AMA OUTPUT REPORT | FIELD OFFICE: | FISCAL YEAR: |
COOPERATOR: | MONTH: | |
TYPE OF PRODUCTS | POUNDS (LBS) | |
FGIS | COOPERATOR | |
PULSES | ||
DRY EDIBLE BEANS | ||
DRY WHOLE PEAS | ||
SPLIT PEAS | ||
LENTILS | ||
RICE | ||
BROWN RICE | ||
ROUGH RICE | ||
MILLED RICE | ||
PROCESSED COMMODITIES | ||
PROCESSED COMM. | ||
OTHER SERVICES | ||
NUMBER OF INSPECTIONS/SERVICE REQUESTS | ||
AFLATOXIN | ||
VOMITOXIN (DON) | ||
BULK WEIGHING | ||
CONDITION ONLY | ||
FALLING NUMBER | ||
PHYTOSANITARY INSPECTION | ||
SANITATION | ||
STOWAGE EXAMINATION-ONLY | ||
OFFICIAL SAMPLING-ONLY | ||
SUBMITTED SAMPLES | ||
REMARKS: | ||
TOTAL GROSS REVENUE: | $ | |
This area for FGIS use: | ||
Point of Contact | Phone Number | Date Completed |
OMB CONTROL NO. 0580-0013: According to the Paperwork Reduction Act of 1995, no persons are 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 0580-0013. 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. | ||
FORM FGIS-930 (03/2015) Previous Editions Obsolete | Expires January 2018 | |
1. Name of the FGIS Field Office. | |||||||||
2. Name of Cooperator. | |||||||||
3. Current fiscal year. | |||||||||
4. Month reported. | |||||||||
5. Number of pounds for services (all pounds) obtained by FGIS Offices. | |||||||||
6. Number of pounds for services (all pounds) obtained by Cooperators. | |||||||||
7. Enter the number of Inspection/Service Requests performed per category when FGIS performs the service. | |||||||||
8. Enter the number of Inspection/Service Requests performed per category when Cooperator performs the service. | |||||||||
9. Any remarks necessary, please place here. | |||||||||
10. Enter Total Gross AMA Revenue billed to customers per Cooperative Agreement for FGIS to bill appropriate percentage for fees. | |||||||||
11. Enter name of person completing the form, phone number, and date form completed. | |||||||||
File Type | application/vnd.ms-excel |
Author | GIPSA USER |
Last Modified By | Greenfield, Andrew - GIPSA |
File Modified | 2015-03-13 |
File Created | 1999-09-09 |