Form PSD 2500
If you, as a packer, market agency, or dealer wish to terminate your trust agreement or trust fund
agreement covering your livestock operation with the Packers and Stockyards Division (PSD), form PSD
2500 must be completed. Completion of the termination of trust agreement/trust fund agreement form
will initiate the procedure to release the collateral funding of the above referenced agreement.
On or after the termination date, as noted on the enclosed form PSD 2500, you, as the principal, must
sign and date the form and return it to the regional office of the PSD listed below. The states, provinces,
and territories covered by each regional office are listed below its address.
Regional Offices of the Packers and Stockyards Division
Agricultural Marketing Service, Fair Trade Practices Program
Atlanta Regional Office
Denver Regional Office
Des Moines Regional Office
75 Ted Turner Dr., SW, Ste 230
3950 Lewiston St., Suite 200
210 Walnut Street, Room 317
Atlanta, GA 30303-3308
Aurora, CO 80011-1556
Des Moines, IA 50309-2110
Telephone: (404) 562-5840
Telephone: (303) 375-4240
Telephone: (515) 323-2579
FAX: (404) 562-5848
FAX: (303) 371-4609
FAX: (515) 323-2590
e-mail:
e-mail:
e-mail:
[email protected]
[email protected]
[email protected]
States Covered
States Covered
States Covered
AL, AR, CT, DC, DE, FL, GA,
AB, AK, AZ, BC, CA, CO, HI,
IA, IL, IN, KY, MB, MI, MO, MN,
LA, MA, MD, ME, MS, NC, NH, ID, KS, MT, NM, NV, OK, OR, ND, NE, OH, ON, SD, WI
NJ, NL, NY, PA, PR, QC, RI, SC, SK, TX, UT, WA, WY
TN, VA, VT, WV
If you have any questions about the form or completing the form, please contact the appropriate regional
office of the Packers and Stockyards Division listed above.
The regional office of the PSD will complete Part I of the form (lines 1 through 7).
You, as the registrant/packer must complete Part II, including the certification (lines 8 through 10).
After you sign and return the form to the regional office, certifying you do not owe outstanding livestock
obligations, the regional office will sign and date Part III (lines 11 through 13), and forward the form to
the trustee as authorization to release the collateral funding the agreement. The regional office will retain
a copy for the registrant’s/packer’s files.
Form PSD 2500
Expires 02/28/2021
Page 3 of 4
Line
No.
8
9
a and b
10
11
through
13
Form PSD 2500
Subject
Instruction
Outstanding
Livestock
Obligations
Check the appropriate box to indicate whether you have outstanding
obligations for any livestock you have purchased or sold on
commission. If yes, attach a list of the sellers that have not yet been
paid, or presented their checks to the bank for payment. Include the
amount and date for each check or draft that has not been paid by
your financial institution.
The principal, or someone authorized to act on the principal’s behalf,
must print their name and sign the form.
Name and Signature
of Registrant or
Packer
Date Signed
Date, Name of
Supervisor and
Signature of
Supervisor
The form must be signed ON OR AFTER the date of termination, as
indicated in on line 7 of the form. If the form is signed prior to the
termination date, an additional copy of form PSD 2500 will be
mailed to you, as the Principal, for completion and signature,
AFTER the termination date.
This section is to be completed by the Packers and Stockyards
Division Regional Office.
Expires 02/28/2021
Page 4 of 4
File Type | application/pdf |
File Title | OMB NO |
Author | IRM |
File Modified | 2018-06-21 |
File Created | 2018-06-21 |