CN-59 Cotton Sampling Inspection Report

Form Approved - OMB NO. 0581-0009

U.S. DEPARTMENT OF AGRICULTURE
AGRICULTURAL MARKETING SERVICE

Note: The Cotton Statistics and Estimates Act, 7 U.S.C. 471-476, authorizes the collection of this information. The information collected will
be used in the analysis, tabulation, and dissemination of accurate and timely information relative to cotton quality and marketing conditions.
This information is required to obtain benefits under this program. 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 0581-0009. The time required to complete this information collection is estimated
to average 3 minutes/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.

COTTON SAMPLING INSPECTION REPORT

TYPE OF SERVICE (Check appropriate box)

NAME AND ADDRESS OR CODE NUMBER OF GIN OR WAREHOUSE

STATE

FORM A
OTHER (Specify)
COUNTY

LOT NO.
SMITH-DOXEY
NAME OF PERSON CONTACTED

DATE

INSPECTION NO. (Please Circle)

PART 1 - GENERAL INSPECTION

1

2

3

4

5

6

3

4

5

6

YES

NO

YES

NO

1. Did person contacted understand instructions:
a. For sampling?
b. For reviewing?
2. Did you:
a. Observe actual sampling procedure?
b. Examine previously drawn samples?
3. Were instructions followed in:
a. Drawing samples?
b. Handling samples?
c. Packaging samples?
d. Identifying samples?
e. Shipping samples?
4. Were appraisal samples drawn?
INSPECTION NO. (Please Circle)

PART 2 - INSPECTION OF MECHANICAL SAMPLER

1

2

1. Was sampler in operation?
2. Time check on sampler:
TIME INTERVAL BETWEEN
GIN BALE NO.

TURNING OF PRESS AND
FIRST SAMPLING

LAST SAMPLING AND
TURNING OF PRESS

NO. OF SEGMENTS IN SAMPLE

BALE WEIGHT

REMARKS

PART 3 - MARKET NEWS

Market news information furnished in this solicitation is voluntary and is used by the USDA in the dissemination of
information relating to cotton marketing conditions. Information is held confidential (7 U.S.C. 473b).

1. DISPOSITION OF CURRENT GINNINGS

2. QUALITY OF COTTON SOLD BY FARMERS AND PRICES RECEIVED

a. Percent sold by Producers

%

b. Percent held by Producers

%

c. Percent placed in CCC Loan

%

3. PRICE PAID FARMERS FOR COTTONSEED

$
CLASSING OFFICE

CN-59 (Exp. X/XXXX) Destroy previous editions.

PER TON
SIGNATURE OF FIELD REPRESENTATIVE

DATE

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USDA is an equal opportunity provider, employer, and lender.

CN-59 (Exp. X/XXXX) Destroy previous editions.