+--------+-------+--------+------+--------+---+--------+---+
| **`U.S |       |        |      |        |   |        |   |
| . Depa |       |        |      |        |   |        |   |
| rtment |       |        |      |        |   |        |   |
|  of Ag |       |        |      |        |   |        |   |
| ricult |       |        |      |        |   |        |   |
| ure`** |       |        |      |        |   |        |   |
|        |       |        |      |        |   |        |   |
| **`Fo  |       |        |      |        |   |        |   |
| od for |       |        |      |        |   |        |   |
|  Progr |       |        |      |        |   |        |   |
| ess an |       |        |      |        |   |        |   |
| d Sect |       |        |      |        |   |        |   |
| ion 41 |       |        |      |        |   |        |   |
| 6(b) R |       |        |      |        |   |        |   |
| eporti |       |        |      |        |   |        |   |
| ng For |       |        |      |        |   |        |   |
| mat`** |       |        |      |        |   |        |   |
|        |       |        |      |        |   |        |   |
| *      |       |        |      |        |   |        |   |
| *`LOGI |       |        |      |        |   |        |   |
| STICS  |       |        |      |        |   |        |   |
| & MONE |       |        |      |        |   |        |   |
| TIZATI |       |        |      |        |   |        |   |
| ON REP |       |        |      |        |   |        |   |
| ORT`** |       |        |      |        |   |        |   |
|        |       |        |      |        |   |        |   |
| `Pl    |       |        |      |        |   |        |   |
| ease S |       |        |      |        |   |        |   |
| ee ``“ |       |        |      |        |   |        |   |
| ``Guid |       |        |      |        |   |        |   |
| elines |       |        |      |        |   |        |   |
|  for U |       |        |      |        |   |        |   |
| SDA Fo |       |        |      |        |   |        |   |
| od for |       |        |      |        |   |        |   |
|  Progr |       |        |      |        |   |        |   |
| ess an |       |        |      |        |   |        |   |
| d Sect |       |        |      |        |   |        |   |
| ion 41 |       |        |      |        |   |        |   |
| 6(b) R |       |        |      |        |   |        |   |
| eporti |       |        |      |        |   |        |   |
| ng``”` |       |        |      |        |   |        |   |
|        |       |        |      |        |   |        |   |
| `      |       |        |      |        |   |        |   |
| for ex |       |        |      |        |   |        |   |
| amples |       |        |      |        |   |        |   |
|  and t |       |        |      |        |   |        |   |
| ips on |       |        |      |        |   |        |   |
|  filli |       |        |      |        |   |        |   |
| ng out |       |        |      |        |   |        |   |
|  this  |       |        |      |        |   |        |   |
| form.` |       |        |      |        |   |        |   |
+--------+-------+--------+------+--------+---+--------+---+
|        |       |        |      |        |   |        |   |
+--------+-------+--------+------+--------+---+--------+---+
| `1. Co |       |        |      |        |   |        |   |
| operat |       |        |      |        |   |        |   |
| ing Sp |       |        |      |        |   |        |   |
| onsor` |       |        |      |        |   |        |   |
+--------+-------+--------+------+--------+---+--------+---+
|        |       |        |      |        |   |        |   |
+--------+-------+--------+------+--------+---+--------+---+
| `2.    |       |        |      |        |   |        |   |
|  Agree |       |        |      |        |   |        |   |
| ment N |       |        |      |        |   |        |   |
