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First Name
Last Name

Please identify by state or country of origin the following information on cattle that were marketed through you or your company and/or marketed by you or your company as beef or beef products:
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  • State/Country of Origin
  • TOTAL A.
    # of Head Purchased/Sold
  • LESS B.
    # of Head NOT Assessed
  • EQUAL C.
    Total # of Head Assessed
  • Total Payment


  • Total Remittance

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Public reporting burden for this collection of information is estimated to average 1.8 min per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to the Dept. of Agriculture, Clearance Officer, STOP 7602, 1400 Independence Avenue, S.W., Washington, D.C. 20250-7602. When replying, refer to the OMB number (0581-0093) and form number in your letter. Under 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 U.S. Dept. of Agriculture prohibits discrimination in its programs on the basis of race, color, national origin, gender, religion, age, disability, sexual orientation, marital or family status, political beliefs, parental status, or protected genetic information. (Not all prohibited bases apply to all programs). Persons with disabilities who require alternative means for communication of program information (braille, large print, audiotape, etc.) should contact USDA's TARGET Center at 202-720-2600 (voice and TDD). To file a complaint of discrimination, write the USDA, Director, Office of Civil Rights, Room 326-W, Whitten Building, 14th and Independence Avenue, SW, Washington, DC 20250-9410 or call 202-720-5964 (voice and TDD). USDA is an equal employment opportunity employer.