Information Collection

Reporting and Recordkeeping Requirements - State, Local, Tribal

IC 182961 under ICR 202101-0581-003 · OMB 0581-0309.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0581-0309 can be found here:

2025-03-24 - Revision of a currently approved collection

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form FGIS 4 Reporting and Recordkeeping Requirements - State, Local, Tribal	Form and Instruction
FGIS 4 Application and Agreement for Contract Service FGIS 4 1.21 (508).pdf www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-100 Conflict of Interest Questionnaire FGIS 100 1.21 (508).pdf htt://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-904 Laboratory Scale Test FGIS 904 1.21 (508).xlsx www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-905 Official Sample-Lot Inspection Certificate FGIS905.pdf www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landilng	Form and Instruction
FGIS-907 Application for Inspection and Weighing Services FGIS 907 1.21 (508).pdf www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=lalnding&topic=landing	Form and Instruction
FGIS-909 Official Export Grain Inspection Certificate FGIS909.pdf www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-913 Warehouseman's Sample-lot Inspection FGIS913.pdf www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-914 Submitted Sample Inspection FGIS914.pdf www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-915 Official Stowage Examination Certificate FGIS915.pdf www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-921-2 Inspection Report - Insects in Grain FGIS 921-2 1.21 (508).pdf www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-921 Inspection Log FGIS 921 1.21 (508).pdf www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-922 Inspection and Weighing Report FGIS 922 1.21 (508).pdf www.gipsa.usda.gov/GIPSA/wepp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-923 Moisture Meter Test FGIS 923 1.21 (508).xlsx www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-924 Barley Pearler and Sieve Test FGIS 924 1.21 (508).xlsx www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-925 Rice Checklist Form FGIS 925 1.21 (508).xlsx www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-927 Testweight Checktest FGIS 927 1.21 (508).xlsx www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-928 Dockage Checklist FGIS 928 1.21 (508).xlsx www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-930 AMA Output Report FGIS 930 1.21 (508).pdf www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-931 Approved Label for Inspected Machinery fgis-931.pdf www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-936 Sampler Condition Report FGIS 936 1.21 (508).xlsx www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-938 Report of Grain Inspected and Weighed for Export FGIS 938 1.21 (508).pdf www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-941 Request for Waiver of Inspection FGIS 941 1.21 (508).pdf www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-942 Application for Designation FGIS 942 1.21 (508).pdf www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-944 Application for License Under the USGSA and/or the AMA o FGIS 944 1.21.pdf www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-945 Application for Registration FGIS 945 1.21 (508).pdf www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-950 Warehouseman's Sample-Lot Inspection Service Contract FGIS 950 1.21 (508).pdf www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-952-1 Sanitation Inspection Report (Beans, Peas, and Lentils) FGIS 952-1 1.21 (508).pdf www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-952-2 Sanitation Inspection Report (Overpacker) FGIS 952-2 1.21 (508).pdf www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-952 Sanitation Inspection Report (Processed Products) FGIS 952 1.21 (508).pdf www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-956 Rice Inspection Services Certificate FGIS956.pdf www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-960 Official Grain Weight Certificate FGIS960.pdf www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-963 Scale Record Log FGIS-963_OMB.pdf www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-964 Supervision of Weight Certificate FGIS964.pdf www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-965-1 Scale Test Report (Railroad Track) FGIS 965-1 1.21 (508).xlsx www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-965-2 Scale Test Report (Vehicle) FGIS 965-2 1.21 (508).xlsx www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-965 Scale Test Report (Hopper) FGIS 965 1.21 (508).xlsx www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-968 Weight Loading Log FGIS 968 1.21 (508).pdf www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-980 Authorization to Use Mechanical Sampler FGIS 980 1.21 (508).pdf www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-983 Contract Service Agreement FGIS 983 1.21 (508).pdf www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-992 Services Performed Report FGIS 992 1.21 (508).pdf www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-993 Commodity Inspection Certificate FGIS993.pdf www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-994 Commodity Inspection Certificate - Submitted Sample FGIS994.pdf www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-998 Questionnaire for Proposed Diverter Type Mechanical Samp FGIS 998 1.21 (508).pdf www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-1001 Application for Approval to Operate as a Weighing Facili FGIS 1001 1.21 (508).pdf www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS-9601 Repair/Modification Notice FGIS 9601 1.21 (508).pdf www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS 907 Application for Inspection and Weighing Services - Mark 20150313153031150.pdf www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction
FGIS 930 AMA Output Report - Mark up 20150313153117840.pdf www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing	Form and Instruction

Information Collection (IC) Details

Record metadata
IC Title	Reporting and Recordkeeping Requirements - State, Local, Tribal