| umber` |       |        |      |        |   |        |   |
+--------+-------+--------+------+--------+---+--------+---+
|        |       |        |      |        |   |        |   |
+--------+-------+--------+------+--------+---+--------+---+
| `3     |       |        |      |        |   |        |   |
| . Coun |       |        |      |        |   |        |   |
| try Na |       |        |      |        |   |        |   |
| me(s)` |       |        |      |        |   |        |   |
+--------+-------+--------+------+--------+---+--------+---+
|        |       |        |      |        |   |        |   |
+--------+-------+--------+------+--------+---+--------+---+
| `      | `YES` |        | `NO` |        |   | `5     |   |
| 4. Fin |       |        |      |        |   | . Repo |   |
| al Rep |       |        |      |        |   | rt # ( |   |
| ort? ` |       |        |      |        |   | 1,2, e |   |
|        |       |        |      |        |   | tc.) ` |   |
+--------+-------+--------+------+--------+---+--------+---+
|        |       |        |      |        |   |        |   |
+--------+-------+--------+------+--------+---+--------+---+
| `6.    |       | `7.    |      |        |   |        |   |
| Report |       |  Repor |      |        |   |        |   |
|  Date` |       | ting P |      |        |   |        |   |
|        |       | eriod` |      |        |   |        |   |
+--------+-------+--------+------+--------+---+--------+---+
|        |       |        |      |        |   |        |   |
+--------+-------+--------+------+--------+---+--------+---+
| `8.    |       |        |      |        |   |        |   |
|  CHECK |       |        |      |        |   |        |   |
|  THE A |       |        |      |        |   |        |   |
| PPROPR |       |        |      |        |   |        |   |
| IATE B |       |        |      |        |   |        |   |
| OXES:` |       |        |      |        |   |        |   |
+--------+-------+--------+------+--------+---+--------+---+
|        |       |        |      |        |   |        |   |
+--------+-------+--------+------+--------+---+--------+---+
| `      |       | `Sect  |      | `D     |   | `M     |   |
| Food f |       | ion 41 |      | irect  |   | onetiz |   |
| or Pro |       | 6 (b)` |      | Feed ` |   | ation` |   |
| gress` |       |        |      |        |   |        |   |
+--------+-------+--------+------+--------+---+--------+---+
|        |       |        |      |        |   |        |   |
+--------+-------+--------+------+--------+---+--------+---+
| **[COM |       |        |      |        |   |        |   |
| MODITY |       |        |      |        |   |        |   |
| LOG    |       |        |      |        |   |        |   |
| ISTICS |       |        |      |        |   |        |   |
| IN     |       |        |      |        |   |        |   |
| FORMAT |       |        |      |        |   |        |   |
| ION]{. |       |        |      |        |   |        |   |
| underl |       |        |      |        |   |        |   |
| ine}** |       |        |      |        |   |        |   |
|        |       |        |      |        |   |        |   |
| (Co    |       |        |      |        |   |        |   |
| mplete |       |        |      |        |   |        |   |
| this   |       |        |      |        |   |        |   |
| s      |       |        |      |        |   |        |   |
| ection |       |        |      |        |   |        |   |
| for    |       |        |      |        |   |        |   |
| all    |       |        |      |        |   |        |   |
| pro    |       |        |      |        |   |        |   |
| grams) |       |        |      |        |   |        |   |
+--------+-------+--------+------+--------+---+--------+---+
|        |       |        |      |        |   |        |   |
+--------+-------+--------+------+--------+---+--------+---+

