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pdfOMB CONTROL NO. 0581-0308
U.S. DEPARTMENT OF AGRICULTURE
AGRICULTURAL MARKETING SERVICE
FAIR TRADE PRACTICES PROGRAM
PACKERS AND STOCKYARDS DIVISION
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)).
1a. Complainant Name
1b. Complainant Address
1c. Complainant Telephone
1d. Complainant E-Mail
2a. Defendant Name
2b. Defendant Address
2c. Defendant Telephone
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
5a. Name of Business
where transaction
occurred:
5b. Address of Business
where transaction
occurred:
6. Briefly describe the transaction involved, including the terms of the contract or agreement and the
alleged violation. Attach all supporting documents and evidence. If space is insufficient, continue on
additional page and attach.
7. Itemize and explain how you calculated the amount claimed.
8. Date
9. Name of Complainant
10. Signature of Complainant
11. Title, if applicable
Form PSD 5000
Expires 02/28/2021
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OMB CONTROL NO. 0581-0308
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 1.5 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 5000
Expires 02/28/2021
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Instructions to Complete
Reparation Complaint
Form PSD 5000
If you believe you have been harmed by the actions of the stockyard owner, market agency or
dealer 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 the cause for action
occurs.
Mail two (2) copies of the completed form with supporting documentation to the appropriate
regional office of the Packers and Stockyards Division as listed below. Retain a copy for
your files.
Submit the completed form and documentation to the regional office of the Packers and
Stockyards Division as 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 Drive 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,
IA, IL, IN, KY, MB, MI, , MN,
LA, MA, MD, ME, MS, NC,
HI, ID, KS, MT, NM, NV,
MO, ND, NE, OH, ON, SD, WI
NH, NJ, NL, NY, PA, PR, QC,
OK, OR, SK, TX, UT, WA,
RI, SC, TN, VA, VT, WV
WY
Additional copies of the report may be obtained from the regional office covering your state, or
on our website located at www.ams.usda.gov. All inquiries concerning any section or part of a
section contained in the report can also be addressed to that regional office.
Line No.
Subject
1
Name, Address,
a,b,c,d Phone and e-mail of
Complainant
2
Name, Address and
a,b,c
Phone of Defendant
3
Date of Transaction
4
5a
Amount Claimed
Name of Business
5b
Location of
Transaction
Form PSD 5000
Instructions
Enter the name and street, city, state and zip+4, phone and email address of the complainant wishing to file a complaint of
reparation.
Enter the name and street, city, state and zip+4 and phone of
the stockyard owner, market agency or dealer the complaint is
being filed against.
Enter the date of the transaction upon which your based your
complaint.
Enter the amount you are claiming as damages.
Enter the name of the business where the transaction took
place.
Enter the street, city, state, zip+4 and phone of the business
where the transaction took place.
Expires 02/28/2021
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Line No.
Subject
6
Description of the
transaction
7
8
9
10
11
Itemize Amount
Claimed
Date
Name of
Complainant
Signature
Title
Instructions
Give a brief description of the events involving the transaction,
including the alleged violation(s). All supporting
documentation must be attached to the complaint.
Itemize the transaction and give an explanation of how you
calculated the amount of damages that you are claiming.
Enter the date you sign the complaint
Enter the name of the complainant.
The complainant must sign the form.
Enter the title of the complainant, if applicable.
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
(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 in
this subchapter1, or of an order of the Secretary made under this subchapter, 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.
1
The phrase “this subchapter,” currently used twice by the U.S.C. in the first sentence of section 309 (7 U.S.C. 210), did not
appear in the original statue. The original law referenced the provisions “of 304, 305, 306, or 307,” or of an order of the
Secretary made under “this title.” However, judicial precedent supports the broader interpretation reflected by the use of “this
subchapter” in the U.S.C., which means Title 333 of the Packers and Stockyards Act, 1921.
Form PSD 5000
Expires 02/28/2021
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File Type | application/pdf |
File Title | Microsoft Word - PSD 5000 ams |
Author | PLTolle |
File Modified | 2018-06-27 |
File Created | 2018-06-27 |