PSD- 7002 Stmt. of Assets, Liabilities, & Equity Special Rept.

OMB No. 0581-0308
Business Entity ID Number

For PSD Use Only

U.S. Department of Agriculture
Agricultural Marketing Service
Fair Trade Practices Program
Packers and Stockyards Division

PSD Bar Code Only

STATEMENT OF ASSETS, LIABILITIES,
AND EQUITY SPECIAL REPORT

Instructions: If an item's value is zero, enter "0". If an item does not apply, enter "NA". If a line does
not apply, enter "N/A". Return completed form to the appropriate P&SP regional office. See separate
instructions for complete information about this report.
GENERAL INFORMATION - SECTION 1
101

Reporting Date
(mm/dd/yyyy)

102 Entity Name
103 Trade Name/d.b.a.
104 Mailing Address
105 City, State, Zip + 4
106 Operating Address
107 City, State, Zip+4
108 Contact Name
109 Contact Telephone

110 Fax Number

111 E-Mail Address

112 Web Address
ASSETS, LIABILITIES, AND EQUITY - SECTION 2

ASSETS
Current Assets:
Cash (Enter overdrafts on line 223)

201

$

Overage in Custodial Bank Account (Enter shortage on line 224)

202

$

Current Cash Equivalents (CD's, Savings, etc.)

203

$

206

$

210

$

213

$

Advances Made on Livestock, Meat and Meat Products

214

$

Other Current Assets

215

$

Trade Accounts Receivable-Net (Due in 1 year or less):
Owners, Officers, and Affiliated Companies

204

$

All Others (Sources Not Related to Company)

205

$

Total Trade Accounts Receivables-Net (Due in 1 year or less) (Total of lines 204 and 205)
Inventory:
Livestock Inventory

207

$

Meat and Meat Products Inventory

208

$

Other Inventory

209

$

Total Inventories (Total lines 207, 208 and 209)
Notes and Loans Receivable (Due in 1 year or less):
Owners, Officers, and Related Entities

211

$

Others (Sources Not Related to Company)

212

$

Total Notes and Loans Receivable (Due in 1 year or less) (Total lines 211 and 212)

Total Current Assets (Total lines 201, 202, 203, 206, 210, 213, 214, and 215)

216

$

Property, Plant, & Equipment (Net of depreciation and amortization)

217

$

221

$
$

Other Assets:
Investments in subsidiaries and affiliated companies

218

$

Due from Owners, Officers, and Related Entities (Due in 1 year or more)

219

$

Other Assets

220

$

Total Other Assets (Total lines 218, 219, and 220)
TOTAL ASSETS (Total lines 216, 217, and 221)

222

OMB No. 0581-0308

LIABILITIES
Current Liabilities:
Overdraft

223

$

Shortage in Custodial Bank Account

224

$

229

$

Total Current Maturities of Long-Term Debt (Total lines 230 and 231)

232

$

Other Current Liabilities

233

$

Trade Account Payables
Livestock Payables (Due in 1 Year or Less)

225

$

Meat and Meat Products Payables (Due in 1 Year or Less)

226

$

Other Payables to Owners, Officers, and Related Entities (Due in 1 Year or Less)

227

$

Other Payables (Sources Not Related to Company)

228

$

Total Trade Account Payables (Total lines 225, 226, 227, and 228)
Current Maturities of Long-Term Debt: (Demand notes and portion of long-term notes due in 1 year or less)
Owners, Officers, and Related Entities

230

$

Others (Sources Not Related to Company)

231

$

Total Current Liabilities (Total lines 223, 224, 229, 232, and 233)

234

$

239

$

TOTAL EQUITY (Total lines 240 through 243)

244

$

TOTAL LIABILITIES AND EQUITY (should equal line 222)

245

$

Other Liabilities:
Long -Term Debt, Less Current Maturities: (Due in 1 year or more)
Owners, Officers, and Related Entities

235

$

Others (Sources Not Related to Company)

236

$

Total Long-Term Debt, Less Current Maturities (Total lines 235 and 236)

237

$

All Other Liabilities

238

$

TOTAL LIABILITIES (Total of lines 234, 237 and 238)
EQUITY
Owner's Equity (Unincorporated)

240

$

Stock Issued (Incorporated)

241

$

Additional paid-in capital

242

$

Retained Earnings

243

$

OR

FINANCING INFORMATION - SECTION 3
301 Is the entity liable for any contingent liabilities?

