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pdfU.S. Department of Agriculture
Grain Inspection, Packers and Stockyards Administration
Packers and Stockyards Program
CONTRACT SUBMISSION COVER SHEET
Submit this form with each example contract.
Initial submission: Submit existing swine marketing contracts.
Subsequent submission: For offered, revised, expired, or withdrawn contracts, submit by the business day following
offer, revision, expiration, or withdrawal.
Identification Information
1. Date of Submission
2. Packer Name
(MM/DD/YYYY)
3. Federal Inspection
4. Plant Name
5. Plant Location: City, State
Number
6. Contract Category
(Choose 1)
Swine or Pork Market Formula Purchase with a Ledger
Swine or Pork Market Formula Purchase without a Ledger
Other Market Formula Purchase with a Ledger
Other Market Formula Purchase without a Ledger
Other Purchase Arrangement with a Ledger
Other Purchase Arrqangement without a Ledger
Contract Information
Contract Name
Previously Existing Contract
New
Replacement
Expiration
Withdrawal of Offer
8. Is this a Verbal Contract? Yes
If Yes, attach P&SP-343 or supporting documentation
No
Certification: I certify that this report has been prepared by me or under my direction and that to the best of
my knowledge and belief this report is true and correct.
9. Name: First
Last
10. Title
11. Phone Number
7. Submission Type
(Choose 1)
12. Signature
Response is required to identify and obtain examples of swine packer marketing contracts that are currently available
(7 U.S.C. 198a and 9 CFR 206). Submitted information held confidential (9 CFR 201.96).
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 0581-0021.
The time required to complete this information collection is estimated to average 5.5 hours for initial filing including time to review
instructions, search existing data resources, gather the data needed, and complete and review the information collection, and 15 minutes for
subsequent filing.
The U.S. Department of Agriculture (USDA) prohibits discrimination in all 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, genetic information, political beliefs, 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, Director, Office of Civil Rights, 1400 Independence
Avenue, S.W., Washington, D.C. 20250-9410, or call (800) 795-3272 (voice) or (202) 720-6382 (TDD). USDA is an equal opportunity provider and
employer.
Form P&SP-342
Expires 07/31/2016
Page 1 of 1
File Type | application/pdf |
Author | Pounds Barnett, Gayle - GIPSA |
File Modified | 2016-06-15 |
File Created | 2016-02-18 |