## CCC-1045ELS See Page 9 for Privacy Act Statement

(09-06-07)

### U. S. DEPARTMENT OF AGRICULTURE

Commodity Credit Corporation

  ----------------------------------------- ------------- ----------------
                                            1\. Agreement      
                                            No.           

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#### EXTRA LONG STAPLE COTTON DOMESTIC USER/EXPORTER AGREEMENT

(Revision 1)

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| **NOTE:** The authority for collecting the following information is   |
| Pub. L. 107-171. This authority allows for the collection of          |
| information without prior                                             |
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| OMB approval mandated by the Paperwork Reduction Act of 1995. The     |
| time required to complete this information collection is estimated to |
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| average 30 minutes per response, including the time for reviewing     |
| instructions, searching existing data sources, gathering and          |
| maintaining                                                           |
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| the data needed, and completing and reviewing the collection of       |
| information.                                                          |
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**THIS AGREEMENT**, made and entered into by and between Commodity
Credit Corporation, a corporate agency of the United States (\"CCC\"),
and

+--------------------------------+---+---------------------------------+
| 2\. NAME OF DOMESTIC           |   |                                 |
| USER/EXPORTER:                 |   |                                 |
+--------------------------------+---+---------------------------------+
| 3.  MAILING ADDRESS OF         | 4 |                                 |
|     DOMESTIC USER/EXPORTER:    | \ |                                 |
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| 5.  STREET ADDRESS, CITY,      |   |                                 |
|     STATE, OF RECORD KEEPING   |   |                                 |
|     OFFICE:                    |   |                                 |
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| 6\. TAXPAYER ID NO. *(9 digits |   | SSN Taxpayer ID No.             |
| SSN/TIN)* AND TYPE :           |   |                                 |
+--------------------------------+---+---------------------------------+
| 7A. NAME OF CONTACT PERSON:    |   | 7B. TELEPHONE NO. *(Include     |
|                                |   | Area code)***:**                |
|                                |   |                                 |
|                                |   |                                 |
+--------------------------------+---+---------------------------------+
|                                |   | 7C. FAX NO. *(Include Area      |
|                                |   | code)***:**                     |
|                                |   |                                 |
|                                |   |                                 |
+--------------------------------+---+---------------------------------+
|                                |   | 7D. E-MAIL:                     |
|                                |   |                                 |
|                                |   |                                 |
+--------------------------------+---+---------------------------------+
| 8\. DOMESTIC USER/EXPORTER     |   |                                 |
| MULTIPLE TRADE NAMES AND       |   |                                 |
| LOCATIONS:                     |   |                                 |
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  **9. CHECK ONE BOX:** DOMESTIC USER EXPORTER

  -----------------------------------------------------------------------

("Domestic User or Exporter", as applicable) is for the purpose of
authorizing the Domestic User or Exporter to participate in the Special
Competitiveness Provisions for Extra Long Staple Cotton as authorized by
the Farm Security and Rural Investment Act of 2002.

**CCC-1045ELS** (09-06-07) Page 2 of 9

## SECTION A. GENERAL

**Section A-1. General Provisions**

(a) Beginning with the effective date of this Agreement, the Commodity
    Credit Corporation (CCC) will, in accordance with the terms and
    conditions of this Agreement and regulations promulgated by CCC,
    make payments in the form of certificates or cash, as designated by
    the Domestic User or Exporter named above. Such payments will be
    made for eligible cotton in accordance with the regulations found in
    7 CFR Part 1427 governing the Extra Long Staple (ELS) Cotton
    Competitiveness Payment Program.

(b) No payments in excess of those allowed by legislation will be issued
    by CCC.

**Section A-2. Eligible and Ineligible Cotton**

\(a\) For the purposes of this Agreement, eligible cotton shall be
domestically produced baled ELS cotton which must be one of the
following:

> \(1\) baled lint;
>
> \(2\) loose: samples removed from ELS cotton bales for classification
> purposes which have been rebaled;

\(b\) For the purposes of this Agreement, the following types of cotton
are not eligible:

\(1\) lint cleaner waste resulting from the ginning process ("motes");

\(2\) lint produced from the cottonseed crushing process ("linters");

\(3\) imported cotton;

\(4\) textile mill wastes;

(5) waste from the mote cleaning process ("pills");

\(6\) any eligible cotton which has been blended with textile mill waste
or other fibers, including motes, linters and pills;

> \(7\) upland cotton; or

\(8\) cotton not listed as eligible in this Agreement.

