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OMB Control No. 0581-0308 

Business Entity ID Number For PSD Stamp Only PSD Bar Code Only

U.S. Department of Agriculture

Agricultural Marketing Service

Fair Trade Practices Program

Packers and Stockyards Division

ANNUAL REPORT

OF PACKERS

Select this box if you want to receive

electronic notification to file your

annual report. This will begin in the

next reporting cycle.

Electronic Filing

Instructions: If a line's value is zero, enter "0". If a line does not apply, enter "N/A". Return completed form to the 

PSD Central Reporting Unit. If all lines are not completed when the form is received, the form will be returned. See 

separate instructions for complete information about this report.

You must complete form PSD 3005 for each plant that you use for your firm's operation. The total values reported in Section 2 of

Form PSD 3005 will be combined and reported as the totals in Section 3 of this form.

GENERAL INFORMATION - SECTION 1

101 Reporting Period 

(mm/dd/yyyy) a. FROM: b. TO:

~ 

102 Entity Name

103 Trade Name/d.b.a.

~ 

104 Mailing Address

105 City, State, Zip+4

106 Operating Address

~ 

107 City, State, Zip+4

108 Contact Name

109 Contact Telephone 110 Fax Number

111 E-Mail Address 112 Web Address

ORGANIZATIONAL STRUCTURE - SECTION 2

List owners, officers, partners, and members in control of this business with their ownership percentage.

a. Name b. Title c. %

201

202

203

204

205

206 Type organization: Individual Partnership Corporation L.L.C. L.L.P. Co-op Association

207 Is this the same organization type reported last year? Yes No

208 Does the entity own or operate scales on which payment to sellers is determined? Yes No

209 What is the basis of payment made to the entity for most livestock you purchase? Per Head Live Wt. Dressed Wt./Carcass Basis

210 Do you use an electronic instrument to measure carcass characteristics to determine payment to sellers? Yes No

211 If line 210 is Yes, list the manufacturer and the type of instrument.

212 Is this business owned or controlled by another business entity - If Yes, list the name and address on line 213 Yes No

213 Owned/controlling business name and address

214

Does this Business, including any Owners, Officers, Directors, Members or Employees,

own an interest in any other Market Agency, Dealer Organization, or Packing

Company?

Yes No

If line 214 is yes, give the name of related firms, name of person or firms with relationship, and percentage of ownership under lines 215-218

a. Name of Related Firm b. Name of Person/Firm with Relationship c. %

215

216

217

218

Form PSD 3004 Expires 01/31/2025 Page 1 of 6
OMB Control No. 0581-0308 

LIVESTOCK FEEDING OPERATIONS, PROCUREMENT, SLAUGHTER,

AND MEAT PROCESSING - SECTION 3

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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If you use only one plant for slaughter operations, report values here. If you use more than one plant, then use Supplement Form 3005 for each plant and 

report totals here.

301 Plant Name

302 Mailing Address

303 City, State, Zip + 4

304 Plant Physical Address (if 

different from 106)

305 Is this plant federally or state inspected? Federal State Neither

306 FSIS or state plant inspection number:

307 Do you own or lease this plant? Own Lease Neither

Custom Slaughter: If you custom slaughter for other businesses than the plant listed in line 301, complete lines 308-318,

otherwise continue to line 319.

List the names and addresses of the entities for which you provided custom slaughter services at this plant in lines 308-311. List only entities for which you 

custom slaughtered at least 100 head or more. Add additional pages as necessary.

Entity Name Entity Address Telephone

308 1st Entity

309 2nd Entity

310 3rd Entity

311 4th Entity

For each entity listed on lines 308-311 enter the number of head slaughtered on lines 312-315. Combine number of head slaughtered for additional

entities reported on separate pages, and enter on line 316. For those entities you slaughter less than 100 head, enter number of head on line 317. Total

all values on line 318.

