AMS-71 form WA-502

AMS-71.xlsm

Warehouse Regulations Under the United States Warehouse Act

AMS-71 form WA-502

OMB: 0581-0305

Document [xlsx]
Download: xlsx | pdf















INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.
TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO.







Notice of Request for Revision to and Extension of a Currently Approved Information Collection; United States Warehouse Act (USWA) 0581-0305




DATE PREPARED


September 3, 2020
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT
ANNUAL BURDEN








REPORTS RECORDS





















TOTAL






FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD-
SECTION OF DESCRIPTION (If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS
REGS.




so state)
PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J)








RESPONDENT



KEEPER
(A) (B) (C) (D) (E) (F) (G) (H) (I) (J) (K)
US Warehouse Act 735 Application for License or Modification of License for the Conduct of a Public Warehouse WA-50 500 1.0000 500.00 0.0800 40.00

0.00
USWA USWA 735; 7 CFR 1423, 7 CFR 1427.1081 Financial Statement Supplement (for Agricultural Products) WA-51-2 3,000 1.0000 3,000.00 0.7500 2,250.00

0.00
USWA 735 Application for a License to Inspect, Classify, Sample, and/or Weigh Agricultural Products under the United States Warehouse Act WA-53 2,100 1.0000 2,100.00 0.2500 525.00

0.00
USWA 735 Bond to Cover Lost Paper Warehouse Receipts under the United States Warehouse Act (occasionally) WA-62 20 1.0000 20.00 0.5000 10.00

0.00
735 Receipt Signature Authority (occasionally) WA-70 1,000 1.0000 1,000.00 0.2500 250.00

0.00
735 Warehouse Operator's Bond & Related Forms WA-80 204 1.0000 204.00 0.2500 51.00

0.00

Warehouse Operator's Bond & Related Forms (10 for each form of WA-81, WA-82, WA-83, WA-84, WA-85, WA-87, WA-88, WA-89, WA-90, WA-91) WA-81, 82, 83, 84, 85, 87, 88, 89, 90, 91 100 1.0000 100.00 0.2500 25.00

0.00

SUBTOTAL


6,924.00
3,151.00

0.00

TOTAL OF ALL PAGES


17,762.00
8,115.50 1,249.00
32,474.00
TOTAL - COLUMNS "F" AND "I" = OMB 831, 13 b; COLUMNS "H" AND "K" = OMB 831, 13c


19,011.00
40,589.50















































INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.
TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO.







Notice of Request for Revision to and Extension of a Currently Approved Information Collection; United States Warehouse Act (USWA) 0581-0305




DATE PREPARED


September 3, 2020
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT
ANNUAL BURDEN








REPORTS RECORDS





















TOTAL






FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD-
SECTION OF DESCRIPTION (If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS
REGS.




so state)
PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J)








RESPONDENT



KEEPER
(A) (B) (C) (D) (E) (F) (G) (H) (I) (J) (K)
USWA 735 Returned & Destroyed Receipt Record WA-105 100 1.0000 100.00 0.2500 25.00

0.00
USWA 735, 7 CFR 1423.9 Memorandum of Adjustments (occasionally) WA-125 700 1.0000 700.00 0.5000 350.00

0.00
7 CFR 1427.1082, 7 CFR 1427.1084 Memorandum of Adjustments (Electronic response) (occasionally) WA-125ER 20 1.0000 20.00 0.5000 10.00

0.00
USWA 735 Certificate of Loss of Canceled/Uncanceled Warehouse Receipts (Affidavit) WA-139 200 1.0000 200.00 0.2500 50.00

0.00
USWA 735 Agreement to Assume Agricultural Product Storage Obligations WA-140 77 1.0000 77.00 0.2500 19.25

0.00
USWA 735 Agreement with Respect to Agricultural Product Storage Obligations WA-141 77 1.0000 77.00 0.2500 19.25

0.00

SUBTOTAL


1,174.00
473.50 0
0.00













































INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.
TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO.