**Section A-3. Completion and Execution of the Agreement**

To be eligible for payment, Domestic Users and Exporters must submit an
original and one copy of this Agreement for approval and execution by
CCC. An Agreement must be completed for each Taxpayer Identification
Number. Submit Agreements to the Financial Review Branch, Contract
Reconciliation Division (FRB/CRD), Kansas City Commodity Office (KCCO).
An executed copy of the approved Agreement will be returned to the
Agreement holder.

General operational and policy questions regarding the ELS Cotton
Competitiveness Payment Program should be directed to

the Farm Service Agency, Financial Review Branch, Contract
Reconciliation Division, Kansas City Commodity Office,

telephone (816) 926-6663 or at the address listed in Section A-8.

## CCC-1045ELS (09-06-07) Page 3 of 9

## Section A-4. Payment Rate

\(a\) The general payment rate shall be based in accordance with the
regulations found in 7 CFR Part 1427 governing the ELS Cotton
Competitiveness Payment Program.

\(b\) The payment rate for eligible ELS cotton will be announced by CCC
each Thursday afternoon and shall apply to all bales consumed by
Domestic Users and export shipments made by Exporters between 12:01 a.m.
Friday through Midnight of the following Thursday (hereinafter called
"rate week"). ELS Cotton Competitiveness Payment Program rates may be
accessed by Agreement Holders through the following Internet Address:
**http://www.fsa.usda.gov/pas/news/releases/index.htm**

\(c\) All qualities of eligible ELS cotton will earn the same per pound
payment rate.

**Section A-5. Issuance of Payments**

After receipt of the application for payment, together with required
supporting documents, CCC will issue payments in an amount determined by
multiplying the per pound payment rate determined in accordance with
Section A-4 of this Agreement times the net pounds determined in
accordance with Section B-4 or C-4, as applicable, of this Agreement. If
a cash payment is not made within

30 days of receipt of valid documentation demonstrating eligibility, CCC
will pay interest at the prompt payment interest rate.

**Section A-6. Excessive Payment**

If the Domestic User or Exporter receives a payment in excess of the
entitled payment in accordance with this Agreement, the Domestic User or
Exporter shall refund to CCC an amount equal to the excess payment, plus
interest thereon, as determined by CCC.

**Section A-7. Record Retention and Access**

From the effective date of this Agreement until the earlier of three
years after the termination date of this Agreement or July 31, 2011, the
Domestic User or Exporter shall keep records and furnish such
information and reports relating to this Agreement as may be requested
by CCC. Periodically CCC may require Agreement Holders to forward to
KCCO copies of any and all records which supports the Agreement Holder's
claims for payment. Such records shall be available at all reasonable
times for an audit or inspection by authorized representatives of CCC,
United States Department of Agriculture, or the Comptroller General of
the United States. Failure to keep, or make available, such records may
result in termination of this Agreement by CCC and refund to CCC of all
payments received, plus interest thereon, as determined by CCC.

**Section A-8. Submission of Documents**

\(a\) **Submit ALL ELS COTTON DOMESTIC USER/EXPORTER DOCUMENTS to the
Financial Review Branch, Contract Reconciliation Division, KCCO.**

+-----------------------------------+-----------------------------------+
| **Mailing Address:**              | **Express Mail Address:**         |
+-----------------------------------+-----------------------------------+
| U.S. Department of Agriculture    | U.S. Department of Agriculture    |
|                                   |                                   |
| Farm Service Agency               | Farm Service Agency               |
|                                   |                                   |
| FRB/CRD                           | FRB/CRD                           |
|                                   |                                   |
| Mail Stop 8758                    | Kansas City Commodity Office      |
|                                   |                                   |
| Kansas City Commodity Office      | 9240 Troost Avenue                |
|                                   |                                   |
| P.O. Box 419205                   | Stop 8758                         |
|                                   |                                   |
| Kansas City, Missouri 64141-6205  | Kansas City, Missouri 64131-4676  |
|                                   |                                   |
| Phone Number: (816)-926-6663      | Office Hours: 7:00 - 4:30         |
|                                   |                                   |
|                                   | Phone Number: (816)-926-6663      |
+-----------------------------------+-----------------------------------+

> \(b\) All documents submitted to CCC for this program must be legible,
> accurate, and contain the Agreement number
>
> assigned by CCC.

