OMB Control No. 0581-0308 

Business Entity ID Only For PSD Use Only PSD Bar Code Only 

U.S. Department of Agriculture 

Agricultural Marketing Service 

Fair Trade Practices Program 

Packers and Stockyards Division 

SPECIAL REPORT FOR REVIEW OF DEALER, 

MARKET AGENCY AND PACKER BONDS 

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. Only complete the section of this report that relates to your type of operation. 

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 

BOND INFORMATION - SECTION 2 

Note: Only complete the section that relates to your type of operation 

Livestock Sold by a Market Agency: 

201 Number of Public Sale Days that were held during this reporting period: 

a. Cattle b. Hogs c. Sheep & Goats d. Horses & Mules e. Total (a+b+c+d)

202 Gross Value of all Livestock Sold on 

Commission: $ $ $ $ $ 

Livestock Purchased as a Dealer for their own account and on Commission for the accounts of others: 

a. Cattle b. Hogs c. Sheep & Goats d. Horses & Mules e. Total (a+b+c+d)

203 Cost of livestock purchased on a dealer 

basis for registrant's account $ $ $ $ $ 

204 

Cost of livestock bought on commission 

for the account of others regardless of 

who paid for the livestock $ $ $ $ $ 

Combined cost of livestock purchased as 

a dealer, and bought on commission, per 

quarter 

205 

a. First Quarter

$

b. Second Quarter

 $ 

c. Third Quarter

$ 

d. Fourth Quarter

$ 

Livestock Purchased as a Packer: 

206 Type of Livestock Purchased Cattle Calves Hogs Sheep/Goats 

207 Total Cost of Livestock Purchased for Feeding: $ 

208 Total Cost of Livestock Purchased for Slaughter: $ 

209 Total Livestock Purchased: $ 

Form PSD 7003 Expires 01/31/2025 Page 1 of 2
 

 

 

OMB Control No. 0581-0308 

CERTIFICATION - SECTION 3

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. 

301 Print Name 302 Signature 

303 Phone Number 304 Date 305 Title 

 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, 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, no persons are 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 1.5 

hours per response, including the time to review instructions, search existing data resources, gather the data needed, and complete and review the information 

collection. 

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 7003 Expires 01/31/2025 Page 2 of 2