FGIS 956 Rice Inspection Services Certificate

FORM FGIS-956
JAN 07

Approved OMB No. 0580-0013

UNITED STATES DEPARTMENT OF AGRICULTURE
FEDERAL GRAIN INSPECTION SERVICE

AGRICULTURAL MARKETING ACT OF 1946
ORIGINAL

RICE INSPECTION SERVICES CERTIFICATE

US-STFO-1-00010

OFFICIAL WHITE CERTIFICATE

NOT NEGOTIABLE

EXAMPLE ONLY – NOT FOR OFFICIAL USE
LEVEL OF INSPECTION:

ISSUED AT:

Original

DATE OF SERVICE:

Kansas City, KS

IDENTIFICATION:

May 30, 2007

LOCATION:

SEE REMARKS

QUANTITY: (this is NOT a weight certificate)

Stuttgart, AR

TYPE OF MOVEMENT:

4,492,400 Pounds

DATE SAMPLED:

Out

METHOD OF SAMPLING:

May 30, 2007

GRADE AND COMMODITY:

Bag Trier

U.S. No. 1 Long Grain Milled Rice

RESULTS:

Objectionable Seeds 1 (% Preselected)
REMARKS:

Multiple Lot, Identity Preserved Inspection Inspection for quality, checkweighing, and checkloading, were performed
on December 28, 2006, December 30, 2006, January 2 - 7, 2007. The inspection for condition was performed prior to
loading. Condition of Container: Good Condition of Commodity: Good Condition of Carrier: Clean Quantity and
Container: 44,444 - 45 Kilo Polyweave Bags Marking: Arabic Writing/Picture of Sword/Arabic
Writing/American/Parboiled Rice/Grade 1/Long Grain/U.S.A. Product/Arabic Writing/45 KG. Net/Arabic Writing Arabic
Writing/Picture of Sword/(Trademark)/U.S.A. Long Grain Parboiled Rice/Grade 1/Product of U.S.A./By/******* /P.O.
Box ***/Stuttgart Arkansas 72160/U.S.A./Crop Year: 2006/2007/Arabic Writing/NON Genetically Modified Product
This rice does not contain live or dead weevils or other insects, insect webbing or insect refuse. This rice was
observed being fumigated with 408 grams of Gastoxin in each carrier after it was loaded but was not sampled and
examined after fumigation. Phyto Number: 7738932 U.S.D.A. F.G.I.S. Identity Preserved Code: TP-11 Estimated
Total Weight (Pounds): Gross – 4,504,844 Tare - 12,444 Net – 4,492,400 Applicant States: L/C W035057 issued
11/22/06 by Banque Saudi Fransi/JP Morgan Ref No. ISTE-295793 Shipper: TWEET ENTERPRIZES, P.O. BOX 211,
STUTTGART, ARKANSAS 72160 Consignee: TMC INC., 211 SOUTH LESLIE, STUTTGART, ARKANSAS 72160
TEL. 870 673 2509 FAX 870 673 2500 Identification Seal Number Date Sampled Quantity UP 560212 7512865-66
12/28/2006 1389 EEC 105 7512867-68 12/30/2006 1389 EEC 10216 7512869-70 12/30/2006 1389 NOKL 524014
7512871-72 12/30/2006 1389 CSXT 123404 7512873-74 12/30/2006 1389 RBOX 31289 7512875-76 1/2/2007 1389
EEC 1150 7512877-78 1/2/2007 1389 SSW 60752 7512879-80 1/2/2007 1389 SOU 526229 7512881-82 1/3/2007
1389 NS 4032443 7512883-84 1/3/2007 1389 MP 358140 7512885-86 1/3/2007 1389 SP 247757 7512887-88
1/3/2007 1389 EEC 485 7512889-90 1/3/2007 1389 SSW 59215 7512891-92 1/3/2007 1389 CSXT 507332 751289394 1/4/2007 1389 SP 231206 7512895-96 1/4/2007 1389 RBOX 43085 7512897-98 1/4/2007 1389 EEC 3108
7512899-900 1/4/2007 1389 VCY 764971 7511101-02 1/4/2007 1389 CSXT 142821 7511103-04 1/5/2007 1389 SOU
528267 7511105-06 1/5/2007 1389 SP 247694 7511107-08 1/5/2007 1389 GVSR 774181 7511109-10 1/5/2007 1389
CSXT 124754 7511111-12 1/5/2007 1389 SSW 67115 7511113-14 1/6/2007 1389 AGR 162 7511115-16 1/6/2007
1389 SSW 60678 7511117-18 1/6/2007 1389 CSXT 123580 7511119-20 1/6/2007 1389 BNSF 723154 7511121-22
1/7/2007 1389 EEC 2419 7511123-24 1/7/2007 1389 MP 369063 7511125-26 1/7/2007 1389 SP 253053 7511127-28
1/7/2007 1389

I CERTIFY THAT THE SERVICES SPECIFIED ABOVE WERE PERFORMED WITH THE RESULTS STATED.

APPLICANT NAME: Riceland Foods
ISSUING OFFICE:

NAME OR SIGNATURE: Diane K. Palecek

FGIS - Stuttgart Field Office

This certificate is issued under the authority of the Agricultural Marketing Act of 1946, as amended (7 U.S.C. 1621 et seq.), and the regulations thereunder (7 CFR 868.1 et seq.), and is receivable in all courts of the United States as prima facie
evidence of the truth of the statements therein contained. This certificate does not excuse failure to comply with the provisions of the Federal Food, Drug, and Cosmetic Act, or other Federal Laws.
WARNING: Sec. 203(h) of the Agricultural Marketing Act of 1946 provides that anyone who shall knowingly falsely make, issue, alter, forge, or counterfeit any official certificate, or aid, assist, or be party to such actions, is
subject to a fine of not more than $1000 or imprisonment for not more than 1 year, or both. The conduct of all services and the licensing of personnel under the regulations governing such services shall be accomplished without
discrimination as to race, color, religion, sex, national origin, age, or handicap.
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 0580-0013. The time required to complete this information collection is estimated to average 17 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.

EXAMPLE ONLY – NOT FOR OFFICIAL USE