## CCC-1045ELS (09-06-07) Page 4 of 9

\(c\) Applications for payment will be processed according to the date
stamped received on the application by KCCO upon receipt. An
application/report will not be considered received by CCC until such
time as it has been submitted without error, and completed in full.

(d) CCC may request documents in electronic format as systems are
    developed.

**Section A-9. Regulations and Other Authorities**

Provisions of this Agreement are subject to applicable laws and
authorities including but not limited to:

> 7 CFR Part 780, Appeal Regulations
>
> 7 CFR Part 1427, Cotton
>
> 7 CFR Part 1401, Commodity Certificates and In-Kind Payments, and
> other Forms of Payment

**Section A-10. Term of Agreement**

This Agreement will continue in force until it is terminated in writing
by CCC or at the mutual agreement of the parties. CCC may also terminate
this Agreement without prior written notice when required to do so by
programmatic requirements, expiration of authorizing legislation, or
exhaustion of funds.

**Section A-11. Program Violations**

If the Domestic User or Exporter is suspected by CCC to have knowingly:
(1) adopted any scheme or device which violates this Agreement; (2) made
any fraudulent representation; or (3) misrepresented any fact affecting
a determination under this Agreement, CCC will notify the appropriate
investigating agencies of the United States and may terminate the
Agreement with a full refund of payments plus interest and debar the
offending company from further government participation as deemed
necessary to protect the interests of the government. No Member or
Delegate of Congress or Resident Commissioner shall be admitted to any
share or part of this Agreement or to any benefit to arise therefrom,
except that this provision shall not be construed to extend to their
interest in any incorporated company, if this Agreement is for the
general benefit of such company, nor shall it be construed to extend to
any benefit which may accrue to such official in their capacity as a
producer.

**Section A-12. Appeals**

\(a\) Domestic Users or Exporters who dispute a KCCO decision may
request a review of the decision by the Deputy Administrator, Commodity
Operations (DACO), Farm Service Agency. Such request must be in writing
and contain the relevant facts upon which the review will be heard and
must be received by Deputy Administrator for Commodity Operations (DACO)
within 15 days from the date of receipt of the disputed decision.
Requests must be directed to:

Director, Warehouse and Inventory Division

Farm Service Agency

U.S. Department of Agriculture

P.O. Box 2415 STOP 0553

Washington, DC 20250-0553

Facsimile 202 690-0014

E-Mail: **Step2@wdc.fsa.usda.gov**

\(b\) Domestic Users or Exporters who dispute a review decision by DACO
may appeal such decision to the National Appeals Division. Such an
appeal must be made within 30 days of receipt of a DACO decision. Such
appeal will be conducted in accordance with 7 CFR Part 780 and must be
directed to the National Appeals Division.

**SECTION B. DOMESTIC USER**

**Section B-1. Eligible Domestic User**

A Domestic User is a person regularly engaged in purchasing eligible ELS
cotton for the purpose of manufacturing such cotton into cotton products
in the United States. In the event the cotton is not used for that
purpose, the payment received shall be returned immediately and with
interest.

**CCC-1045ELS** (09-06-07) Page 5 of 9

**Section B-2. ELS Cotton Eligible for Payment**

ELS cotton eligible for payment is cotton consumed by the Domestic User
in the United States on or after the effective date of this Agreement
during the rate week in which a positive payment rate, as determined in
accordance with Section A-4 of this Agreement, is in effect.

**Section B-3. Date of Consumption**

\(a\) The payment rate is the rate in effect on the date of consumption.
The date of consumption is the date the bagging and ties are removed
from the bale.

\(b\) Eligible ELS cotton will be considered consumed by the Domestic
User on the date the bagging and ties are removed from the bale in the
normal opening area, immediately prior to use, in a building or
collection of buildings where the cotton in the bale will be used in the
continuous process of manufacturing the cotton into cotton products.

\(c\) Some Domestic User\'s official company records may show bales in
the consumption process either a few hours before or after the physical
removing of bagging and ties. This is permissible provided the same
method of reporting is consistently used each week.

(c) When bales are designated to be dyed, they shall be considered
    consumed when bagging and ties are removed immediately prior to the
    cotton entering the dyeing process.

**Section B-4. Determining the Quantity of Eligible ELS Cotton**

The quantity of eligible ELS cotton with respect to which a payment is
made available in accordance with this Agreement shall be determined
based upon the net weight of each bale of eligible ELS cotton (gross
weight minus the weight of the bagging and ties). The net bale weight
shall be determined based upon the net pounds as shown on the purchase
invoice on which settlement for payment was made, supported by weight
sheets including a detailed list of bale numbers.

