FGIS 907 Application for Inspection and Weighing Services

This is a fillable form; fill out, print, sign original, and mail to service area FGIS Field Office.
U.S. DEPARTMENT OF AGRICULTURE
AGRICULTURAL MARKETING SERVICE
FEDERAL GRAIN INSPECTION SERVICE
APPLICATION FOR INSPECTION AND
WEIGHING SERVICES

FORM APPROVED OMB NO. 0580-0013. According to the Paperwork Reduction Act of 1995,
no persons are required to respond to a collection of information unless it displays a valid OMB
control number. The time required to complete this information collection is estimated to average
5 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.

Pursuant to Section 7 and 7a of the United States Grain Standards Act as amended (7 U.S.C. 79 and 79a) and the regulations thereunder (7 CFR 800 et.
seq.) and/or Section 203(h) of the Agricultural Marketing Act of 1946, as amended (7 U.S.C. 1622) and the regulations and standards thereunder
(7 CFR Parts 57 and 868), we apply for services described below

1. Type of Services (check all that apply)

Original Inspection

Reinspection

Appeal Inspection

Official Weighing

Review of Weighing

Board Appeal Inspection

Supervision of Weighing

Retest

3. Kind of Official Inspection Service Requested (check all that apply)
Official Sample Lot
Submitted Sample
Sampling
Official Weighing
Stowage Examination
Grade and Factor
Condition
Factors Only

2. Where are the services to be
performed (check one)

United States
Canada

Checkweigh/Checkload/Checkcount
Supervision of Weighing
Official Commercial
Other Criteria (list in remarks)

4. Type of Grain/Commodity

5. Location of Grain/Commodity

6. Contract Number (if applicable)

7. Carrier or Other Identification

8. Quantity (specify in pounds, bushels, etc.)

9. Contract Grade (Factor or Specifications)

10. Number and Kind of Containers

11. Container Markings

12. Appeal Request

File Sample
New Sample

13. Name, Address and Telephone Number of Applicant (Firm Name)

14. Name and Address of Interested Party (agent, consignee)

13a. Applicant FGIS Account Number:
15. Remarks

In submitting this application, we expressly agree that the fees and charges for the inspection and weighing services shall be assessable to and payable by us in
accordance with the fees and charges described in the regulations (7 CFR 800 et. seq.) under the United States Grain Standards Act and/or described in the regulations
(7 CFR 868) under the Agricultural Marketing Act of 1946. I declare that the foregoing statements are true to the best of my knowledge, information and belief.
16. Date (mm/dd/yy)

17. Name of Firm

18. Signature of Person Making Application

Warning: Attempts to influence any official personnel with respect to the performance of his/her duties under the U.S. Grain Standards Act may upon
conviction thereof, be subject to imprisonment for not more than 5 years and/or a fine of not more than $20,000. 18 U.S.C. 1001 provides for a fine of
not more than $10,000 or imprisonment for not more than 5 years, or both, for false or fraudulent statements made to an agency of the United States.
The offering of any gratuity, as described in 7 CFR 800.187, will be deemed an attempt to influence official inspection personnel.
For Use by FGIS
19. Application Received By

20. Date (mm/dd/yy)

23. Certificate No. or Nos.

24. Remarks

21. Field Office

22. Fees

FORM FGIS-907 (01/18) Previous editions are obsolete. Expires January 2021.

CLEAR FORM

25. Car Initials and
Number or other
Identification

1
2

26. Quantity
(Cargos) or Marked
Capacity Per Carlot
or Part Carlot

27. Kind of
Grain and
Reason For
Appeal 1
or Review

28. Requested
Sample Basis
(Check)
Official
File

New

29. Date 2 of
Original
Service

30. Check if
Original
Certificate
For The
Service is
Attached

31. Remarks

List factor(s) and/or other criteria in question. For requests filed in advance, show the scope of the inspection in question.
Show only date of inspection being appealed or weighing service being reviewed.