Yes

No

If Yes, give brief explanation on line 302.

302
303 At the end of the reporting period, were Accounts Receivable and/or Inventories, or any part thereof, pledged or
assigned as collateral under a financing or loan agreement?

Yes

No

If the answer to 303 is "Yes", complete lines 304 through 308 for each financial lending institution. Attach additional sheets if more than one.
304 Name of Lending Institution
305 Mailing Address
306 City, State, Zip +4
307 Contact Name
308 Contact Telephone Number

Form PSD 7002

Expires XX/XX/XXXX

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OMB No. 0581-0308

309 Are Inventories collateralized under the agreement?

Yes

No

310 Are Accounts Receivable collateralized under the agreement?

Yes

No

312 Enter borrowing payable as of the end of the reporting period
$
At any time during the year, Have you been notified by your financial institution you were in violation
313 of any covenants of your financial agreement?

Yes

No

314 If so notified, have you been provided a waiver from your financial institution?

Yes

No

315 Are any company owners, directors, officers or stockholders named as a guarantor under the agreement?

Yes

No

316 If company is a subsidiary of another, is the Parent Company named as a guarantor under the agreement?

Yes

No

311 Enter borrowing limit under the agreement

$

Restrictions or covenants under financing or loan agreement
317 Minimum cash balance to be maintained on deposit

$

318 Minimum working capital to be maintained.

$

319 Other (describe)
Livestock Trust Ratio Calculation
Reference the instruction sheet in calculating your Livestock Trust ratio

320 Calculated Trust Ratio

CERTIFICATION - SECTION 4

Under the Packers and Stockyards Act any person who willfully makes or causes any false entry or statement of fact in this report shall be deemed guilty of offense
against the United States, and be subject to a fine of $1,000 to $5,000, or to imprisonment for a term of not more than 3 years, or to both fine and imprisonment.
With my signature, I certify the information provided on this form is true and correct to the best of my knowledge and belief, I am an owner, officer, or have
been authorized by responsible management to certify this report.
401 Print Name
402 Signature
403 Phone Number

404 Date

405 Title

Submitted information is confidential (9 CFR 201.96). Failure to report may result with a complaint filed against the entity in a United States District Court
charging the entity with violations of the Packers and Stockyards Act and seeking civil penalties as authorized by law, until report receipt. Section 10 of the FTC Act
made applicable by Section 402 of the Act (7 U.S.C. 222).
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 is 0581-0308. The time required to complete this information collection is
estimated to average 1.5 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.
In accordance with Federal law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, this institution is prohibited from
discriminating on the basis of race, color, national origin, sex, age, disability, and reprisal or retaliation for prior civil rights activity. (Not all prohibited bases
apply to all programs.) 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 State or local Agency that administers the program 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 is also available in languages other
than English.
To file a complaint alleging discrimination, complete the USDA Program Discrimination Complaint Form, AD-3027, found online at
http://www.ascr.usda.gov/complaint_filing_cust.html, or at any USDA office or write a letter addressed to USDA and provided 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: (a) mail: U.S.
Department of Agriculture, Office of the Assistant Secretary for Civil Rights, 1400 Independence Avenue, SW, Washington, D.C. 20250-9410; (b) fax: (202)
690-7442; or (c) email: [email protected].

