Instructions to Complete 

Application for Registration 

Packer Buyer 

Form PSD 1100 

Applicants employed by a packer on salary or other compensation and buying livestock for such 

packer use form PSD 1100 to register as a packer buyer. If any information is missing or 

incorrect, the Packers and Stockyards Division (PSD) will return the application form to the 

principal for completion or correction. 

Operating without proper registration and bond may subject the principal to severe civil penalties 

as authorized by law for each violation, and additional penalties for each day the violation 

continues (7 U.S.C § 203). 

Submit the completed form to the PSD regional office where the PACKER is bonded. The 

Areas covered by each regional office are listed below the regional office's address. 

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 

Areas 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 

Areas 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 

Areas 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. 

Packer-buyer must complete Lines No. 1 through 12 and sign and complete Line No. 13. 

The Packer must complete Line 14 through 20. 

Subject Instruction 

1 Name of 

Applicant to be 

Registered 

Enter the name of the individual to be registered. 

2a 

through 

2e 

Mailing Address Enter your mailing address, including street, city, county, 

state, and zip+4. This is the address where all correspondence 

from the Packers and Stockyards Division will be sent. 

Form PSD 1100 Expires 01/31/2025 Page 1 of 2 
Subject Instruction

3a 

through 

3e 

Operating Address 

(if different from 

mailing address)

Enter the operating address and/or physical location. Enter 

street, city, county, state, and zip+4. This is the address where 

you conduct your business services. 

4 Phone Enter the phone number where you can be reached.

5 Cell Enter your cellphone number.

6 Fax Enter your fax number.

7 E-Mail Address Enter your e-mail address.

8 Livestock to be 

Purchased

for Slaughter

Check the appropriate box to indicate each class of livestock 

you will be purchasing for slaughter. 

9 Names and 

locations of posted 

stockyards, 

feedlots, or 

websites...

Enter the name and address, including city and state, of each 

of the posted stockyards, feedlots, or web sites where you will 

purchase livestock for slaughter. 

10 If you operate a 

buying station...

Enter the name and address, including city, state, and zip+4 

where you operate a buying station.

11 If previously 

registered, list 

registered name 

and address.

If you were previously registered with the Packers and 

Stockyards Division list each of the name(s) under which you 

were previously registered, and the address(es) of the prior 

business(s).

12 Do you own an 

interest in other 

operations.... 

If you currently operate as, or own any interest in, any dealer 

organization(s), market agency(s), stockyard company(s), or 

packing company(s), check “Yes” and provide details in the 

next section, otherwise, check “No.”

12a 

through 

12c 

Name, Location,

Percentage of 

Control

Enter the name(s), location, including city, state, and zip+4, 

and the percentage of control or ownership that you maintain 

in any of the businesses.

13a 

through 

13c 

Signature of 

Applicant, Print 

Name, and Date

The applicant must sign the application and print the name of 

the person signing. Enter the date the form was signed. 

THIS SECTION IS TO BE COMPLETED BY THE PACKER-EMPLOYER.

14a 

through 

14c 

Signature of 

Employer, Print 

Officer’s name, 

Date

An authorized officer of the packer-employer must sign the 

form, print their name, and enter the date the form was signed. 

15 Official title Enter the official title of the officer signing the application.

16 Name of Firm Enter the full name of the employing packer firm.

17 Address Enter the address, including city, state and zip+4 of the packer 

firm.

18 Telephone Enter the telephone number of the packer firm.

19 Email Address Enter the email address of the packer firm.

20 Website Address, 

if applicable

Enter the website address of the packer firm, if applicable.

Form PSD 1100 Expires 01/31/2025 Page 2 of 2