PSD- 7001 Status of Custodial Bank Account for Shippers' Proceeds

OMB Control No. 0581-0308

Business Entity ID Number

For PSD Stamp Only

U.S. Department of Agriculture
Agricultural Marketing Service
Fair Trade Practices Program
Packers and Stockyards Division

PSD Bar Code Only

STATUS OF CUSTODIAL BANK ACCOUNT FOR
SHIPPERS' PROCEEDS SPECIAL REPORT

Instructions: If an item's value is zero, enter "0". If an item does not apply, enter "NA". Upon completion
please verify that all items have been answered. Return completed form to the appropriate PSD regional
office. See separate instructions for complete information about this report.
GENERAL INFORMATION - SECTION 1
101 Entity Name
102 Trade Name/d.b.a
103 Mailing Address
104 City, State, Zip
105 Physical Address
106 City, State, Zip + 4
107 Contact Name
108 Contact Telephone

110 E-Mail Address

109 Fax

111 Web Address

NOTE: When more than one custodial account is mainained by the firm, complete a separate form for each bank.
CUSTODIAL ACCOUNT INFORMATION - SECTION 2
201 Name of Bank
202 Mailing Address
203 City, State, Zip
204 Bank Contact Name
205 Bank Contact Telephone
CUSTODIAL ACCOUNT DESIGNATION - SECTION 3
Attach copies of the first page of the bank statement, and a voided check from the account, showing the designation "Custodial Bank Account for
301
Shippers Proceeds.
ANALYSIS OF CUSTODIAL BANK ACCOUNT FOR SHIPPERS' PROCEEDS - SECTION 4
401

Date of Custodial Analysis ( as of mm/dd/yyyy)
Balance as per Bank Statement

402 $

Deposits in transit in mail or bank, but not on statement (Attach documentation)
Certificates of deposit and savings accounts designated as custodial funds and
on deposit in the bank carrying the custodial account (Attach copy of CD
and account statement)

403 $

404 $

Proceeds on hand

405 $
406 $

Proceeds receivables (from Line 512)

407 $

Total of Lines 402 through 406
Outstanding checks and drafts that have not cleared bank

408 $

Proceeds due consignors of livestock for which checks have not yet been issued

409 $

Unpaid expense items deducted from consignors' proceeds remaining in account

410 $

Total of Lines 408 through 410

411 $

Overage or Shortage in Account

412 $

Accounts Receivable - (from line 513)

413 $

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OMB Control No. 0581-0308

PROCEEDS/ACCOUNTS RECEIVABLES - SECTION 5
A Proceed Receivable is money that is owed the market for the purchase of livestock that has not yet been collected. The auction market may carry these amounts
as a Proceeds Receivable, owed to the market, until the close of the seventh day counted from the date of the sale. After the close of the seventh day subsequent to
the sale date, the market must reimburse the custodial account for any uncollected funds and the item(s) may no longer be classified as a Proceeds Receivable when
preparing the custodial account analysis (reconciliation). An exception to this 7 day rule is when the purchase is made by an owner, officer or employee of the
market. The payment for purchases by these related parties must be made by the close of the next business day, and may no longer be classified as a Proceeds
Receivable when preparing the custodial account analysis (reconciliation) after the close of the next business day, from the date of the sale. Additionally, any time
the market extends credit to a buyer, (approves a buyer to pay other than by the close of the next business day) the auction market must reimburse the custodial
account for the amount of the payment for which credit has been extended.

Date of Sale

Is the buyer a
market, owner,
officer, employee,
or credit buyer

Name of Buyer

a. Amount of Proceeds
Receivable

b. Amount of Accounts
Receivable

501

$

$

502

$

$

503

$

$

504

$

$

505

$

$

506

$

$

507

$

$

508

$

$

509

$

$

510

$

$
$

511

Total from Additional Pages (enter 0 if no other pages used)

$

512

Total Proceeds Receivable (enter on line 406)

$

513

Total Accounts Receivable (enter on line 413)

$

CREDIT BUYERS - SECTION 6
Enter the name and address of all buyers for whom you have extended credit - Add an additional page if necessary
a. Name of credit buyer

b. Address (street, city, state, zip+4)

601
602
603
604
CERTIFICATION - SECTION 7
Under the Packers and Stockyards Act any person who willfully makes, or causes any false entry or statement of fact in this report shall be deemed guilty of offense
against the United States, and be subject to a fine of $1,000 to $5,000, or to imprisonment for a term of not more than 3 years, or to both fine and imprisonment.
With my signature, I certify the information provided on this form is true and correct to the best of my knowledge and belief,
I am an owner, officer, or have been authorized by responsible management to certify this report.
701 Print Name
702 Signature
703 Phone Number

