FAS-100 Report of Exports for Exporter's Own Account

FAX: 202-690-3270 or 3273

OMB Approval No. 0551-0007

FAS-100 Rev. 11-01

U. S. DEPARTMENT OF AGRICULTURE
Foreign Agricultural Service

REPORT OF EXPORTS FOR EXPORTER'S OWN ACCOUNT
NOTE:

This report is required by law (Section 602 of the Agricultural Trade Act of 1978, as amended). Any person who knowingly
fails to report export sales pursuant to requirement of this Law can be subject to a $25,000 fine or imprisonment for not
more than one year, or both.

IMPORTANT: Report should be typewritten or prepared in ink. TO BE TREATED AS CONFIDENTIAL information under Section
602 of the Agricultural Trade Act of 1978, as amended. Reference instructions for export sales report, a separate document.
EXPORTER (Name and Address)

1 REPORT FOR
PERSON(S) AUTHORIZED TO EXECUTE THIS
PERIOD ENDING FORM (Name, title, office location & phone number)
YR. MO. DA.
FIRM NO.

2

COMMODITY NAME

3

COMMODITY CODE

4

MARKETING YEAR
20_____ / _____

01

5 COUNTRY OF PRESENT LOCATION OR INTERMEDIATE DESTINATION

02

NAME

NAME

NAME

NAME

CODE

CODE

CODE

CODE

03
UNIT OF MEASURE AS SPECIFIED IN INSTRUCTIONS

6

Outstanding quantity exported for
200
exporter's own account (from Item 12 of
previous report

200

200

200

7

New exports made for exporter's own 210
account and/or changes in destination

210

210

210

8

Sum of 6 and 7

220

220

220

220

230

230

230

230

10 Decreases re sulting from sales to other 240
U.S. exporters, contract tolerances and
changes in destination

240

240

240

11 Sum of 9 and 10

250

250

250

250

12 Outstanding balance in exporter's own 260
account (8 minus 11)

260

260

260

DISPOSITION
9

Applied to new and/or outstanding sales.
Transfer to Form FAS -98, Item 7 (new
sales only ) and Item 13

REMARKS

CERTIFICATION
The undersigned hereby certifies that the information contained in this report of ___page(s) is an accurate statement. A false statement in
the certification may subject the undersigned to criminal and civil penalties under Federal statutes.
SIGNATURE

DATE

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 0551-0007. The time required to complete this information collection is estimated to average
30 minutes 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.