Form PSD 7002

Expires XX/XX/XXXX

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Instructions to Complete
Statement of Assets, Liabilities, and
Equity Special Report
Form PSD 7002
As an individual, partnership, corporation, or association engaged in business as a livestock
dealer, buying livestock on commission for the account of others, market agency selling livestock
on a commission basis, or a packer buying livestock for slaughter, you are required to file a
special report with the Packers and Stockyards Division (PSD) on form PSD 7002, Statement of
Assets, Liabilities, and Equity Special Report
You must file the form by the date shown in the letter notifying you to file the special report.
Failure to file this form may result with a complaint filed against the entity in a United States
District Court charging the entity with violations of the Packers and Stockyards Act and seeking
civil penalties as authorized by law If space provided for any item is not sufficient, attach
additional pages containing the information and make reference to the line number on the form.
All information must be completed on this form in its entirety. Failure to do so will result in
the form being returned incomplete.
Submit the completed form to the PSD regional office that covers your area. The Areas covered
by each regional office are listed below its address. Forms and instructions are also located on
PSD's website at https://www.ams.usda.gov/resources/forms.

Regional Offices of the Packers and Stockyards Division
Agricultural Marketing Service, Fair Trade Practices Program
Eastern Regional Office
Midwestern Regional Office
Western Regional Office
75 Ted Turner Drive SW, Ste 230 210 Walnut Street, Room 317
3950 Lewiston St., Suite 200
Atlanta, GA 30303-3308
Des Moines, IA 50309-2110
Aurora, CO 80011-1556
Telephone: (404) 562-5840
Telephone: (515) 323-2579
Telephone: (303) 375-4240
FAX: (404) 562-5848
FAX: (515) 323-2590
FAX: (303) 371-4609
E-mail:
E-mail:
E-mail:
[email protected]
[email protected] [email protected]
States Covered
States Covered
States Covered
AL, AR, CT, DC, DE, FL, GA,
IA, IL, IN, KY, MB, MI, MN,
AB, AK, AZ, BC, CA, CO, HI,
LA, MA, MD, ME, MS, NC,
MO, ND, NE, OH, ON, SD, WI ID, KS, MT, NM, NV, OK, OR,
NH, NJ, NL, NY, PA, PR, QC,
SK, TX, UT, WA, WY
RI, SC, TN, VA, VT, WV

If you have any questions about the form or completing the form, please contact the PSD
Regional Office that covers your area, as listed above. Additional copies of the form may be
obtained from the regional office, or on the PSD website at
https://www.ams.usda.gov/resources/forms

Form PSD 7002

Expires XX/XX/XXXX

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SECTION-BY-SECTION INSTRUCTIONS
FORM HEADER –BUSINESS ENTITY ID
Business Entity ID should be completed using information provided by PSD. If the information
is not already completed on the form, please contact your Regional PSD office listed above to
obtain the number.
Line No.
101
a and b
102
103
104
and
105
106
and
107
108
109
110
111
112

Subject

Instruction
GENERAL INFORMATION - SECTION
Reporting Date
Enter the assets, liabilities and equity analysis date. This is
(mm/dd/yyyy)
the date required in the letter provided by PSD.
Entity Name
Enter the name under which you are registered with PSD.
Trade Name/d.b.a
Enter the trade name under which you operate. This is the
name the business uses, if applicable. If you do not operate
with a “Trade Name”, enter “N/A”.
Mailing Address
Enter your mailing address. Enter street, city, state, and
zip+4 code. This is the address where all correspondence
from the PSD should be sent.
Operating Address
Enter the physical location of your operating address. Enter
street, city, state, and zip +4 code. This is the address where
you conduct your business services.
Contact Name
Enter the name of the person to be contacted regarding
questions on this report.
Contact Telephone
Enter the telephone number where the contact may be
Number
reached.
Fax Number
Enter the Fax number used by the entity.
E-Mail Address
Enter the entity’s e-mail address.
Web Site Address (if
Enter the complete Web site address the business operates.
applicable)
For example: [email protected]
STATEMENT OF ASSETS, LIABILITIES AND EQUITY – SECTION 2

201

Cash

202

Custodial Account
Overage

203

Cash Equivalents

204

Accounts Receivables
from Owners, Officers,
and Affiliated
Companies

Form PSD 7002

Enter the total book balances of all bank accounts. An
overdraft should be reported on line 223.
Enter the dollar amount of overage from analysis of
Custodial Account. (A shortage should be reported on line
224.)
Enter the dollar value of any current cash investments
(savings accounts, securities, CD’s, etc.). Include only those
marketable securities that represent the cash available for
current operations and not otherwise pledged as security.
Enter the dollar amounts owed by owners, officers, or
affiliated companies as a result of delivering goods or
services, and extending credit in the ordinary course of
business.