Form PSD 7001

704 Date

705 Title

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OMB Control No. 0581-0308

Submitted information is confidential (9 CFR 201.96). Failure to report will result in forfeiture to the United States $569 per day until report receipt Section 10 of the
FTC Act made applicable by Section 402 if the Act (7 U.S.C 222). Response is required in order to determine establishment, maintenance and status of custodial
account (9 CFR 201.97).
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 0581-0308. The time required to complete this information
collection is estimated to average 3 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.
In accordance with Federal law and U.S. Department of Agriculture (USDA) civil rights regulations and policies, this institution is prohibited from discriminating on
the basis of race, color, national origin, sex, age, disability, and reprisal or retaliation for prior civil rights activity. (Not all prohibited bases apply to all programs.)
Persons with disabilities who require alternative means of communication for program information (e.g., Braille, large print, audiotape, American Sign Language, etc.)
should contact the responsible State or local Agency that administers the program or USDA’s TARGET Center at (202) 720-2600 (voice and TTY) or contact USDA
through the Federal Relay Service at (800) 877-8339. Additionally, program information is also available in languages other than English.
To file a complaint alleging discrimination, complete the USDA Program Discrimination Complaint Form, AD-3027, found online at
http://www.ascr.usda.gov/complaint_filing_cust.html, or at any USDA office or write a letter addressed to USDA and provide in the letter all of the information
requested in the form. To request a copy of the complaint form, call (866) 632-9992. Submit your completed form or letter to USDA by: (a) mail: U.S. Department of
Agriculture, Office of the Assistant Secretary for Civil Rights, 1400 Independence Avenue, SW, Washington, D.C. 20250-9410; (b) fax: (202) 690-7442; or (c) email:
program.intake@usda.gov.

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Instructions to Complete
Status of Custodial Bank Account for
Shipper’s Proceeds Special Report
Form PSD 7001
As an entity engaged in business as a market agency selling livestock on a commission basis, you
are required to file a special report with the Packers and Stockyards Division (PSD) on Form PSD
7001, Status of Custodial Bank Account for Shipper’s Proceeds Special Report.
You must file the form by the date shown in the letter notifying you to file the special report.
You may be fined $569 for each day the report remains delinquent. If space provided for any
item is not sufficient, attach additional pages containing the information and make reference to
the line number on the form. All information must be completed on this form in its entirety.
Failure to do so will result in the form being returned incomplete.
Submit the completed form to the regional office of the Packers and Stockyards Division as listed
below. The states, provinces, and territories covered by each regional office are listed below its
address. Forms and instructions are also on PSD’s website at www.ams.usda.gov.
Regional Offices of the Packers and Stockyards Division
Agricultural Marketing Service, Fair Trade Practices Program
Atlanta Regional Office
Denver Regional Office
Des Moines Regional Office
75 Ted Turner Drive SW, Ste 230 3950 Lewiston St., Suite 200
210 Walnut Street, Room 317
Atlanta, GA 30303-3308
Aurora, CO 80011-1556
Des Moines, IA 50309-2110
Telephone: (303) 375-4240
Telephone: (404) 562-5840
Telephone: (515) 323-2579
FAX: (303) 371-4609
FAX: (404) 562-5848
FAX: (515) 323-2590
E-mail:
E-mail:
E-mail:
PSDDenverCO@usda.gov
PSDAtlantaGA@usda.gov
PSDDesMoinesIA@usda.gov
States Covered
States Covered
States Covered
AL, AR, CT, DC, DE, FL, GA,
AB, AK, AZ, BC, CA, CO, HI, IA, IL, IN, KY, MB, MI, , MN,
LA, MA, MD, ME, MS, NC,
ID, KS, MT, NM, NV, OK, OR, MO, ND, NE, OH, ON, SD, WI
NH, NJ, NL, NY, PA, PR, QC,
SK, TX, UT, WA, WY
RI, SC, TN, VA, VT, WV
If you have any questions about the form or completing the form, please contact the regional office
of the Packers and Stockyards Division that covers your state, province, or territory, as listed above.
You may also contact the Central Reporting Unit at 303-375-4264 or PSD-CRU@ams.usda.gov.

FORM HEADER –BUSINESS ENTITY ID
Business Entity ID should be completed using information provided by PSD. If the information is
not already completed on the form, please contact your Regional PSD office to obtain the number.

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Line
No.
101
102
103
and
104

Subject

Instruction

General Information – Section 1
Entity Name
Enter the name under which you are registered with PSD.
Trade Name/d.b.a.
Enter the trade name under which you operate. This is the
name the business uses, if applicable. If you do not
operate with a “Trade Name”, enter “N/A.”
Mailing Address
Enter the mailing address. Enter street, city, state, and
zip+4. This is the address where all correspondence from
the Packers and Stockyards Division should be sent.

