| This form is available electronically. | ||||||||||||
| FSA-85-1 U.S. Department of Agriculture (03-26-03) Farm Service Agency 
 Reporting and Recordkeeping Requirements 
 
 
 | 1. OMB No. | 2. Title of Clearance | ||||||||||
| 0560-0120 | Reporting Requirements Under U.S. Warehouse Act | |||||||||||
| 3. | 4. | 5. | 6. | 7. | Annual Burden on the Public (Col. 8 x 9=10 and Col. 10 x 11=12) | |||||||
| Description (Title of Form, Report or Record) | Report | Record | Form No. | Regulation Part/Sec. | 8. | 9. | 10. | 11. | 12. Total Burden Hours | |||
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					 | No. of Respondents | No. of Reports Filed Per Person | Total Annual Responses | Average Time to Respond | Exempt | Non-Exempt | ||
| Item 1-Application for License or Modification of License for the Conduct of a Public Warehouse | x | 
 | WA-50 | 735 | 500 
 
 | 1 | 500 | .08 | 
 | 40 | ||
| Item 2-Financial Statement-Warehouse Operator's Report of Assets | x | 
 | WA-51-2 | 735 1423 
 | 3000 | 1 | 3000 | .75 | 
 | 2250 | ||
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 | 1427.1081 | 
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| Item 3-Applicaton for a License to Inspect, Classify, Sample, and/or Weigh Warehouse Commodities | x | 
 | WA-53 | 735 | 2100 | 1 | 2100 | .25 | 
 | 525 | ||
| Item 4-Bond to Cover Lost Paper Warehouse Receipts Under the United States Warehouse Act | x | 
 | WA-62 | 735 | 20 | Occas. | 20 | .50 | 
 | 10 | ||
| Item 5 - Warehouse Operator to Submit Names & Signatures of Persons Authorized to Sign Receipts | x | 
 | WA-70 | 735 | 1000 | Occas. | 1000 | .25 | 
 | 250 | ||
| Item 6-Warehouse Operator's Bond & Related Forms | x | 
 | WA-80 | 735 | 204 
 | 1 | 204 | .25 | 
 | 51 | ||
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 | WA-81,82,83,84 85,87,88,89,90 | 
 | 10 (Each) 
 | 1(each) | 100 | .25 | 
 | 25 | ||
| 
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 | 91 | 
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| Item 7 -Returned and Destroyed Receipt Record | x | 
 | WA-105 | 735 | 100 | 1 | 100 | .25 | 
 | 25 | ||
| Item 8-Memorandum of Adjustments | x | 
 | WA-125 | 735 1423.9 | 700 | Occas. | 700 | .50 | 
 | 350 | ||
| Memorandum of Adjustments-Electronic Response | x | 
 | WA-125ER | 1427.1082 1427.1084 | 20 | Occas. | 20 | .50 | 
 | 10 | ||
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| TOTALS  | 
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| File Type | application/msword | 
| File Title | This form is available electronically | 
| Author | USDA-MDIOL00000DG8C | 
| Last Modified By | Fry, Judy - FSA, Washington, DC | 
| File Modified | 2014-09-03 | 
| File Created | 2014-09-03 |