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Reporting and Recordkeeping Requirements - State, Local, Tribal
Reporting and Recordkeeping Requirements (US Grain Standards Act and Agricultural Marketing Act of 1946)
OMB: 0581-0309
IC ID: 182961
OMB.report
USDA/AMS
OMB 0581-0309
ICR 202101-0581-003
IC 182961
( )
Documents and Forms
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
View Information Collection (IC)
IC Title:
Reporting and Recordkeeping Requirements - State, Local, Tribal
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
Modified
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Form and Instruction
FGIS 4
Application and Agreement for Contract Service
FGIS 4 1.21 (508).pdf
http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing
Yes
No
Fillable Printable
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
Yes
No
Fillable Printable
Form and Instruction
FGIS-904
Laboratory Scale Test
FGIS 904 1.21 (508).xlsx
http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing
Yes
No
Fillable Printable
Form and Instruction
FGIS-905
Official Sample-Lot Inspection Certificate
FGIS905.pdf
http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landilng
Yes
No
Fillable Printable
Form and Instruction
FGIS-907
Application for Inspection and Weighing Services
FGIS 907 1.21 (508).pdf
http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=lalnding&topic=landing
Yes
No
Fillable Printable
Form and Instruction
FGIS-909
Official Export Grain Inspection Certificate
FGIS909.pdf
http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing
Yes
No
Fillable Printable
Form and Instruction
FGIS-913
Warehouseman's Sample-lot Inspection
FGIS913.pdf
http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing
Yes
No
Fillable Printable
Form and Instruction
FGIS-914
Submitted Sample Inspection
FGIS914.pdf
http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing
Yes
No
Fillable Printable
Form and Instruction
FGIS-915
Official Stowage Examination Certificate
FGIS915.pdf
http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing
Yes
No
Fillable Printable
Form and Instruction
FGIS-921-2
Inspection Report - Insects in Grain
FGIS 921-2 1.21 (508).pdf
http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing
Yes
No
Fillable Printable
Form and Instruction
FGIS-921
Inspection Log
FGIS 921 1.21 (508).pdf
http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing
Yes
No
Fillable Printable
Form and Instruction
FGIS-922
Inspection and Weighing Report
FGIS 922 1.21 (508).pdf
http://www.gipsa.usda.gov/GIPSA/wepp?area=forms&subject=landing&topic=landing
Yes
No
Fillable Printable
Form and Instruction
FGIS-923
Moisture Meter Test
FGIS 923 1.21 (508).xlsx
http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing
Yes
No
Fillable Printable
Form and Instruction
FGIS-924
Barley Pearler and Sieve Test
FGIS 924 1.21 (508).xlsx
http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing
Yes
No
Fillable Printable
Form and Instruction
FGIS-925
Rice Checklist Form
FGIS 925 1.21 (508).xlsx
http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing
Yes
No
Fillable Printable
Form and Instruction
FGIS-927
Testweight Checktest
FGIS 927 1.21 (508).xlsx
http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing
Yes
No
Fillable Printable
Form and Instruction
FGIS-928
Dockage Checklist
FGIS 928 1.21 (508).xlsx
http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing
Yes
No
Fillable Printable
Form and Instruction
FGIS-930
AMA Output Report
FGIS 930 1.21 (508).pdf
http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing
Yes
No
Fillable Printable
Form and Instruction
FGIS-931
Approved Label for Inspected Machinery
fgis-931.pdf
http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing
Yes
No
Fillable Printable
Form and Instruction
FGIS-936
Sampler Condition Report
FGIS 936 1.21 (508).xlsx
http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing
Yes
No
Fillable Printable
Form and Instruction
FGIS-938
Report of Grain Inspected and Weighed for Export
FGIS 938 1.21 (508).pdf
http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing
Yes
No
Fillable Printable
Form and Instruction
FGIS-941
Request for Waiver of Inspection
FGIS 941 1.21 (508).pdf
http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing
Yes
No
Printable Only
Form and Instruction
FGIS-942
Application for Designation
FGIS 942 1.21 (508).pdf
http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing
Yes
No
Fillable Printable
Form and Instruction
FGIS-944
Application for License Under the USGSA and/or the AMA of 0946
FGIS 944 1.21.pdf
http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing
Yes