**Section B-5. Weekly Consumption /Application for Payment Report**

\(a\) The Domestic User must report the activity for each rate week
beginning on the effective date of the Agreement on a Weekly

Consumption/Application for Payment Report (CCC1045ELS-1) hereafter
referred to as the Application/Report. The

Application/Report must be submitted no later than close of business
(COB) Wednesday, following each rate week even when no payment is being
earned. If the Domestic User's facility is temporarily closed for any
reason, a negative Application/Report must be submitted the week prior
to or after the plant closing occurs. Failure to submit
Application/Reports will result in delays in payments until all
delinquent Application/Reports are received. The Application/Report, and
any other required documents received from a Domestic User that contain
errors or omissions will not be processed for payment.

(b) The Application/Report must contain the following information:

    1.  Date -- Show the date the Application/Report is submitted to
        CCC;

    2.  Agreement Number -- Show your Agreement number assigned by CCC,
        e.g., Y-1234

    3.  Company Name -- Show the name from your Agreement;

    4.  Contact -- Show individual name and phone number;

    5.  Rate week Consumption Dates -- Show the applicable dates, e.g.,
        May 2, 2003 through May 8, 2003;

**CCC-1045ELS** (09-06-07) Page 6 of 9

6.  Payment Rate -- When there is a payment rate in effect, show the
    announced payment rate for specified dates. A zero payment rate must
    be shown as "0";

> The payment amount is computed as follows:
>
> (Net Pounds Consumed) X (Announced Payment Rate)

7.  Type of Cotton -- Show the type of cotton as lint or loose with the
    number of bales, net pounds on which settlement for payment was
    based for each type of cotton consumed, and when there is a payment
    rate in effect, computed payment amount along with a grand total
    amount due; and

8.  Certification Statement and Signature -- Include the following
    signed certification statement on the Application/Report:

> *"I hereby certify that this document and all supporting documents
> (when required) are being submitted in accordance with the terms of
> the ELS Cotton Domestic User/Exporter Agreement and that the cotton
> covered by this Application/Report was domestically produced, has not
> previously earned a payment under the ELS Cotton Competitiveness
> Payment Program, and is eligible for a payment, if applicable."*

  --------------------- ---------- ------------ --------------------------
                                                

  --------------------- ---------- ------------ --------------------------

Authorized Representative

**Section B-6. Penalties for Late Submission of Applications for
Payment**

Applications for payment submitted after COB Wednesday following the
rate week will be considered late by CCC and receive payment at the
lesser of the payment rate for the rate week, or the submission date. If
not submitted within 30 days after COB Wednesday following the rate
week, the payment rate will be ZERO. If late submission of
Application/Report for payment is beyond the control of the Domestic
User, relief may be requested by contacting the Financial Review Branch,
Contract Reconciliation Division, KCCO.

**Section B-7. Maintenance of Records**

In addition to the records requirements in Section A-7, the Domestic
User must maintain the following records for all cotton consumed:

\(a\) A detailed list of bale numbers and the "landed" net weights
identified by the type of cotton;

\(b\) Documentation supporting the acquisition of cotton, including a
register of purchase contracts, amendments, and cancellations. Records
must show the number of bales received each week by type of cotton
supported by purchase contracts and weight sheets documenting the
"landed" net weight when received at the mill.

\(c\) Documentation that provides the capability to trace the "consumed
bale weight" back to the source purchase contract documents showing the
\"landed\" net weight;

\(d\) A weekly consumption listing which contains a detailed list of
bales consumed weekly showing the bale numbers and net weights on which
settlement for payment was based for each type of cotton (baled lint or
loose). The weekly consumption listing must cross-reference the purchase
invoice number; and

\(e\) Documentation supporting the acquisition, consumption and
disposition of ineligible ELS cotton and upland cotton.

**CCC-1045ELS** (09-06-07) Page 7 of 9

**SECTION C - EXPORTERS**

**Section C-1. Eligible Exporter**

An eligible exporter is a person, including producers or cooperative
marketing associations, regularly engaged in exporting cotton from the
United States.