The conduct of all services and the licensing of (inspecting/grading/sampling) personnel under the regulations governing such
services shall be accomplished without discrimination as to race, color, religion, sex, national origin, age or handicap.
FORM FGIS-907 Reverse

Instructions for Completing FGIS 907
Action by Applicant. Complete items 1 through 18. Return the original to the appropriate FGIS field
office and retain a copy for your records.
1.

Check the box for the services needed. More than one box may be checked if a combination of
services is requested.

2.

Check the appropriate box to indicate whether the service is to be performed in the United States
or Canada.

3.

Check the box indicating the kind and scope of service being requested. For checkweigh,
checkload, checkcount services use the remarks section for the specific service requested.
Also, for condition of container examinations use the remarks section for this specific service.

4.

Enter the type of grain or commodity for the service being requested.

5.

Enter the location of the grain or commodity for the service being requested.

6.

Enter the contract number if applicable.

7.

Enter the carrier or identification for the service being requested.

8.

Enter the quantity in pounds, bushels etc., for the grain or commodity to be inspected.

9.
For inspections during loading, enter the contract grade along with any special grade or other

contract requirements. This information is not applicable to carriers that are to be inspected at
rest.
10.

Enter the number and kind of containers.

11.

Enter the container markings, use the words: “Standard”, “Commercial”, or “Special” for the type
of markings. For “Special” enter the complete container markings in the remarks section. If there
are no markings enter “None”. For bulk rice, enter “Bulk”.

12.

Check the box indicating the type of sample required:

13.

Enter the name and address of the applicant; i.e., the party that will be billed for the service.

13a. Enter the applicant’s FGIS Account number.
14.

If applicable enter the name and address of the agent or person of interest if any.

15.

Enter additional information if necessary.

16.

Enter the date the application was prepared.

17.

Enter the name of the firm that is requesting the service.

18.

Enter the name and signature of the person completing the application.

Action by field office. Review Form FGIS 907. If incomplete, either return the form to the applicant for
completion or insert and initial the missing information. Complete items 19 through 24:
19.

Enter the name of the person who received the application.

20.

Enter the date the application was received.

21.

Enter the name of the field office where the application was filed.

22.

Enter the amount of fees that are to be assessed.

23.

Enter the inspection certificate(s) numbers including the lettered prefix.

24.

Enter any additional pertinent information.

Action by Applicant. For appeal, Board appeal or review services complete items 25 through 31.
25.

Use the lot, carrier, or other identification shown on the certificate for the service in question.
Identify a barge by name, number and any letterhead prefixes and suffixes; a railcar by its
initials and number; a truck or trailer by license number and name or abbreviation of State
(include time of sampling when necessary); and a vessel its name preceded by its means of
propulsion (M/T, M/V, S/S, etc.)

26.

Enter the quantity in terms of bushels, pounds, weight loaded or unloaded, or to be loaded or
unloaded for cargos. For a lot of sacked grain, also enter the type, number, and weight of sacks;
e.g., 6000, 100-lb cotton sacks. For a truckload or trailerload, show truckload, trailerload, parttruckload or part-trailerload as the case may be. For a railcar, enter the marked capacity of the
carrier or “over 130 000 lb” or under 130 000 lb” as the case may be.

27.

Enter the grain and reason for the appeal, Board appeal, or review; e.g., the grade determining
factors or other criteria. For requests filed in advance, show the kind of grain and contract grade.

28.

Enter the sample basis desired for the appeal inspection. All Board appeal inspections will be
performed on the basis of the official file sample.

29.

Enter the date of the original service. For applications filed in advance of loading, enter the
expected date and time of loading if possible.

30.

Indicate whether the original certificate for the inspection being appealed is attached. If the
certificate is not attached, explain in item 31.

31.

Enter any additional pertinent information.

CONTACT INFORMATION:
Contact the field office responsible for the geographic area in which the service will be provided.
Details for these locations can be found on the FGIS website. The signed form should also be mailed to
this location. For further information on the Application for Inspection and Weighing Services contact:
Patrick McCluskey, Chief
Field Management Division
Policies, Procedures, and Market Analysis Branch
[email protected]