LP-48 Soybean Certification of Non-Producer Status

U.S. DEPARTMENT OF AGRICULTURE AGRICULTURAL MARKETING SERVICE LIVESTOCK AND SEED PROGRAM

SOYBEAN PROMOTION, RESEARCH, AND CONSUMER INFORMATION PROGRAM (SPARC)

OMB NO. 0581-0093

A program of promotion, research, and consumer information designed to strengthen, expand, and develop new foreign and domestic markets for soybeans and soybean products

STATEMENT OF CERTIFICATION OF NON-PRODUCER STATUS

INSTRUCTIONS: Certificate must be filled out correctly and completely. When completed it must be given to the purchaser of your soybeans, otherwise the purchaser is required under Federal Law to deduct ½ percent of 1 percent of the net market price from the final settlement.

Information on this form is required by (7 CFR 1220.241). Information is held confidential (7 CFR 1220.243).

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).

_{SELLERS STATEMENT}

I claim non-producer status for

bushels of soybeans which I am selling this date:

, 20 .

SELLERS NAME

_ADDRESS

_{CITY, STATE, ZIP}

CERTIFICATION STATEMENT

I certify that I have purchased the soybeans to be sold in the transaction accompanying this certification and therefore do not owe an assessment on such soybeans.

_{(CHECK APPROPRIATE BOX)}

I collected ½ percent of 1 percent of the net market value when beans were purchased.

I received a Statement of Certification of Non-Producer status (Form No. LP-48) from the person from whom I purchased these beans.

IDENTIFICATION NUMBER

_{SIGNATURE OF SELLER}

_{POSITION/TITLE}

_DATE

Name and address of company or individual reporting this transaction on their SOYBEAN REPORT AND REMITTANCE FORM (Form No. LP-46)

(persons or entity to whom you are giving this certificate).

BUYERS NAME

_ADDRESS

_{CITY, STATE, ZIP}

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 .03 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.

LP-48 (Expiration Date XX/XX/XXXX) See reverse for burden/non-discrimination statement

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.

LP-48 (Expiration Date XX/XX/XXXX)