**Section C-2. ELS Cotton** **Eligible for Payment**

ELS cotton eligible for payment is cotton for which no payment under
this program, either to a domestic user or to an exporter, has been
paid, and which is shipped by an eligible Exporter on or after the
effective date of this Agreement during the rate week in which a
positive payment rate, as determined in accordance with Section A-4 of
this Agreement, is in effect.

**Section C-3. Date of Export**

\(a\) Eligible ELS cotton will be considered exported based on the
on-board-vessel-date as shown on the bill of lading.

\(b\) For intermodal shipments, the date that the containers are placed
on board the vessel, will be used as the date of export. Intermodal
shipments must be clearly identified.

\(c\) For truck and rail shipments to Canada or Mexico, the date the
shipment crosses the international border will be used as the date of
export.

**Section C-4. Determining the Quantity of Eligible ELS Cotton**

\(a\) The quantity of eligible ELS cotton with respect to which a
payment is made available in accordance with this Agreement shall be
determined based upon the net weight of each bale of eligible cotton
(gross weight minus the weight of the bagging and ties).

\(b\) The net bale weight shall be determined based upon the net pounds
as shown on the purchase invoices on which settlement for payment was
made, supported by the applicable weight/tag lists showing the warehouse
receipt weights of the shipping warehouse or gin weights if the cotton
was not placed in a warehouse, or the reweights certified by a licensed
weigher. When an exporter's weight sheet lists a greater total net
weight claimed for payment than the net weight shown on the sales
invoice, a letter of explanation will be required. Franchised or
inflated weights will not be accepted for payments.

\(c\) Exported dyed cotton must be clearly identified and supported by
the pre-dyed bale tag list and the post-dyed bale tag list. Payment
claims must be based on the pre-dyed net bale weight.

**Section C-5. Proof of Export**

\(a\) The exporter must furnish CCC the following:

\(1\) Form CCC-1045ELS-2, ELS Cotton Competitiveness Payment Program
Exporter Application for Payment, shall be prepared for all positive pay
shipments based on the date of export. Blank copies of the
CCC-1045ELS-2, may be reproduced by the Exporter as needed. Computer
printouts in the same format as the CCC-1045ELS-2, are acceptable. Form
CCC-1045ELS-2, and other required documents received from an Exporter
that contain errors or omissions will not be processed for payment.

\(2\) A copy of the bill of lading must include: the on-board vessel
date in accordance with Section C-3, bill of lading number, bales and
pounds exported for each type of eligible cotton, vessel name, port of
export, destination, and exporter and consignee/notify party. The bill
of lading must be signed. When an Exporter has multiple Bills of Lading
on one invoice, the invoice must be copied to show the bales and pounds
to be applied for each Bill of Lading. Each Bill of Lading will be
treated as a single shipment.

## CCC-1045ELS (09-06-07) Page 8 of 9

\(3\) For eligible cotton exported to Canada or Mexico by truck or rail,
a copy of the bill of lading must be submitted. The bill of lading must
include car or truck number, bales and pounds exported for each type of
eligible cotton, origin shipping location, destination and exporter and
consignee/notify party. Documentation evidencing the date the shipment
crossed the border issued by an independent third party, such as a
freight forwarder, will be required on these shipments. Documents such
as a Mexican Pedimento de Importacion or similar document such as the
Cargo Release Control Document are also acceptable but not required for
payment. These supporting documents must be maintained and available for
review in the exporter's files.

\(4\) Weight sheets which show the following information:

\(i\) a legible detailed list of bale numbers;

(ii) the weights of individual bales as shipping warehouse receipt
     weights, gin weights, or certified reweight

> sheets if the bales are reweighed at the U.S. port;

\(iii\) certified reweights if individual bales are reweighed at the
shipping warehouse and are immediately containerized for intermodal
shipment or the bales are shipped to the port for containerization;

\(iv\) grand total of bales, net pounds and gross pounds by type of
eligible cotton.

\(5\) A copy of the export sale invoice showing the importer name, grand
total of bales, and the grand total of net pounds invoiced by type of
eligible cotton. When an exporter has multiple sale invoices for one
bill of lading, the invoices must be combined for entry as one shipment.

\(6\) All documents submitted to CCC must show the assigned Agreement
number and application number.

\(b\) For any week in which the payment rate derived in accordance with
Section A-4 is zero, no applications are required to be submitted to CCC
by the Exporter.

\(c\) All shipment documents must be maintained by the Exporter and be
accessible for review by CCC, including weight sheets for shipments
during periods when zero payment rates were in effect.