Steer/Heifer (hd) Cow/Bull (hd) Calf (hd) Hog (hd) Sheep/Goat (hd) Other (hd)

312 1st Entity

313 2nd Entity

314 3rd Entity

315 4th Entity

316 Total additional pgs.

317 Total < 100 hd.

318 Total

Committed Procurement: Livestock procured more than 14 days before slaughter:

Steer/Heifer (hd) Cow/Bull (hd) Calf (hd) Hog (hd) Sheep/Goat (hd) Other (hd)

319 Packer owned

320 From other packers

321 All other sources

322 Total

Non-Committed Procurement: Livestock procured 14 days or fewer before slaughter:

Steer/Heifer (hd) Cow/Bull (hd) Calf (hd) Hog (hd) Sheep/Goat (hd) Other (hd)

323 From other packers

324 Direct

325 Through public

markets

326 Total

Form PSD 3004 Expires 01/31/2025 Page 2 of 6
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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OMB Control No. 0581-0308 

Slaughter Adjustments: Livestock procured but not slaughtered:

Steer/Heifer (hd) Cow/Bull (hd) Calf (hd) Hog (hd) Sheep/Goat (hd) Other (hd)

327 Livestock sold

328 Dead or condemned

329 Total

Total Slaughter: Line 330 equals line 318 plus 322, plus 326, minus line 329

Steer/Heifer (hd) Cow/Bull (hd) Calf (hd) Hog (hd) Sheep/Goat (hd) Other (hd)

330 Total Slaughter

Number of Livestock Paid for Based on Carcass Grade; Carcass Weight or Carcass Grade and Weight (i.e., not liveweight):

Steer/Heifer (hd) Cow/Bull (hd) Calf (hd) Hog (hd) Sheep/Goat (hd) Other (hd)

331 Carcass Basis/

Dressed Wt.

Meat Processing Activities:

Beef (1000 lbs) Pork (1000 lbs) Veal (1000 lbs) Lamb (1000 lbs) Other (1000 lbs)

332 Purchased externally

or transferred in

333

Total Products

shipped (exclude

offal)

FINANCIAL INFORMATION - SECTION 4

401 Number of days livestock was purchased during the reporting year

402 Total value of livestock purchased for feeding $

403 Total value of livestock purchased for slaughter $

404 Total value of all livestock purchased (line 402 plus 403) $

Enter name and location of bank used for livestock payments. Add additional banks if necessary

405 Name of Financial Institution

406 Physical Address

407 City, State, Zip +4

408 Contact Name 409 Contact Telephone

410 As of the end of the reporting period, were Accounts Receivable and/or Inventories, or any part thereof, pledged or 

assigned as collateral under a financing or loan agreement? Yes No

411 At any time during the year, Have you been notified by your financial institution that you were

in violation of any terms, conditions, and/or covenants of your financial agreement? Yes No

412 If so notified, have you been provided a waiver from your financial institution? Yes No

413 If the financial institution named in line 405 is the same as that used for your financial or loan agreement,

check this box. Otherwise, complete lines 414 through 418, as necessary.

Same as 405

If the checkbox for 413 is not selected, complete lines 414 through 418 for each financial lending institution. Attach 

additional sheets if more than one.

414 Name of Lending Institution

415 Mailing Address

416 City, State, Zip +4

417 Contact Name 418 Contact Telephone

Livestock Trust Ratio Calculation

419

Reference the instruction sheet in calculating your Livestock Trust ratio

Calculated Trust Ratio

Form PSD 3004 Expires 01/31/2025 Page 3 of 6
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OMB Control No. 0581-0308 .

STATEMENT OF ASSETS, LIABILITIES, AND EQUITY - SECTION 5

Include values only for the reporting entity. NOTE: If you ONLY provide custom slaughter, and/or your livestock purchase volume is under $500k,

you do not need to complete sections 5 and 6.

ASSETS

Current Assets:

Cash (Enter overdrafts on line 522) 501 $

Current Cash Equivalents (CD's, Savings, etc.) 502 $

Trade Accounts Receivables-Net (Due in 1 year or less):

Owners, Officers, and Affiliated Companies 503 $

All Others (Sources Not Related to Company) 504 $

Total Trade Accounts Receivable-Net (Due in 1 year or less) (Total lines 503 and 504) 505 $

Inventory:

Livestock Inventory 506 $

Meat and Meat Products Inventory 507 $

Other Inventory 508 $

Total Inventories (Total lines 506, 507, and 508) 509 $

Notes and Loans Receivable (Due in One Year or Less):

Owners, Officers, and Related Entities 510 $

Others (Sources Not Related to Company) 511 $

Total Notes and Loans Receivable (Due in 1 Year or Less) (Total lines 510 and 511) 512 $