Notice of Request for Revision to and Extension of a Currently Approved Information Collection; United States Warehouse Act (USWA) 0581-0305




DATE PREPARED


September 3, 2020
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT
ANNUAL BURDEN








REPORTS RECORDS





















TOTAL






FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD-
SECTION OF DESCRIPTION (If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS
REGS.




so state)
PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J)








RESPONDENT



KEEPER
(A) (B) (C) (D) (E) (F) (G) (H) (I) (J) (K)
USWA 735, 7 CFR 1427.1084 Warehouse Examination Reports (Cotton) (10 min for each form) WA-220, WA-221, WA-222 140 1.0000 140.00 0.5000 70.00

0.00
USWA 735 Warehouse Operator's Statement and Examiner's Comparison of Obligated Stocks WA-225 140 1.0000 140.00 0.5000 70.00

0.00
USWA 735 Order for Printing U.S. Warehouse Receipt Forms WA-237 50 1.0000 50.00 0.1700 8.50

0.00
USWA 735, 7 CFR 1423.9 Warehouse Examination Report (Grain & Misc.) (15 min for each form) WA-302, WA-303 3,200 1.0000 3,200.00 0.5000 1,600.00

0.00
USWA 735, 7 CFR 1423.9, 7 CFR 1427.1084 Warehouse Operator's Statement and Examiner's Comparison of Obligations and Stocks WA-308 3,200 1.0000 3,200.00 0.5000 1,600.00

0.00
USWA 735 Schedule of Charges -- Tariff for Storing and Handling Agricultural Products WA-372 (no required format) 800 1.0000 800.00 0.2500 200.00

0.00

SUBTOTAL


7,530.00
3,548.50 0
0.00




























































INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.
TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO.







Notice of Request for Revision to and Extension of a Currently Approved Information Collection; United States Warehouse Act (USWA) 0581-0305




DATE PREPARED


September 3, 2020
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT
ANNUAL BURDEN








REPORTS RECORDS





















TOTAL






FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD-
SECTION OF DESCRIPTION (If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS
REGS.




so state)
PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J)








RESPONDENT



KEEPER
(A) (B) (C) (D) (E) (F) (G) (H) (I) (J) (K)
USWA 735 Licensing Agreement for Export Food Aid Commodity Warehouse Operators WA-502 10 1.0000 10.00 0.7500 7.50 10 26.000 260.00
7 CFR 1423, USWA 735 Original Warehouse Examination Report (Processed Commodities) WA-561 50 1.0000 50.00 0.5000 25.00

0.00
7 CFR 1423.9, USWA 735 Subsequent Examination Report (Processed Commodities) WA-562 50 1.0000 50.00 0.5000 25.00

0.00
7 CFR 1423.9, USWA 735 Inventory Adjustment Notice WA-570 50 1.0000 50.00 0.5000 25.00

0.00
7 CFR 1423.9, USWA 735 Port Facility Examination Checklist WA-580 10 1.0000 10.00 0.5000 5.00

0.00
7 CFR 1423.9, USWA 735 Transloading Examination Checklist WA-580-1 10 1.0000 10.00 0.5000 5.00

0.00

SUBTOTAL


180.00
92.50 10
260.00




























































INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.
TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO.







Notice of Request for Revision to and Extension of a Currently Approved Information Collection; United States Warehouse Act (USWA) 0581-0305




DATE PREPARED


September 3, 2020
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT
ANNUAL BURDEN








REPORTS RECORDS





















TOTAL






FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD-
SECTION OF DESCRIPTION (If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS
REGS.




so state)
PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J)








RESPONDENT



KEEPER
(A) (B) (C) (D) (E) (F) (G) (H) (I) (J) (K)
USWA 735 Addendum to the Terms and Conditions of the Licensing/Provider Agreement WA-400 100 1.0000 100.00 0.5000 50.00


