Form FSI-439 "N.y.s. Commercial Feed Tonnage Report" - New York

What Is Form FSI-439?

This is a legal form that was released by the New York State Department of Agriculture and Markets - a government authority operating within New York. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on March 1, 2014;
  • The latest edition provided by the New York State Department of Agriculture and Markets;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form FSI-439 by clicking the link below or browse more documents and templates provided by the New York State Department of Agriculture and Markets.

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Download Form FSI-439 "N.y.s. Commercial Feed Tonnage Report" - New York

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FSI-439 (Rev.3/14)
N.Y.S. COMMERCIAL FEED TONNAGE REPORT
New York State Department of Agriculture and Markets
Division of Food Safety and Inspection
10B Airline Drive, Albany, New York 12235
OWNER NAME/COMPANY NAME ____________________________
Estab No: ____________________
TRADE NAME/DBA ________________________________________
File No: ______________________
ADDRESS________________________________________________
Entity No: ____________________
CITY, STATE ZIP ___________________________________________
Report Period: ________________
Contact Name:__________________________________________
Phone Number:_________________________ Extension:_______ E-Mail: _____________________________________
N
: R
F
T
C
. D
.
OTE
OUND TO THE NEAREST
ULL
ON FOR EACH FEED
ODE
O NOT USE DECIMALS OR FRACTIONS
F
F
S
F
I
S
ORMULA
EED
OLD
EED
NGREDIENTS
OLD
Commodity
Total Number of Tons
Commodity
Total Number of Tons
Feed
Feed
(Whole Tons Only)
Code
Code
(Whole Tons Only)
Broiler Feeds –
Complete
(01)
Alfalfa Products
(50)
Supplement
(02)
Animal Products
(51)
Turkey Feeds -
Barley Products
(52)
Complete
(03)
Beet Products
(53)
Supplement
(04)
Brewery Products
(54)
Starter – Grower -
Citrus Products
(55)
Complete
(05)
Corn Products
(56)
Supplement
(06)
Cottonseed Products
(57)
Layer - Breeder
Distillers Products
(58)
Complete
(07)
Drug Products
(59)
Supplement
(08)
Fats & Oils
(60)
Beef Feeds -
Grain Sorghum Products
(61)
Complete
(09)
Lespedeza Products
(62)
Supplement
(10)
Linseeds & Flax Products
(63)
Dairy Feeds -
Marine Products
(64)
Complete
(11)
Milk Products
(65)
Supplement
(12)
Minerals
(66)
Swine Feeds -
Molasses
(67)
Complete
(13)
Oat Products
(68)
Supplement
(14)
Peanut Products
(69)
Sheep Feeds -
Rice Products
(70)
Complete
(15)
Rye Products
(71)
Supplement
(16)
Soybean Products
(72)
Mineral Feeds
Urea Products
(73)
Supplement
(17)
Vitamins
(74)
Scratch Grains
(18)
Wheat Products
(75)
Horse Feeds
(19)
Feed Ingredients Misc.
(76)
Liquid Feeds
(30)
B. Total Tonnage Feed Ingredients
W
HOLE TONS ONLY
Formula Feed Misc.
(40)
A. Total Tonnage Formula Feeds
C. Total Tonnage – Add Lines A and B
W
HOLE TONS ONLY
**C
R
**
ONTINUED ON
EVERSE
FSI-439 (Rev.3/14)
N.Y.S. COMMERCIAL FEED TONNAGE REPORT
New York State Department of Agriculture and Markets
Division of Food Safety and Inspection
10B Airline Drive, Albany, New York 12235
OWNER NAME/COMPANY NAME ____________________________
Estab No: ____________________
TRADE NAME/DBA ________________________________________
File No: ______________________
ADDRESS________________________________________________
Entity No: ____________________
CITY, STATE ZIP ___________________________________________
Report Period: ________________
Contact Name:__________________________________________
Phone Number:_________________________ Extension:_______ E-Mail: _____________________________________
N
: R
F
T
C
. D
.
OTE
