Instructions for CCC-49

APPLICATION FOR APPROVAL OF WAREHOUSE FOR COTTON STORAGE AGREEMENT (CSA)

Warehouse operators use this form when applying for a Cotton Storage Agreement to store CCC-owned and loan cotton.

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 816-926-6662 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 3 through 27D.

Items 1 and 2 are for CCC use only.

Items 3-27D

Fld Name / Item No.	Instruction
3 Name and Location of Warehouse	Enter the name and location of the warehouse exactly as printed on the warehouse receipts or as shown on the electronic warehouse receipt profile.
4 Mailing Address	Enter the full mailing address of the warehouse including zip code.
5 County	Enter the county in which the warehouse is located.
6 Name of Warehouse Operator	Enter the individual(s) or legal entity name of warehouse operator. Example 1: John J. Doe, individual Example 2: Doe Cotton Warehouse, Inc., corporation
7A – 7B Name of Manager or Superin-tendent	Item 7A. Enter the name of the manager or superintendent of the warehouse. Item 7B. Enter the e-mail address for the manager or superintendent.
8 Telephone Number	Enter the telephone number of the warehouse, including area code.
9 FAX Number	Enter the FAX number of the warehouse, including area code.
10A – 10D Type License, Storage Capacity	Item 10A. Check “YES” if the warehouse is licensed under the United States Warehouse Act or “NO” if not. Item 10B. Check “YES” if warehouse is licensed by the State where the warehouse is located or “NO” if not. Item 10C. Check “YES” if warehouse operates gin and or compress facilities or “NO” if not. Item 10D. Enter the licensed storage capacity of the warehouse.
11A – 11E Warehouse Operation	Item 11A. Check if warehouse is operated by an individual. Item 11B. Check if warehouse is operated by a partnership. Item 11C. Check if warehouse is operated by a corporation or cooperative. Item 11D. Check if warehouse is operated by a limited liability company. Item 11E. Check if warehouse is operated by other than individual, partnership, or corporation, and specify type of business operation in space provided.
12A - 12F Corporation, Cooperative, Officers, and Other Owners	Item 12A. Enter the name of the president, member or individual and shares held in the corporation or cooperative. Item 12B. Enter the name of the vice-president or member and shares held in the corporation or cooperative. Item 12C. Enter the name of the secretary or member and shares held in the corporation or cooperative. Item 12D. Enter the name of the treasurer or member and shares held in the corporation or cooperative. Item 12E. Enter the name of the general manager, member or like officer and shares held in the corporation or cooperative. Item 12F. Enter names of principal stockholder(s) and shares held in the corporation or cooperative if shares held represent 20 percent or more interest.
13 Names of Partners	Enter the names of all partners, if a partnership.
14 Limited Partnership	Check “YES” if the partnership is operated as a limited partnership or “NO” if not. If “YES” is checked, attach a statement signed by all partners explaining the limitations of the partnership.
15A – 15D Unit Identity, Location, Capacity of Warehouse	Item 15A. Enter each building, section, or warehouse unit identifier that will be used for cotton storage. Item 15B. Enter the street address with zip code and city if different than Item 3. Item 15C. Enter the capacity in bales, by building or warehouse unit. Item 15D. Enter the total bale capacity for Item 15C.
16A – 16C Owned Units	Item 16A. Check “YES” if all warehouse units are owned or “NO” if not. If “YES” is checked, go to item 17. Item 16B. Enter the warehouse unit identity, the name of the lessor, and the date (MM-DD-YYYY) the lease expires. Item 16C. Check “YES” if the warehouse operator has a renewal option on leased unit(s) or “NO” if not.
17 Location of Railroad Siding	Check “YES” if any building, section, or unit of the warehouse is located on a railroad siding that is serviceable for placement of rail cars or “NO” if not. If “YES,” complete Item 18. If “NO,” go to Item 19.
18 Name of Railroad	Enter the name of the railroad if Item 17 is checked “YES.”
19A – 19B Felony Court Case Pending	Item 19A. Check “YES” if a local, state, or Federal felony court case is pending against the warehouse operator or responsible official or employee of the warehouse or “NO” if not. If “YES,” complete Item 19B. Item 19B. Explain the nature of the pending court case if Item 19A is checked “YES.”
20 Fire Insurance	Enter the name of the applicant’s cotton fire insurance underwriter.
21 Inland Marine All Risk Insurance	Check “YES” if the applicant has insurance on cotton commonly known as inland marine all risk insurance or “NO” if not.
22 Receipts	The applicant agrees to provide receipts that meet the conditions of Item 22.
23 Business Operating Hours	The applicant agrees to certain core business hours and posting of signage for clarification.
24A – 24B Receiving and Loadout Capabilities	Item 24A. Enter the number of bales the warehouse operator can receive and place in storage during a normal 40-hour workweek. Item 24B. Enter the number of bales the warehouse operator can pick out, load, and ship during a normal 40-hour workweek. Note: The warehouse operator agrees to load out the warehouse operator's Approved capacity at the rate of 4.5 percent per week.
25 Other	Identify the item number and enter any other additional information pertaining to that item number.
26 Certification	The applicant certifies that all statements are true and correct.
27A – 27D Legal Entity Name of Warehouse	Item 27A. Enter the legal entity name of the warehouse operator as shown in Item 6. Item 27B. Enter the signature of an authorized individual, i.e., corporate officer, partner, or proprietor. Item 27C. Enter the title of the person signing for the warehouse operator. Item 27D. Enter the date (MM-DD-YYYY) 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.