No
Fillable Printable
Form and Instruction
FGIS-945
Application for Registration
FGIS 945 1.21 (508).pdf
http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing
Yes
No
Fillable Printable
Form and Instruction
FGIS-950
Warehouseman's Sample-Lot Inspection Service Contract
FGIS 950 1.21 (508).pdf
http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing
Yes
No
Fillable Printable
Form and Instruction
FGIS-952-1
Sanitation Inspection Report (Beans, Peas, and Lentils)
FGIS 952-1 1.21 (508).pdf
http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing
Yes
No
Fillable Printable
Form and Instruction
FGIS-952-2
Sanitation Inspection Report (Overpacker)
FGIS 952-2 1.21 (508).pdf
http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing
Yes
No
Fillable Printable
Form and Instruction
FGIS-952
Sanitation Inspection Report (Processed Products)
FGIS 952 1.21 (508).pdf
http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing
Yes
No
Fillable Printable
Form and Instruction
FGIS-956
Rice Inspection Services Certificate
FGIS956.pdf
http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing
Yes
No
Fillable Printable
Form and Instruction
FGIS-960
Official Grain Weight Certificate
FGIS960.pdf
http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing
Yes
No
Fillable Printable
Form and Instruction
FGIS-963
Scale Record Log
FGIS-963_OMB.pdf
http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing
Yes
No
Fillable Printable
Form and Instruction
FGIS-964
Supervision of Weight Certificate
FGIS964.pdf
http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing
Yes
No
Fillable Printable
Form and Instruction
FGIS-965-1
Scale Test Report (Railroad Track)
FGIS 965-1 1.21 (508).xlsx
http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing
Yes
No
Fillable Printable
Form and Instruction
FGIS-965-2
Scale Test Report (Vehicle)
FGIS 965-2 1.21 (508).xlsx
http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing
Yes
No
Fillable Printable
Form and Instruction
FGIS-965
Scale Test Report (Hopper)
FGIS 965 1.21 (508).xlsx
http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing
Yes
No
Fillable Printable
Form and Instruction
FGIS-968
Weight Loading Log
FGIS 968 1.21 (508).pdf
http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing
Yes
No
Fillable Printable
Form and Instruction
FGIS-980
Authorization to Use Mechanical Sampler
FGIS 980 1.21 (508).pdf
http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing
Yes
No
Fillable Printable
Form and Instruction
FGIS-983
Contract Service Agreement
FGIS 983 1.21 (508).pdf
http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing
Yes
No
Fillable Printable
Form and Instruction
FGIS-992
Services Performed Report
FGIS 992 1.21 (508).pdf
http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing
Yes
No
Fillable Printable
Form and Instruction
FGIS-993
Commodity Inspection Certificate
FGIS993.pdf
http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing
Yes
No
Fillable Printable
Form and Instruction
FGIS-994
Commodity Inspection Certificate - Submitted Sample
FGIS994.pdf
http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing
Yes
No
Fillable Printable
Form and Instruction
FGIS-998
Questionnaire for Proposed Diverter Type Mechanical Sampler Installation
FGIS 998 1.21 (508).pdf
http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing
Yes
No
Fillable Printable
Form and Instruction
FGIS-1001
Application for Approval to Operate as a Weighing Facility
FGIS 1001 1.21 (508).pdf
http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing
Yes
No
Fillable Printable
Form and Instruction
FGIS-9601
Repair/Modification Notice
FGIS 9601 1.21 (508).pdf
http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing
Yes
No
Fillable Printable
Form and Instruction
FGIS 907
Application for Inspection and Weighing Services - Mark up
20150313153031150.pdf
http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing
Yes
No
Fillable Printable
Form and Instruction
FGIS 930
AMA Output Report - Mark up
20150313153117840.pdf
http://www.gipsa.usda.gov/GIPSA/webapp?area=forms&subject=landing&topic=landing
Yes
No
Fillable Printable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Natural Resources
Subfunction:
Agricultural Innovation and Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
842
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
0 %
Requested
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
129,215
0
0
0
129,215
0
Annual IC Time Burden (Hours)
16,784
0
0
0
16,784
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
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Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.