105
and
106
107

Operating Address

Enter the physical location of your operating address.
Enter street, city, state, and zip +4. This is the address
where you conduct your business services.
Contact Name
Enter the name of the person to be contacted regarding
questions on the special report
108
Contact Telephone
Enter the telephone number where the contact may be
Number
reached.
109
Fax Number
Enter the Fax number used by the entity.
110
E-Mail Address
Enter the Entity’s e-mail address.
111
Web Site Address (if
Enter the complete Web site address the business
applicable)
operations. For example:
www.WebSiteName@domain.com.
CUSTODIAL ACCOUNT INFORMATION – SECTION 2
NOTE: If you maintain multiple custodial accounts for your business, please complete a
separate form for each bank.
201
Name of Bank
Enter the name of the bank where the custodial bank
account is maintained.
202
Mailing Address
Enter the address (street, city, state, and zip + 4) of the
and
bank.
203
204
Bank Contact Name
Enter the name of your bank contact.
205

Bank Contact
Enter the telephone number of the bank contact.
Telephone
CUSTODIAL ACCOUNT DESIGNATION – SECTION 3
Custodial Account
Attach a copy of the first page of your bank statement, and
Designation
a copy of a voided check, as documentation of the
designation.
ANALYSIS OF CUSTODIAL ACCOUNT – SECTION 4
Date of Custodial
Enter the custodial account analysis date. This is the
Analysis
analysis date requested by PSD in the accompanying letter.
Balance as per Bank
Enter the balance on the analysis date as shown on the
Statement
bank statement.
Deposits in transit
Enter the total dollar amount of any deposits sent to the
bank by the analysis date, but not yet posted to the account.
Attach documentation of the deposit(s).

301

401
402
403

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Line
No.
404

Subject

Instruction

Certificates of deposit
and savings account
designated as custodial
funds

405

Proceeds on hand

406
407
408

Proceeds receivables
Total
Outstanding checks
and drafts

409

Proceeds due
consignors
Unpaid expense items

Enter the balance as of the analysis date of certificates of
deposits or saving accounts that are designated as custodial
account. These accounts and certificates of deposit must
be at the same bank that holds the custodial checking
account. Attach copy of CD and account statement.
Enter the total dollar amount of cash and checks received
from the sale of livestock that have not been deposited to
the account as of the analysis date.
Enter the total shown on line 512 of this report.
Enter the sum of lines 402 through 406.
Enter the total dollar amount of checks or drafts issued
from the custodial account that have not cleared as of the
analysis date.
Enter the total dollar amount of any livestock sales by the
market agency which has not yet been paid.
Enter the total dollar amount of unpaid expense items.
Unpaid expense items are valid sale expenses deducted
from the consignors’ sales proceeds (for example, check off
fees, health inspections, etc.). Do not include amounts due
to the market for services such as commissions or yardage.
Enter the sum of lines 408 through 410.
Subtract line 411 from line 406. If the account is short,
show the amount as negative.

410

411
412
413
501
through
510

Form PSD 7001

Total
Overage or Shortage in
the account
Enter the total shown on line 513 of this report.
Accounts Receivable
PROCEEDS/ACCOUNTS RECEIVABLES – SECTION 5
a. Amount of
A Proceed Receivable is money that is owed the market for
Proceeds
the purchase of livestock that has not yet been
Receivables
collected. The auction market may carry these amounts as
b. Amount of
a Proceeds Receivable, owed to the market, until the close
Accounts
of the seventh day counted from the date of the sale. After
Receivables
the close of the seventh day subsequent to the sale date, the
market must reimburse the custodial account for any
uncollected funds and the item(s) may no longer be
classified as a Proceeds Receivable when preparing the
custodial account analysis (reconciliation). An exception
to this 7 day rule is when the purchase is made by an
owner, officer or employee of the market. The payment for
purchases by these related parties must be made by the
close of the next business day, and may no longer be
classified as a Proceeds Receivable when preparing the
custodial account analysis (reconciliation) after the close of
the next business day, from the date of the sale.
Additionally, any time the market extends credit to a
buyer, (approves a buyer to pay other than by the close of
the next business day) the auction market must reimburse
the custodial account for the amount of the payment for
which credit has been extended.
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Line
No.
511
512
513
601a
through
605a
601b
through
605b

701
702
703
704
705

Form PSD 7001

Subject

Instruction

Total from Additional
Pages
Total of Proceeds
Receivable
Total of Accounts
Receivable

Enter additional page totals of Proceeds Receivables and/or
Accounts Receivables
Enter the sum of lines 501-510a

Name of Credit Buyer
Address

Enter the sum of lines 501-510b
Credit Buyers – Section 6
Enter the names of all buyers for whom you have extended
credit.
Enter the address (street, city, state, and zip+4) of each
buyer for whom you have extended credit.

CERTIFICATION – SECTION 7
Print the name of the owner, officer, partner, or member
responsible for this report.
Signature (Owner, or
The report must be signed by a responsible person.
responsible person)
Phone Number
Enter the telephone of the person signing the report.
Date
Enter the date the report is signed.
Title
Enter the title of the person signing the report.
Print Name

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