Fld Name /
Item No.

Instruction

Name and Location of Warehouse

Enter the name and location of the warehouse exactly as printed on the warehouse receipts or as shown on the electronic warehouse receipt profile.

Mailing Address

Enter the full mailing address of the warehouse including zip code.

County

Enter the county in which the warehouse is located.

Name of Warehouse Operator

Enter the individual(s) or legal entity name of warehouse operator.

Example 1: John J. Doe, individual

Example 2: Doe Cotton Warehouse, Inc., corporation

7A – 7B

Name of Manager or Superin-tendent

Item 7A. Enter the name of the manager or superintendent of the warehouse.

Item 7B. Enter the e-mail address for the manager or superintendent.

Telephone Number

Enter the telephone number of the warehouse, including area code.

FAX Number

Enter the FAX number of the warehouse, including area code.

10A – 10D

Type License, Storage Capacity

Item 10A. Check “YES” if the warehouse is licensed under the United States Warehouse Act or “NO” if not.

Item 10B. Check “YES” if warehouse is licensed by the State where the warehouse is located or “NO” if not.

Item 10C. Check “YES” if warehouse operates gin and or compress facilities or “NO” if not.

Item 10D. Enter the licensed storage capacity of the warehouse.

11A – 11E

Warehouse Operation

Item 11A. Check if warehouse is operated by an individual.

Item 11B. Check if warehouse is operated by a partnership.

Item 11C. Check if warehouse is operated by a corporation or cooperative.

Item 11D. Check if warehouse is operated by a limited liability company.

Item 11E. Check if warehouse is operated by other than individual, partnership, or corporation, and specify type of business operation in space provided.

12A - 12F

Corporation, Cooperative, Officers, and Other Owners

Item 12A. Enter the name of the president, member or individual and shares held in the corporation or cooperative.

Item 12B. Enter the name of the vice-president or member and shares held in the corporation or cooperative.

Item 12C. Enter the name of the secretary or member and shares held in the corporation or cooperative.

Item 12D. Enter the name of the treasurer or member and shares held in the corporation or cooperative.

Item 12E. Enter the name of the general manager, member or like officer and shares held in the corporation or cooperative.

Item 12F. Enter names of principal stockholder(s) and shares held in the corporation or cooperative if shares held represent 20 percent or more interest.

Names of Partners

Enter the names of all partners, if a partnership.

Limited Partnership

Check “YES” if the partnership is operated as a limited partnership or “NO” if not. If “YES” is checked, attach a statement signed by all partners explaining the limitations of the partnership.

15A – 15D

Unit Identity, Location, Capacity of Warehouse

Item 15A. Enter each building, section, or warehouse unit identifier that will be used for cotton storage.

Item 15B. Enter the street address with zip code and city if different than Item 3.

Item 15C. Enter the capacity in bales, by building or warehouse unit.

Item 15D. Enter the total bale capacity for Item 15C.

16A – 16C

Owned Units

Item 16A. Check “YES” if all warehouse units are owned or “NO” if not. If “YES” is checked, go to item 17.

Item 16B. Enter the warehouse unit identity, the name of the lessor, and the date (MM-DD-YYYY) the lease expires.

Item 16C. Check “YES” if the warehouse operator has a renewal option on leased unit(s) or “NO” if not.

Location of Railroad Siding

Check “YES” if any building, section, or unit of the warehouse is located on a railroad siding that is serviceable for placement of rail cars or “NO” if not. If “YES,” complete Item 18. If “NO,” go to Item 19.

Name of Railroad

Enter the name of the railroad if Item 17 is checked “YES.”

19A – 19B

Felony Court Case Pending

Item 19A. Check “YES” if a local, state, or Federal felony court case is pending against the warehouse operator or responsible official or employee of the warehouse or “NO” if not. If “YES,” complete Item 19B.

Item 19B. Explain the nature of the pending court case if Item 19A is checked “YES.”

Fire Insurance

Enter the name of the applicant’s cotton fire insurance underwriter.

Inland Marine All Risk Insurance

Check “YES” if the applicant has insurance on cotton commonly known as inland marine all risk insurance or “NO” if not.

Receipts

The applicant agrees to provide receipts that meet the conditions of Item 22.

Business Operating Hours

The applicant agrees to certain core business hours and posting of signage for clarification.

24A – 24B

Receiving and Loadout Capabilities

Item 24A. Enter the number of bales the warehouse operator can receive and place in storage during a normal 40-hour workweek.

Item 24B. Enter the number of bales the warehouse operator can pick out, load, and ship during a normal 40-hour workweek.

Note: The warehouse operator agrees to load out the warehouse operator's Approved capacity at the rate of 4.5 percent per week.

Other

Identify the item number and enter any other additional information pertaining to that item number.

Certification

The applicant certifies that all statements are true and correct.

27A – 27D

Legal Entity Name of Warehouse

Item 27A. Enter the legal entity name of the warehouse operator as shown in Item 6.

Item 27B. Enter the signature of an authorized individual, i.e., corporate officer, partner, or proprietor.

Item 27C. Enter the title of the person signing for the warehouse operator.

Item 27D. Enter the date (MM-DD-YYYY) 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.