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Line No.
205
206
207
208
209

210
211
212
213

Subject
Accounts Receivables
from All Others
Total Trade Accounts
Receivable-Net (Due in
1 year or less)
Livestock Inventory
Meat and Meat Products
Inventory
Other Inventory

Total Inventories
Notes Receivable from
Owners Officers,
Related Entities
Notes Receivable from
All Others

215

Total Notes and Loans
Receivable (Due in 1
year or less)
Advances on Livestock
and Meat
Other Current Assets

216

Total Current Assets

217

Plant, Property and
Equipment

218

220

Investments in
subsidiaries and related
companies
Due from owners,
officers and related
entities
Other Assets

221
222
223

Total Other Assets
Total Assets
Overdraft

214

219

Form PSD 7002

Instruction
Enter the dollar amounts owed by customers as a result of
delivering goods or services, and extending credit in the
ordinary course of business.
Enter the sum total of lines 204 and 205.
Enter the dollar amount of livestock held for the purpose of
sale to customers.
Enter the dollar amount of meat and meat food products
inventory.
Enter any merchandise, raw materials, work in process,
finished goods, operating supplies and ordinary maintenance
materials and parts other than livestock, to be consumed in
the business during the next year.
Enter the sum total of lines 207, 208 and 209.
Enter the total dollar value owed to the company by owners,
officers, or related entities that is due in 1 year or less.
Enter the total dollar value owed to the company by other
than owners, officers or related entities that is due in 1 year
or less.
Enter the sum total of lines 211 and 212.
Enter the dollar value of cash advances given for the
purchase of livestock, meat, and meat products.
Enter the dollar value of prepaid expenses and other assets
expected to be converted to cash or sold or consumed during
the next year.
Enter the sum total of lines 201, 202, 203, 206, 210, 213,
214, and 215.
Enter the dollar value of land, buildings, plant, equipment
and amortizable assets less accumulated depreciation and
amortization.
Enter the total dollar value of any investments in subsidiaries
and related companies.
Enter the dollar value due from owners, officers, and related
entities that is expected to be received in more than 1 year
from the reporting date of this report.
Enter the total dollar value of all others assets expected to be
converted to cash, or sold or consumed in more than 1 year
from the reporting date of this report.
Enter the sum total of lines 218, 219, and 220.
Enter the sum total of lines 216, 217, and 221.
Enter the total overdraft balances of all bank accounts,
except custodial accounts.
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Line No.
224
225

Subject
Custodial Account
Shortage
Livestock Payables

226

Meat and Meat Products

227

Other Payables to
Owners, Officers, and
Related Entities
Other Payables

228
229
230

231
232
233
234
235

236

237
238
239
240
241
242
243
244
245

Form PSD 7002

Total Payables
Current Maturities of
Long-Term Debt related
to Owners, Officers and
Related Entities
Current Maturities of
Long-Term Debt related
to Others
Total Current Maturities
of Long Term Debt
Other Current Liabilities
Total Current Liabilities
Long-Term Debt, less
Current Maturities
related to Owners,
Officers, and Related
Entities
Long-Term Debt, less
Current Maturities
related to Others
(Sources Not Related to
Company)
Total Long-Term Debt,
Less Current Maturities
All Other Liabilities
Total Liabilities
Owner’s Equity
(Unincorporated)
Stock Issued
Additional paid-in
capital
Retained Earnings
Total Equity
Total Liabilities and
Equity

