Instructions to Complete Special Report for Review of

Dealer, Market Agency and Packer Bonds

Form PSD 7003

As an entity regulated by the Packers and Stockyards Act, you are required to file a special report with the 

U.S. Department of Agriculture’s Packers and Stockyards Division (PSD) on Form PSD 7003 Special 

Report for Review of Dealer, Market Agency and Packer Bonds.

Provide information for each line on the form that that applies to the period specified in the request letter.

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

Submit the completed form by the date stated on the letter notifying you to file the special report, to the 

PSD regional office that covers your area. The areas covered by each regional office are listed below its 

address. 

Failure to file this form 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, until report receipt. Section 10 of the FTC Act made applicable by Section 402 of the 

Act (7 U.S.C. 222). 

All information must be completed on this form in its entirety. Failure to do so will result in the 

form being returned incomplete.

Regional Offices of the Packers and Stockyards Division

Agricultural Marketing Service, Fair Trade Practices Program

Eastern Regional Office

75 Ted Turner Drive SW, Ste 230 

Atlanta, GA 30303-3308 

Telephone: (404) 562-5840 

FAX: (404) 562-5848 

E-mail:

PSDAtlantaGA@ams.usda.gov

States Covered 

AL, AR, CT, DC, DE, FL, GA, 

LA, MA, MD, ME, MS, NC, 

NH, NJ, NL, NY, PA, PR, QC, 

RI, SC, TN, VA, VT, WV

Midwestern Regional Office

210 Walnut Street, Room 317 

Des Moines, IA 50309-2110 

Telephone: (515) 323-2579 

FAX: (515) 323-2590 

E-mail:

PSDDesMoinesIA@ams.usda.gov

States Covered 

IA, IL, IN, KY, MB, MI, MN, 

MO, ND, NE, OH, ON, SD, WI

Western Regional Office

3950 Lewiston St., Suite 200 

Aurora, CO 80011-1556 

Telephone: (303) 375-4240 

FAX: (303) 371-4609 

E-mail: PSDDenverCO@ams.usda.gov

States Covered 

AB, AK, AZ, BC, CA, CO, HI, 

ID, KS, MT, NM, NV, OK, OR, 

SK, TX, UT, WA, WY

If you have any questions about the form or completing the form, please contact the PSD Regional Office that 

covers your area, as listed above. Additional copies of the form may be obtained from the regional office, or on the 

PSD website at https://www.ams.usda.gov/resources/forms

Form PSD 7003 Expires 01/31/2025 Page 1 of 3
SECTION-BY-SECTION INSTRUCTIONS 

FORM HEADER – BUSINESS ENTITY ID

Business Entity ID should be completed using information on request letter. You may also contact the 

appropriate regional office as listed above to obtain this information 

Line No. Subject Instruction

GENERAL INFORMATION - SECTION 

101

a and b

Reporting Period The reporting period covers the period of time specified in the 

request letter (FROM) [date], (TO) [date]. Please use the date 

format MM/DD/YYYY

102 Entity Name Enter the name under which you are registered with PSD.

103 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/d.b.a,”, enter N/A.

104 

and

105 

Mailing Address Enter your mailing address (street, city, state, and zip+4). This 

is the address where all correspondence from PSD should be 

sent. 

106 

and 

107 

Operating Address Enter the physical location of your operating address (street, 

city, state, and zip+4). This is the address where you conduct 

your business services. 

108 Contact Name Enter the name of the person to be contacted regarding 

questions on the annual report.

109 Contact Telephone Enter the telephone where the contact person may be reached.

110 Fax Number Enter the Fax used by the entity.

111 E-Mail Address Enter the entity’s e-mail address.

112 Web Site Address (if 

applicable)

Enter the complete Web site address the business operates. 

For example: www.WebSiteName@domain.com 

BOND INFORMATION – SECTION 2

201 Number of Public Sale 

Days

Enter the number of day’s livestock sales were conducted by 

the market.

202 Gross Value of Livestock Enter the gross value of livestock sold on commission, for 

each category of livestock, during the reporting period.

203 

a 

through 

e 

Cost of livestock 

purchased as a dealer

Enter the cost for each category of livestock, and the total cost 

of livestock purchased on a dealer basis during the reporting 

period. 

204 

a 

through 

e 

Cost of livestock bought 

on commission 

Enter the cost for each category of livestock and the total cost 

of livestock purchased as an order buyer during the reporting 

period. You must include all livestock that you bought on 

commission regardless whether you or another entity paid for 

it. 

Form PSD 7003 Expires 01/31/2025 Page 2 of 3
Line No. Subject Instruction

205 Combined cost of 

livestock, per quarter 

Enter the combined cost of livestock purchased as a dealer, 

and bought on commission, per quarter, during the reporting 

period.

206 Type of Livestock 

Purchased

Check the appropriate box to indicate the type of livestock the 

entity purchased for slaughter and/or feeding, during the 

reporting period.

207 Livestock Purchased for 

Feeding

Enter the gross dollar amount of all livestock purchased for 

feeding, during the reporting period.

208 Livestock Purchased for 

Slaughter

Enter the gross dollar amount of all livestock purchased for 

slaughter, during the reporting period.

209 Total Livestock Purchased Enter the sum total of lines 208 and 209.

CERTIFICATION – SECTION 3

301 Print Name Print the name of the owner, officer, partner, or member 

responsible for this report.

302 Signature The report must be signed by a responsible person.

303 Phone Number Enter the phone number of the person signing the report.

304 Date Enter the date the report is signed.

305 Title Enter the title of the person signing the report.

Form PSD 7003 Expires 01/31/2025 Page 3 of 3