This form is available electronically. See Page 2 for the Privacy Act and Paperwork Reduction Act Statements.
WA-140 U.S. DEPARTMENT OF AGRICULTURE Form Approved - OMB No. 0560-0120
(10-31-11) Farm Service Agency
License No. |
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AGREEMENT TO ASSUME AGRICULTURAL PRODUCT STORAGE OBLIGATIONS
(a) License No. |
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(b) Assuming License No. |
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(c) |
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, (d) |
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(Acquiring Entity) |
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(Type Entity) |
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has acquired (or is acquiring) possession of the warehouse known as (e) |
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(Common Name of Warehouse and location City, State) |
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[License No. (f) |
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] currently operated by (g) |
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, |
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(Relinquishing Entity) |
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(h) |
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as a public warehouse, under the license number cited, issued under the |
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(Type Entity) |
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provisions of the United States Warehouse Act (7 U.S.C. 241-256) (the Act); and |
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(i) |
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now has certain obligations representing |
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(Relinquishing Entity) |
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agricultural products in these warehouses but its license, under the Act has been (or is to be) revoked or amended; and |
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(j) |
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is applying for license, or an amendment to license |
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(Acquiring Entity) |
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under the Act to conduct public warehouses for the storage of agricultural product(s) and will operate the named warehouse |
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currently operated by (k) |
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under the license stated above; and |
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(Relinquishing Entity) |
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Farm Service Agency is charged with the supervision of warehouses licensed under the provisions of the Act |
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and desires to make certain that all storage obligations made by (l) |
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(Relinquishing Entity) |
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for agricultural products stored in this warehouse will be fulfilled. |
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It is agreed that (m) |
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(Acquiring Entity) |
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assumes full and complete responsibility for the storage and delivery of all agricultural product(s) obligations now |
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in the control of (n) |
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(Relinquishing Entity) |
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in the named warehouse, at the time of acceptance of the named warehouse by (o) |
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(Acquiring Entity) |
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and to assume storage and delivery of the said obligations according to the terms and provisions of the Act, regulations, licensing |
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agreements, and warehouse receipts originally issued by (p) |
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(Relinquishing Entity) |
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WA-140 (10-31-11) Page 2 of 2
The parties have executed this agreement this (q) |
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day of (r) |
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Month / Year |
(s) |
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(t) |
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Acquiring Entity |
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Relinquishing Entity |
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(1) By |
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(1) By |
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Officer |
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Officer |
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(2) Its |
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(2) Its |
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Office |
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Office |
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(3) Witness |
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(3) Witness |
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(4) City, State |
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(4) City, State |
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NOTE: |
The following statement is made in accordance with the Privacy Act of 1974 (5 U.S.C. 552a - as amended). The authority for requesting the information identified on this form is 7 CFR Part 735, 7 CFR Part 1427, the United States Warehouse Act (Pub. L. 106-472), and the Commodity Credit Corporation Charter Act (15 U.S.C. 714 et seq.). The information will be used to document the agreement between the acquiring entity and the relinquishing entity concerning the assumption of responsibility for agricultural product storage and delivery obligations. The information collected on this form may be disclosed to other Federal, State, Local government agencies, Tribal agencies, and nongovernmental entities that have been authorized access to the information by statute or regulation and/or as described in applicable Routine Uses identified in the System of Records Notice for USDA/FSA-2, Farm Records File (Automated) and USDA/FSA-3, Consultants File. Providing the requested information is voluntary. However, failure to furnish the requested information will result in a determination of ineligibility to obtain new licensing or retain existing licensing under the United States Warehouse Act.
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 0560-0120. The time required to complete this information collection is estimated to average 15 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.
The provisions of appropriate criminal and civil fraud, privacy, and other statutes may be applicable to the information provided. RETURN THIS COMPLETED FORM TO THE KANSAS CITY COMMODITY OFFICE, WAREHOUSE LICENSE AND EXAMINATION DIVISION, STOP 9148, P.O. BOX 419205, KANSAS CITY, MO 64141-6205.
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The U.S. Department of Agriculture (USDA) prohibits discrimination in all of its programs and activities on the basis of race, color, national origin, age, disability, and where applicable, sex, marital status, familial status, parental status, religion, sexual orientation, political beliefs, genetic information, reprisal, or because all or part of an individual’s income is derived from any public assistance program. (Not all prohibited bases apply to all programs.) Persons with disabilities who require alternative means for communication of program information (Braille, large print, audiotape, etc.) should contact USDA’s TARGET Center at (202) 720-2600 (voice and TDD). To file a complaint of discrimination, write to USDA, Assistant Secretary for Civil Rights, Office of the Assistant Secretary for Civil Rights, 1400 Independence Avenue, S.W., Stop 9410, Washington, DC 20250-9410, or call toll-free at (866) 632-9992 (English) or (800) 877-8339 (TDD) or (866) 377-8642 (English Federal-relay) or (800) 845-6136 (Spanish Federal-relay). USDA is an equal opportunity provider and employer.
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | anita.crowell |
File Modified | 0000-00-00 |
File Created | 2021-01-28 |