USWA 735 Licensing Agreement for Cotton Warehouse Operators WA-401 204 1.0000 204.00 0.5000 102.00 204 26.000 5,304.00
USWA 735 Licensing Agreement for Grain and Rice Warehouse Operators WA-402 1,000 1.0000 1,000.00 0.5000 500.00 1,000 26.000 26,000.00
USWA 735 Licensing Agreement for Wool Warehouses WA-403 0 0.0000 0.00 0.0000 0.00

0.00
USWA 735 Licensing Agreement for Tobacco Warehouses WA-404 0 0.0000 0.00 0.0000 0.00

0.00
USWA 735 Licensing Agreement for Nut Warehouse Operators WA-405 10 1.0000 10.00 0.5000 5.00 10 26.000 260.00

SUBTOTAL


1,314.00
657.00 1,214
31,564.00




























































INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.
TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO.







Notice of Request for Revision to and Extension of a Currently Approved Information Collection; United States Warehouse Act (USWA) 0581-0305




DATE PREPARED


September 3, 2020
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT
ANNUAL BURDEN








REPORTS RECORDS





















TOTAL






FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD-
SECTION OF DESCRIPTION (If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS
REGS.




so state)
PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J)








RESPONDENT



KEEPER
(A) (B) (C) (D) (E) (F) (G) (H) (I) (J) (K)
USWA 735 Licensing Agreement for Dry Bean Warehouse Operators WA-406 15 1.0000 15.00 0.5000 8.00 15 26.000 390.00
USWA 735 Licensing Agreement for Sweeteners Warehouses WA-407 0 0.0000 0.00 0.0000 0.00

0.00
USWA 735 Licensing Agreement for Cottonseed Warehouses WA-408 0 0.0000 0.00 0.0000 0.00

0.00
USWA 735 Provider Agreement to Electronically File & Maintain Warehouse Receipts & USWA Documents WA-460 10 1.0000 10.00 0.5000 5.00 10 26.000 260.00
USWA 735 Addendum to the Provider Agreement to Electronically Maintain Cotton Warehouse Receipts WA-460-1 10 1.0000 10.00 0.5000 5.00

0.00
USWA 735 Addendum to the Provider Agreement to Electronically File & Maintain Grain Warehouse Receipts and USWA Documents WA-460-2 10 1.0000 10.00 0.5000 5.00

0.00

SUBTOTAL


45.00
23.00 25
650.00




























































INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.
TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO.







Notice of Request for Revision to and Extension of a Currently Approved Information Collection; United States Warehouse Act (USWA) 0581-0305




DATE PREPARED


September 3, 2020
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT
ANNUAL BURDEN








REPORTS RECORDS





















TOTAL






FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD-
SECTION OF DESCRIPTION (If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS
REGS.




so state)
PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J)








RESPONDENT



KEEPER
(A) (B) (C) (D) (E) (F) (G) (H) (I) (J) (K)
USWA 735 Addendum to the Provider Agreement to Electronically File & Maintain Wool Warehouse Receipts WA-460-3 0 0.0000 0.00 0.0000 0.00

0.00
USWA 735 Addendum to the Provider Agreement to Electronically File & Maintain Tobacco Warehouse Receipts WA-460-4 0 0.0000 0.00 0.0000 0.00

0.00
USWA 735 Addendum to the Provider Agreement to Electronically File & Maintain Nut Warehouse Receipts WA-460-5 0 0.0000 0.00 0.0000 0.00

0.00
USWA 735 Addendum to the Provider Agreement to Electronically File & Maintain Dry Bean Warehouse Receipts WA-460-6 0 0.0000 0.00 0.0000 0.00

0.00
USWA 735 Addendum to the Provider Agreement to Electronically File & Maintain Sweetener Warehouse Receipts WA-460-7 0 0.0000 0.00 0.0000 0.00

0.00
USWA 735 Addendum to the Provider Agreement to Electronically File & Maintain Cottonseed Warehouse Receipts WA-460-8 0 0.0000 0.00 0.0000 0.00

0.00

SUBTOTAL


0.00
0.00 0
0.00




























































INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.
TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO.