<table>
<tbody>
<tr class="odd">
<td><p><code>Table A.</code></p>
<p><code> GENERAL COMMODITY INFORMATION</code></p>
<p><code>(quantities in actual NMT)</code></p>
<p><code>Include sub-totals (by commodity) and Totals</code></p></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td><p><code>Commodity</code></p></td>
<td><p><code>Agreement Allocation</code></p></td>
<td><p><code>Amount Received</code></p></td>
<td><p><code>Date Received</code></p>
<p><code>Month/Year</code></p></td>
<td><p><code>Balance</code></p></td>
<td><p><code>Expected Delivery Date</code></p></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td><p><code>Total</code></p></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td><p><code>Table B.</code></p>
<p><code>COMMODITY RECEIPT AND LOSSES</code></p>
<p><code>(quantities in actual NMT)</code></p>
<p><code>Include sub-totals (by commodity) and Totals</code></p></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td><p><code>----------Losses/Damages (L/D)--------</code></p></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td><p><code>Report # (1,2, etc.)</code></p></td>
<td><p><code>Commo-dity</code></p></td>
<td><p><code>Bill of Lading Amount</code></p></td>
<td><p><code>Amount</code></p>
<p><code>Rec</code><code>’</code><code>d at Port (Survey Report)</code></p></td>
<td><p><code>Ocean</code></p>
<p><code>Tran-sport L/D</code></p></td>
<td><p><code>Inland</code></p>
<p><code>Trans-port L/D</code></p></td>
<td><p><code>Ware-house L/D</code></p></td>
<td><p><code>Distri-bution L/D</code></p></td>
<td><p><code>Total</code></p>
<p><code>Losses/</code></p>
<p><code>Damages</code></p></td>
<td><p><code>Balance</code></p></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td><p><code> Total</code></p></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td><p><code>9. Provide an explanation for any commodity losses/damages, and any problems encountered in the commodity delivery process. (Specify when, where, and why.)</code></p></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td><p><code>10. List any claims on lost or defective goods. What is </code><code>current</code><code> status of these claims?</code></p></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td><p><code>11. Was the port able to adequately handle the commodity offloading without a large loss of commodity; did the port authorities and customs authorities handle the commodity clearance process efficiently?</code><code>  Was the surveyor present? Was he cooperative? Note name and firm of surveyor.</code></p></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td><p><code>12.  Were any measures taken to cut down on warehouse expenses, i.e. sharing space with other commodities, other PVOs, etc.?</code></p></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td><p><code>13. Were there any security measures that worked well or not well (warehousing)?</code></p></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td><p><code>14. Did the country</code><code>’</code><code>s intermodal system (trucking, rail, etc.)provide timely delivery?  What were your experiences?</code></p></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td><p><strong><u>DIRECT DISTRIBUTION INFORMATION</u></strong></p>
<p>If no commodities were used for direct distribution/feeding during
this reporting period, go directly to the “Monetization Information”
section of this report.</p></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td><p><code>Table C.</code></p>
<p><code>DIRECT DISTRIBUTION</code></p>
<p><code>(quantities in actual MT)</code></p>
<p><code>Include sub-totals (by commodity) and Totals</code></p></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td><p><code>Report #</code></p></td>
<td><p><code>Commodity</code></p></td>
<td><p><code>Amount</code></p>
<p><code>Distribu-ted (NMT)</code></p></td>
<td><p><code>Distribu-tion</code></p>
<p><code>Region</code></p></td>
<td><p><code>Type of</code></p>
<p><code>Institution</code></p>
<p><code>(Include Food for Work)</code></p></td>
<td><p><code>Number of</code></p>
<p><code>Recipient Insti-</code></p>
<p><code>tutions</code></p></td>
<td><p><code>Number of</code></p>
<p><code>Benefi-</code></p>
<p><code>ciaries </code></p></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td><p><code>Sub-total</code></p></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td><p><code>Total</code></p></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td><p><code>15. What have been the project impacts on the beneficiaries and the community?</code><code>  </code><code>How did the targeted recipients/participants respond to the food aid/donation?</code></p></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td><p><code>16. Compare the progress to date with planned project targets.</code></p></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td><p><code>17.  Describe how the monitoring procedures as outlined in the agreement are functioning, noting any adjustments or changes made.</code></p></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td><p><code>18.</code>
<code>  Was the commodity appropriate for the country/region?  If not, could another commodity and/or package type, have been used that would have improved the program?</code></p></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td><p><code>19. Has this distribution program helped reduce the need for future food aid?  Have new or are potential development prospects evident? </code></p></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td><p><strong><u>MONETIZATION INFORMATION</u></strong></p>
<p>(Use this section only if program involves sale of
commodities)</p></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td><p><code>20. Sales - Were any commodities sold during this reporting period?</code></p></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td><p><code>YES</code></p></td>
<td></td>
<td><p><code>NO</code></p></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td><p><code>If </code><code>“</code><code>NO</code><code>”</code><code>, use this block to provide a brief explanation and fill out only the </code><code>“</code><code>aggregate</code><code>”</code><code> section in Table D.</code></p></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td><p><code>Table D.</code></p>
<p><code>SALES</code></p>
<p><code>(Include Totals)</code></p></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td><p><code>Report #</code></p></td>
<td><p><code>Commod-ity</code></p></td>
<td><p><code>Date(s) of Sale (Month/Yr)</code></p></td>
<td><p><code>Amount Sold (NMT)</code></p></td>
<td><p><code>Price per MT (LC)</code></p></td>
<td><p><code>Exchange Rate (LC to USD)</code></p></td>