Instruction
Enter the dollar amount of shortage from the Custodial
Account analysis.
Enter the total dollar amount you owe for livestock. (Due in
one year or less)
Enter the total dollar amount you owe for meat and meat
products (Due in one year or less)
Enter the total dollar amount you owe to owners, officers,
and related entities, for other than livestock. (Due in one year
or less)
Enter the total dollar amount you owe to all vendors for
other than livestock. (Due in one year or less)
Enter the sum total of lines 225, 226, 227, and 228.
Enter dollar amount of notes and loans due by you to
owners, officers, and related entities in 1 year or less.
Enter the dollar amount of notes and loans due by you to
other than owners, officers, and related entities in 1 year or
less.
Enter the sum total of lines 230 and 231.
Enter the total dollar value of any current liabilities due
within 1 year of the reporting date of this report.
Enter the sum total of lines 223, 224, 229, 232, and 233.
Enter the total dollar amount of notes, mortgages, bonds, and
installments that are payable to owners, officers, and related
entities after 1 year.
Enter the total dollar amount of notes, mortgages, bonds, and
installments that are payable to other than owners, officers,
and related entities after 1 year.
Enter the sum total of lines 235 and 236.
Enter all other liabilities owed after 1 year.
Enter the sum total of lines 234, 237, and 238.
If unincorporated, enter the dollar amount of the owner’s net
worth.
If incorporated, enter the dollar amount of stock issued.
If incorporated, enter the dollar value of any additional paidin capital.
If incorporated, enter the retained earnings.
Enter the sum of lines 240 through 243
Enter the sum total of lines 239 and 244 (should equal line
222).
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Line No.
301
302
303

304
305
through
308
309
310
311
312
313
314
315
316
317
318
319
320

Form PSD 7002

Subject

Instruction
FINANCING INFORMATION – SECTION 3
Contingent Liabilities
Check appropriate box indicating whether your firm has
contingent Liabilities
Describe financial
Briefly explain the possible direct financial obligations
obligations
which are unsettled as to the certainty of the liability and the
amount.
Pledged as Collateral
Check appropriate box indicating whether your firm had
Accounts Receivable and/or Inventories or any part thereof,
pledged or assigned as collateral under a financing
agreement.
Financial Institution
Enter the name of the financial institution that has security
with Security Interests
interests in your firm.
Name, Address, City,
Enter the name, mailing address, contact name, and contact
State, Zip+4, Contact
telephone number of the financial institution with a security
Name, Contact Number interest in your firm.
Inventories
Check appropriate box to indicate whether inventories are
Collateralized
collateralized under the agreement.
Accounts Receivable
Check appropriate box to indicate whether accounts
Collateralized
receivable are collateralized under the agreement.
Borrowing Limit
Enter the dollar value of the borrowing limit under the
agreement.
Borrowing Payable
Enter the dollar value of the borrowing payable as of the end
of the reporting period.
Violation of Financial
Check appropriate box indicating whether you received
Agreement
notification you were in violation of any covenants of your
financial agreement.
Waiver Provided
If line 313 is Yes, check appropriate box indicated financial
institution provided a waiver.
Owners, Directors,
Check appropriate box indicating whether or not any
Officers or Stockholder company owners, directors, officers or stockholders are
as Guarantors
named as a guarantor under the agreement.
Parent Company Named Check appropriate box indicating whether or not the parent
as Guarantor
company is named as a guarantor under the agreement.
Minimum Cash Balance Enter the dollar value of the minimum cash balance required
to be maintained on deposit.
Minimum Working
Enter the dollar value of the minimum working capital
Capital
required to be maintained.
Other
Enter any other restrictions or covenants under the financing
or loan agreement.
Livestock Trust Ratio
To calculate your Livestock Trust ratio, add Cash, ShortTerm Securities (Certificate of Deposits, Money Market
accounts, etc.) Account Receivables, and Livestock and
Meat Inventories together, as of the analysis date. Divide
this number by the amount of livestock Account Payables as
of the analysis date. Enter this amount. (Add lines 201, 202,
203, 206, 207, and 208 and divide by line 225)
CERTIFICATION – SECTION 7
Expires XX/XX/XXXX

Page 5 of 9

Line No.
401
402
403
404
405

Form PSD 7002

Subject
Print Name
Signature
Phone number
Date
Title

Instruction
Print the name of the owner, officer, partner, or member
responsible for this report.
The report must be signed a responsible person.
Enter the phone number of the person signing the report
Enter the date the report is signed.
Enter the title of the person signing the report.

Expires XX/XX/XXXX

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