Notice of Request for Revision to and Extension of a Currently Approved Information Collection; United States Warehouse Act (USWA) 0581-0305




DATE PREPARED


September 3, 2020
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT
ANNUAL BURDEN








REPORTS RECORDS





















TOTAL






FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD-
SECTION OF DESCRIPTION (If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS
REGS.




so state)
PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J)








RESPONDENT



KEEPER
(A) (B) (C) (D) (E) (F) (G) (H) (I) (J) (K)
USWA 735 Addendum to the Provider Agreement to Electronically File & Maintain Rice Warehouse Receipts WA-460-9 10 1.0000 10.00 0.5000 5.00

0.00
USWA 735 Addendum to the Provider Agreement to Electronically File & Maintain Coffee Warehouse Receipts WA-460-11 10 1.0000 10.00 0.5000 5.00

0.00
USWA 735 Addendum to the Provider Agreement to Electronically File & Maintain Cocoa Warehouse Receipts WA-460-12 10 1.0000 10.00 0.5000 5.00

0.00
USWA 735 Addendum to the Provider Agreement to Electronically File & Maintain Orange Juice Warehouse Receipts WA-460-13 10 1.0000 10.00 0.5000 5.00

0.00
USWA 735 Provider Agreement to Electronically File & Maintain Other Electronic Documents WA-490 10 1.0000 10.00 0.5000 5.00

0.00
USWA 735 Addendum to the Provider Agreement to Electronically File & Maintain Other Electronic Documents WA-490-1 10 1.0000 10.00 0.5000 5.00

0.00

SUBTOTAL


60.00
30.00 0
0.00




























































INSTRUCTIONS: Use this form when a single information collection document involves multiple reporting and recordkeeping requirements. The totals of the figures in cols. should be entered in item 13 of OMB-83-1: cols. (D) &/or (I) = 13a (respondent is only counted once); cols. F & I = 13b; cols. H & K = 13c. (F)Total/(D)Total = (E)Average (H)Total/(F)Total = (G)Average (K)Total/(I)Total = (J)Average
NOTE: The columns will calculate automatically. If Col. E's response is something other than annually, i.e., 1/6 years, list as "1/6" & decimal will display.
TITLE OF INFORMATION COLLECTION DOCUMENT OMB NO.







Notice of Request for Revision to and Extension of a Currently Approved Information Collection; United States Warehouse Act (USWA) 0581-0305




DATE PREPARED


September 3, 2020
IDENTIFICATION OF REPORTING OR RECORDKEEPING REQUIREMENT
ANNUAL BURDEN








REPORTS RECORDS





















TOTAL






FORMS NO (S) NO. OF NO OF TOTAL ANNUAL HOURS TOTAL NO. OF ANNUAL RECORD-
SECTION OF DESCRIPTION (If "none" RESPONDENTS RESPONSES RESPONSES PER HOURS RECORD- HOURS PER KEEPING HOURS
REGS.




so state)
PER (Col. D x E) RESPONSE (Col. F x G) KEEPERS RECORD- (Col. I x J)








RESPONDENT



KEEPER
(A) (B) (C) (D) (E) (F) (G) (H) (I) (J) (K)
USWA 735, 7 CFR 1423.2, 7 CFR 1427.1082 Warehouse Operator to Submit Reports, as requested, on operations, contents, commodity conditions No required format 500 1.0000 500.00 0.2500 125.00

0.00
USWA 735 Warehouse Operator to Submit Notices of Removal of Commodities from Storage No required format 25 1.0000 25.00 0.4000 10.00

0.00
USWA 735 Warehouse Operator to Report Occurrences of Disasters or Losses FAX, memo, or other appropriate means 10 1.0000 10.00 0.5000 5.00

0.00





0.00
0.00

0.00





0.00
0.00

0.00





0.00
0.00

0.00

SUBTOTAL


535.00
140.00 0
0.00
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File Modified0000-00-00
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