Advances Made on Livestock 513 $

Other Current Assets 514 $

Total Current Assets (Enter the sum total of lines 501, 502, 505, 509, 512, 513, and 514) 515 $

Property, Plant, & Equipment (Net of Depreciation and Amortization) 516 $

Other Assets:

Investments in Subsidiaries and Affiliated Companies 517 $

Due from Owners, Officers, and Related Entities (Due in 1 year or more) 518 $

Other Assets 519 $

Total Assets (Total of lines 517 through 519) 520 $

TOTAL ASSETS (Total of lines 515, 516, and 520) 521 $

LIABILITIES

Current Liabilities:

Overdraft 522 $

Trade Accounts Payables:

Livestock Payables (Due in 1 Year or Less) 523 $

Other Payables to Owners, Officers, and Related Entities (Due in 1 Year or Less) 524 $

Other Payables (Sources Not Related to Company)(Due in 1 Year or Less) 525 $

Total Trade Accounts Payables (Total lines 523, 524, and 525) 526 $

Current Maturities of Long-Term Debt: (Demand notes and portion of long-term notes due in 1 year or less)

Owners, Officers, and Related Entities 527 $

Others (Sources Not Related to Company) 528 $

Total Current Maturities of Long-Term Debt (Total lines 527 and 528 529 $

Other Current Liabilities 530 $

Total Current Liabilities (Total lines 522, 526, 529, and 530) 531 $

Other Liabilities:

Long -Term Debt, Less Current Maturities: (Due in 1 year or more)

Owners, Officers, and Related Entities 532 $

Others (Sources Not Related to Company) 533 $

Total Long-Term Debt, Less Current Maturities (Total of lines 532 and 533) 534 $

All Other Liabilities 535 $

TOTAL LIABILITIES (Total of lines 531, 534 and 535) 536 $

Form PSD 3004 Expires 01/31/2025 Page 4 of 6
 

 

 

 

 

 

 

 

 

 

 

 

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OMB Control No. 0581-0308 

EQUITY

Owner's Equity (Unincorporated) 537 $

OR

Stock Issued (Incorporated) 538 $

Additional Paid-in Capital 539 $

Retained Earnings 540 $

TOTAL EQUITY (Total lines 537 through 540) 541 $

TOTAL LIABILITIES AND EQUITY (should equal line 521) 542 $

 STATEMENT OF REVENUE AND EXPENSES - SECTION 6

Include values only for reporting entity.

Income Statement

Net Sales (Gross sales less sales returns & allowances) 601 $

Cost of Sales

Opening Inventory 602 $

Livestock Purchases 603 $

Meat and Meat Product Purchases 604 $

Other Purchases 605 $

Subtotal (sum lines 602 to 605) 606 $

Closing Inventory 607 $

Total Cost of Sales (line 606 less 607) 608 $

Gross Profit (line 601 less 608) 609 $

Operating Expenses

Manufacturing 610 $

General, Sales, and Administrative 611 $

Depreciation & Amortization 612 $

Total Operating Expenses 613 $

Operating Income or Loss (line 609 less line 613) 614 $

Adjustments to Operating Income

Other Additions to Income 615 $

Interest Expense (enter as a negative number) 616 $

Other Deductions from Income (enter as a negative number) 617 $

Adjustments to Operating Income + or - (Enter the sum total of lines 615 through 617; enter as + or -) 618 $

Net Profit or Loss Before Taxes (Add line 618 plus line 614) 619 $

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. Section 10 of the FTC Act, made applicable by Section 402 of the Act (7 U.S.C. 222).

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. (This form must be signed by a person listed in liens 201-205) 

701 Print Name 702 Signature

703 Telephone Number 704 Date 705 Title

Form PSD 3004 Expires 01/31/2025 Page 5 of 6
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OMB Control No. 0581-0308 .

Submitted information is confidential (9 CFR 201.96). Failure to report may result with a complaint filed against the entity in a United States District

Court charging the entity with violations of the Packers and Stockyards Act and seeking civil penalties as authorized by law per day until report receipt.

Section 10 of the FTC Act, made applicable by Section 402 of the Act (7 U.S.C. 222).

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 7 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 provided 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.

Form PSD 3004 Expires 01/31/2025 Page 6 of 6