**Section C-6. Payment**

\(a\) The payment rate is the rate in effect on the date of export in
accordance with Section C-3.

\(b\) Within 60 calendar days after the date of export, the application
for payment CCC-1045ELS-2 and all supporting documents required in
Section C-5 must be submitted to CCC. The payment will be calculated by
multiplying the payment rate announced for the rate week in which the
cotton was shipped times the net weight shown on the weight sheets.

\(c\) Failure to submit the required documents within 60 calendar days
of the date of export will cause forfeiture of the

> payment. If late submission of application for payment is beyond the
> control of the Exporter, relief may be requested by contacting
> Financial Review Branch, Contract Reconciliation Division, KCCO
> Section A-8.

\(d\) CCC will issue payments only to the Agreement holder submitting
applications. Names on supporting documents other than the name of the
Agreement holder must be documented as follows:

> Company/Trade Name: The Exporter name on the bill of lading may be
> different from the Agreement holder name if the Exporter operates
> under multiple trade names. CCC must be advised of the multiple trade
> names that operate under the same Agreement number when the Agreement
> is executed; and
>
> Other Name: When a bill of lading is submitted as a supporting
> document for payment and the shipper of record is different from the
> Agreement holder making the application for payment, an **original**
> letter from the shipper of record must be submitted showing:

1\. Vessel name or container number 2. Bill of lading number

3\. Bill of lading date 4. Number of bales/weight

5\. A certification that the shipper of record 6. Authorized original
signature

will not claim payment for the cotton shipped

## CCC-1045ELS (09-06-07) Page 9 of 9

> The Agreement holder who has made application for payment agrees to
> furnish documentation, as deemed necessary by CCC regarding these
> shipments.

**Section C-7. Maintenance of Records**

In addition to the records requirements in Section A-7, the exporter
must maintain the following records for all export shipments including
during periods when zero payment rates were in effect:

\(a\) Sales contracts;

\(b\) Export reports showing importing country and importer name;

\(c\) Bill of lading showing pounds and bales exported by type of cotton
and date of export (on-board vessel date);

\(d\) Record of bale numbers and bale net weight by type of cotton and
origin of cotton;

\(e\) Invoices to importers; and

\(f\) Exporter's purchase invoices.

**10. DOMESTIC USER/EXPORTER:**

**The Domestic User/Exporter submits this Agreement and agrees to the
terms and conditions herein, signed and dated:**

  ------- ------------------------------------------------------------------
  *(a)*        

  ------- ------------------------------------------------------------------

PRINT NAME

  ------- ----------------------------------- ---- ------- ------------------------
  *(b)*                                            *(c)*        

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AUTHORIZED SIGNATURE TITLE

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  *(d)*             

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DATED *(MM-DD-YYYY)*

11\. **COMMODITY CREDIT CORPORATION:**

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  This Agreement is executed by CCC and shall        
  be effective *(a)*                            

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*(MM-DD-YYYY)*

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  *(b)*                                                 *(c)*        

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On Behalf of CCC Date *(MM-DD-YYYY)*

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  *NOTE:*   *The following statements are made in accordance with the
            Privacy Act (5 USC 552a). The Farm Security and Rural investment
            Act of 2002 (Pub. L. 107-171), and regulations at 7 CFR Part
            1427 authorize this agreement and other collections of
            information required for participation in the ELS Cotton
            Competitiveness Payment Program. In addition to the already
            published routine uses, the information will be used to
            determine eligibility to receive payment and to determine
            payment amounts. Providing this information is voluntary;
            however, without it, participation in the program will be
            denied. This information may be furnished to other USDA
            agencies, IRS, Department of Justice, or other State and Federal
            Law enforcement agencies, and in response to orders of a court
            magistrate or administrative tribunal. The provisions of
            criminal and civil fraud statutes, including 18 USC 286, 287,
            371, 641, 651, 1001; 15 USC 714m; and 31 USC 3729, may be
            applicable to the information provided. **RETURN THIS COMPLETED
            FORM TO THE** **KANSAS CITY COMMODITY OFFICE, MAIL STOP 8758,
            P.O. BOX 419205, KANSAS CITY, MISSOURI 64141-6205.***

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*The U.S. Department of Agriculture (USDA) prohibits discrimination in
all its program 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, SW., Washington, DC 20250-9410, or call (800)
795-3272 (voice) or (202) 720-6382 (TDD).  USDA is an equal opportunity
provider and employer.*