<td><p><code>Proceeds Generated (LC)</code></p></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td><p><code>Sub-totals</code></p></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td><p><code>Aggreg-ate Totals</code></p></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td><p><code>21. Barter - Were any commodities bartered in exchange for other commodities or services?</code></p></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td><p><code>YES</code></p></td>
<td></td>
<td><p><code>NO</code></p></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td><p><code>If yes, please describe the terms of the barter in this block.</code></p></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td><p><code>22. Has a separate special interest bearing account been established?</code></p></td>
<td><p><code>YES</code></p></td>
<td></td>
<td><p><code>NO</code></p></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td><p><code>Table E.</code></p>
<p><code>SPECIAL FUNDS ACCOUNT </code></p>
<p><code>Include Totals</code></p></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td><p><code>Re-port #</code></p></td>
<td><p><code>Begin-ning Balance (LC)</code></p></td>
<td><p><code>Sales Deposits (LC)</code></p></td>
<td><p><code>Interest Earned </code></p>
<p><code>(LC)</code></p></td>
<td><p><code>Other Program Income (LC)</code></p></td>
<td><p><code>Total Deposits (LC)</code></p></td>
<td><p><code>Total Disburs-ments (LC)</code></p></td>
<td><p><code>Account Balance (LC)</code></p></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td><p><code>Aggr. Total</code></p></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td><p><code>23. Use of Funds - Were any funds disbursed from the Special Funds Account during this reporting period?</code></p></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td><p><code>YES</code></p></td>
<td></td>
<td><p><code>NO</code></p></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td><p><code>If </code><code>“</code><code>NO</code><code>”</code><code>, use this block to provide a brief explanation.</code></p></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td><p><code>Table F.</code></p>
<p><code>USE OF FUNDS</code></p>
<p><code>(values in thousands)</code></p>
<p><code>Include Totals</code></p></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td><p><code>Report #</code></p></td>
<td><p><code>Amount (LC)</code></p></td>
<td><p><code>Use of Funds</code></p></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td><p><code>Total</code></p></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td><p><code>24. Describe any issues or discrepancies in the monetization process and procedure.</code></p></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td><p><code>25. Describe any problems encountered in the receipt and disbursement of funds:</code></p></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="even">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
</tr>
<tr class="odd">
<td></td>
<td></td>
<td></td>
<td></td>
<td></td>
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<td><p><code>26.  Describe your experience with the local banking system.  Is it more capable of dealing with future transactions of a similar nature?</code></p></td>
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<td><p><strong><u>FINAL INFORMATION</u></strong></p>
<p>(Complete this section for all programs)</p></td>
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<td><p><code>27.  Describe how this program has helped develop infrastructure/marketing channels (i.e. ports, warehouses, inter</code><code>‑</code><code>mobile transportation systems, stores, commodity markets, etc.)</code><code>	</code><code>	</code></p></td>
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<td><p><code>28.  Is there an increase in privatization?</code></p></td>
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<td><p><code>29.  Were taxes levied on the imported commodities?  If so, was it at a level such that program implementation was jeopardized?</code></p></td>
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<td><p><code>30.  If the (salvageable) commodity had to be reconstituted, what was done to minimize the commodity loss?  Would dual language commodity labels aid in the program's effectiveness?  Why or why not?</code></p></td>
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<td><p><code>31. Were program objectives accomplished as defined in the signed agreement? If so, to what degree? (Both qualitative and quantitative if feasible). What objectives were left unaccomplished? Why?</code></p></td>
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<td><p><code>32.  What were the short and long</code><code>‑</code><code>term direct/indirect impacts of the program to the targeted recipients/participants?  </code></p></td>
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<td><p><code>33.  Unexpected project outcomes, both positive and negative, as defined in the signed agreement should be noted. (Both qualitative and quantitative if feasible).</code></p></td>
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<td><p><code>34. Has your organization had an audit (which meets the A-133 audit guidelines) within the last year?  If yes, please submit audit, with a cover letter, to the address below. If no, please explain. </code></p></td>
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<td><p><code>35. How were your dealings with USDA?  Did you encounter problems with any of the regulations or rules regarding the program?  Do you feel that the forms, web-sites, and staff are friendly and useful?  What recommendations would you make to improve or streamline these or other areas?</code></p></td>
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<td><p><code>Name of report preparer:</code></p></td>
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<td><p><code>Preparer</code><code>’</code><code>s e-mail address:</code></p></td>
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<td><p><code>Preparer</code><code>’</code><code>s phone #:</code></p></td>
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<td><p><code>Date prepared:</code></p></td>
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    Save completed report locally as a Word document.  Submit report as an e-mail attachment to   E-mail questions and comments about this form to the same e-mail address.  

    Mailing address (for audits and/or hard copy reports): 

    Ron Croushorn,Director

    Programming Division

    Export Credits, Stop 1034							

    1400 Independence Avenue

    Washington, D.C.  20250

    Courier or hand delivery address (for audits and/or hard copy reports):  [Please phone PD at (202)720-4221 from lobby for entry into the building]

    Ron Croushorn, Director

    Programming Division

    Export Credits

    1250 Maryland Ave.,S.W.

    Washington, D.C. 20024

    This form was last revised on .