Form FAS-97 Report of Optional Origin Sales

FAX: 202-690-3270 or 3273

OMB Approval No. 0551-0007

FAS-97 Rev. 11-01

NOTE:

U. S. DEPARTMENT OF AGRICULTURE
Foreign Agricultural Service
REPORT OF OPTIONAL ORIGIN SALES
This report is required by law (Section 602 of the Agricultural Trade Act of 1978, as amended). Any person
who knowingly fails to report export sales pursuant to requirements of this Law can be subject to a $25,000
fine or imprisonment for not more than one year, or both.

IMPORTANT: Report should be typewritten or prepared in ink. TO BE TREATED AS CONFIDENTIAL information
under Section 602 of the Agricultural Trade Act of 1978, as amended. Reference instructions for export sales report, a
separate document.
EXPORTER (Name and Address)
1 REPORT FOR
PERSON(S) AUTHORIZED TO EXECUTE
PERIOD ENDING
THIS FORM (Name, title, office location &
phone number)
YR. MO. DA.
FIRM NO.

2

COMMODITY NAME

3

COMMODITY CODE

4

MARKETING YEAR
20

__ /_____

5 COUNTRY OF DESTINATION

01

02

NAME

NAME

NAME

NAME

CODE

CODE

CODE

CODE

03
UNIT OF MEASURE AS SPECIFIED IN INSTRUCTIONS

6

100

100

100

110

110

110

8

Outstanding optional origin sales from Item 15 100
of previous report
Increases resulting from new optional origin 110
sales, contract adjustments, change in marketing
year or change in commodity
Increases resulting from change in destination 115

115

115

115

9

Sum of 6, 7, and 8

120

120

120

120

10 Options exercised to export the commodity from
the United States only. Transfer to Form FAS98, Item 7
11 Options exercised to export the commodity from
other than the United States
12 Decreases resulting from cancellations, contract
adjustments, buy-backs, change in marketing
year or change in commodity
13 Decreases resulting from change in destination

130

130

130

130

140

140

140

140

150

150

150

150

155

155

155

155

14 Sum of 10, 11, 12 and 13

160

160

160

160

15 Outstanding balance for which an option has not 170
been exercised (9 minus 14)
REMARKS

170

170

170

7

CERTIFICATION
The undersigned hereby certifies that the information contained in this report of ___page(s) is an accurate statement. A false
statement in the certification may subject the undersigned to criminal and civil penalties under Federal statutes.
SIGNATURE
DATE
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 0551-0007. The time required to complete this information collection is estimated to average
30 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.