Instructions for CCC-24

Instructions For CCC-24
APPLICATION FOR APPROVAL OF WAREHOUSE FOR UNIFORM GRAIN AND RICE STORAGE AGREEMENT (UGRSA)

Warehouse operators use this form when applying for a Uniform Grain and Rice Storage Agreement to store CCC-owned and loan grain.

Submit the original of the completed form in hard copy or facsimile to the Kansas City Commodity Office, Storage Contract Branch, STOP 8748, P.O. Box 419205, Kansas City, MO 64141-6205; telephone 816-926-6446 or FAX 816-926-1426. Customers who have established electronic access credentials with KCCO may electronically transmit this form to KCCO. Features for transmitting the form electronically are available to those customers with access credentials only. If you would like to establish online access credentials with USDA, follow the instructions provided at the USDA eForms web site.

Warehouse Operators must complete Items 1 through 13D.

Items A through D at top right of page are for CCC use only.

Items 1-13D

Fld Name /
Item No.

Instruction

Legal Name of Entity

Enter the name of the warehouse exactly as printed on the warehouse receipts.

Warehouse Location

Enter the warehouse location(s) (town, county, state).

3 A - 3C

Name of Warehouse Manager or Superinten-dent

Item 3A. Enter the name of the manager or superintendent of the

warehouse.

Item 3B. Enter the telephone number of the warehouse, including area

code.

Item 3C. Enter the FAX number of the warehouse, including area code.

4A - 4B

Type License

Item 4A. Check box to indicate if warehouse is unlicensed, State licensed, or U.S. Warehouse Act (USWA) licensed.

Item 4B. If State or USWA licensed, enter the license number.

Type of Operating Entity

Enter a check mark in the box to indicate if the operating entity is a corporation, general partnership, limited, individual, or other.

If operating entity is other than corporation, general partnership, limited, or individual, enter the type of operating entity in Other (Specify).

6A - 6E

Contract Mailing Address

Item 6A. Enter the contact's full mailing address, including zip code.

Item 6B. Enter the warehouse contact person.

Item 6C. Enter the contact's telephone number, including area code.

Item 6D. Enter the contact's FAX number, including area code.

Item 6E. Enter the contact's E-Mail address.

Mailing Address for Loading Orders and Periodic Invoices

Enter the full mailing address including zip code for use by CCC to mail loading orders and periodic invoices.

8A - 8C

Payee Disburse-ment Mailing Address

Item 8A. Enter the name and full mailing address, including zip code,

of the financial institution where payments should be directed.

Item 8B. Enter the telephone number, including area code.

Item 8C. Enter the FAX number, including area code.

9A - 9C

Name, Title, and Address

Item 9A. Enter the name of the officers, if a corporation, partners, if a

partnership, or individual, if a proprieto

Item 9B. Enter the title of the person in the name column (Item 9A).

Item 9C. Enter the address of the person in the name column (Item 9A).

10(a) - 10(d)

Total Handling Capacity

Item 10a. Enter the total railroad car (hoppers) unload capability and the total load out capability, in bushels, for all warehouse locations during a normal workday.

Item 10b. Enter the total truck unload capability and the total load out capability, in bushels, for all warehouse locations during a normal workday.

Item 10c. Enter the total barge unload capability and the total load out capability, in bushels, for all warehouse locations during a normal workday.

Item 10d. Enter the total vessel unload capability and the total load out capability, in bushels, for all warehouse locations during a normal workday.

11(a) - 11(h)

Location, Receiving, and Load Out of Hopper Rail Cars

Item 11a. Enter the:

location (city and state) where the warehouse operator offers handling by rail,

maximum number of covered hopper rail cars that can be received in a 24-hour workday on a multiple-car basis at the location or "NA" if no such service is provided, and

maximum number of covered hopper rail cars that can be loaded out in a 24-hour workday on a multiple-car basis or "NA" if no such service is provided.

Repeat Items 11a for each warehouse location in Items 11b - 11h. If more locations, attach a separate sheet reporting the additional information.

The warehouse operator must:

To qualify for official weights, receive and load out grain shipped by rail over scales that are certified by the Association of American Railroads (AAR), the servicing rail, Federal Grain and Inspection Service (FGIS), or a qualified independent third party. (Official weights are a requirement for a terminal warehouse.)

To provide official origin grades for rail or barge load out, either have a mechanical sampler agreement (certified by FGIS) or a "Route" sampler agreement (i.e., cars are probed by a licensed sampler or inspector and samples graded by recognized FGIS inspection agency) with CCC.
Items 12a - 13D

12(a) – 12(e)

Approved Weights and Official Origin Grades

Item 12a. Check "Yes" in the "Approved Weights" column if the type of approved weights, as defined in the Uniform Grain and Rice Storage Agreement (UGRSA), are available at the warehouse, or "No" if not.

Check "Yes" in the "Official Origin Grades or Inspections" column if the type of official origin grades or inspections, as defined in the UGRSA, are available at the warehouse, or "No" if not.

Item 12b. If Item 12a is "Yes," check "Yes" in the "Approved Weights" column and the "Official Origin Grades or Inspections" column if the warehouse operator will furnish types of weights and origin grades or inspections to CCC for loading order settlements.

Item 12c. Check "Yes" in the "Official Origin Grades or Inspections" column if official origin grades or inspections are available for rail or barge load out, and if the official origin grades or inspections are based on samples obtained by a diverter-type mechanical sampler authorized by USDA, or "No" if not.

Item 12d. If Item 12a is "Yes" for "Approved Weights" and FGIS is the supervising agency for such weights, place a check in the box beside "FGIS" and enter the FGIS location (full address including zip code).

If Item 12a is checked "Yes," and the supervising agency for such weights is other than FGIS, place a check in the box beside "Other" and enter the name and address (including zip code) of the agency supervising such weights.

Item 12e. If Item 12a is "Yes" for "Official Origin Grades or Inspections" and FGIS is the supervising agency for such Official origin grades or inspections, place a check in the box beside "FGIS" and enter the FGIS location (full address including zip code).

If Item 12a is checked "Yes," and the supervising agency for such "Official Origin Grades or Inspections" is other than FGIS, place a check in the box beside "Other" and enter the name and address (including zip code) of the agency supervising such grades or inspections.

13A - 13D

Certification and Signature

Item 13. The applicant certifies that all statements are true and correct.

Item 13A. Enter the legal entity name of the warehouse as shown in

Item 1.

Item 13B. Enter the signature of an authorized individual, i.e., corporate officer, partner, or proprietor.

Item 13C. Enter the title of the person signing for the warehouse.

Item 13D. Enter the date the application is signed.

If you are mailing or faxing this form, print the form and enter the

signature of an authorized individual, i.e., a corporate officer, partner, or

proprietor. If this form is approved for electronic transmission and you

have established credentials with USDA to submit forms electronically,

use the buttons provided on the form for transmitting the form to the

Kansas City Commodity Office.