OUND TO THE NEAREST
ULL
ON FOR EACH FEED
ODE
O NOT USE DECIMALS OR FRACTIONS
F
F
S
F
I
S
ORMULA
EED
OLD
EED
NGREDIENTS
OLD
Commodity
Total Number of Tons
Commodity
Total Number of Tons
Feed
Feed
(Whole Tons Only)
Code
Code
(Whole Tons Only)
Broiler Feeds –
Complete
(01)
Alfalfa Products
(50)
Supplement
(02)
Animal Products
(51)
Turkey Feeds -
Barley Products
(52)
Complete
(03)
Beet Products
(53)
Supplement
(04)
Brewery Products
(54)
Starter – Grower -
Citrus Products
(55)
Complete
(05)
Corn Products
(56)
Supplement
(06)
Cottonseed Products
(57)
Layer - Breeder
Distillers Products
(58)
Complete
(07)
Drug Products
(59)
Supplement
(08)
Fats & Oils
(60)
Beef Feeds -
Grain Sorghum Products
(61)
Complete
(09)
Lespedeza Products
(62)
Supplement
(10)
Linseeds & Flax Products
(63)
Dairy Feeds -
Marine Products
(64)
Complete
(11)
Milk Products
(65)
Supplement
(12)
Minerals
(66)
Swine Feeds -
Molasses
(67)
Complete
(13)
Oat Products
(68)
Supplement
(14)
Peanut Products
(69)
Sheep Feeds -
Rice Products
(70)
Complete
(15)
Rye Products
(71)
Supplement
(16)
Soybean Products
(72)
Mineral Feeds
Urea Products
(73)
Supplement
(17)
Vitamins
(74)
Scratch Grains
(18)
Wheat Products
(75)
Horse Feeds
(19)
Feed Ingredients Misc.
(76)
Liquid Feeds
(30)
B. Total Tonnage Feed Ingredients
W
HOLE TONS ONLY
Formula Feed Misc.
(40)
A. Total Tonnage Formula Feeds
C. Total Tonnage – Add Lines A and B
W
HOLE TONS ONLY
**C
R
**
ONTINUED ON
EVERSE
T
C
ONNAGE
REDITS
If another manufacturer and/or distributor has paid the fee for any of the formula feed or feed ingredients listed on
the previous page, you do not have to pay for this tonnage. Please complete the following.
Commodity Code
Company Name & Address
Total Tons
(As shown on Front)
__________
(______)
Name: ____________________________________________
__________
(______)
__________
Street: ____________________________________________
(______)
__________
(______)
__________
City, State, Zip: _____________________________________
(______)
(______)
__________
Name: ____________________________________________
(______)
__________
Street: ____________________________________________
(______)
__________
(______)
__________
City, State, Zip: _____________________________________
(______)
__________
(______)
__________
Name: ____________________________________________
(______)
__________
Street: ____________________________________________
(______)
__________
(______)
__________
City, State, Zip: _____________________________________
(______)
__________
(______)
__________
Name: ____________________________________________
(______)
__________
Street: ____________________________________________
(______)
__________
(______)
__________
City, State, Zip: _____________________________________
(______)
__________
Total Tonnage Credit:
NOTE: New York State has amended Article 8 of the Agriculture and Markets Law Relating to the Manufacture
and Distribution of Commercial Feed. Persons distributing less than one hundred (100) TOTAL TONS per year are
exempt from payment; however, you are still required to report tons sold.
FEE ASSESSMENT
D. Total Tonnage From Front (WHOLE TONS ONLY)
E. Total Tonnage Credits
F. Subtract Line E from D
G. If Total Tonnage is greater than 100 Tons multiply total in F by $0.10
$
H. Total Tonnage Fee Due
$
**FOR OFFICE USE ONLY** Amount_______________ Receipt No._______________
All fields must be completed. Incomplete applications may not be processed. If you have questions about the information
requested, call (518) 457-5457; or write to: Department of Agriculture and Markets; 10B Airline Drive; Albany, NY 12235.
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