Form T1A "Monthly Report of Kansas Grade a Milk Producer Sales or Deliveries to Milk Producer's Association Cooperative, Milk Processor or Milk Distributor" - Kansas

What Is Form T1A?

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

Form Details:

  • Released on January 1, 2019;
  • The latest edition provided by the Kansas Department of Agriculture;
  • 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 fillable version of Form T1A by clicking the link below or browse more documents and templates provided by the Kansas Department of Agriculture.

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Download Form T1A "Monthly Report of Kansas Grade a Milk Producer Sales or Deliveries to Milk Producer's Association Cooperative, Milk Processor or Milk Distributor" - Kansas

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Kansas Department of Agriculture
1320 Research Park Dr
Manhattan, KS 66502
Phone 785-564-6700
Fax 785-564-6776
KDA.Dairy@KS.GOV
Monthly Report of Kansas Grade A Milk Producer Sales or Deliveries
to Milk Producer’s Association Cooperative, Milk Processor or Milk Distributor
Name of Association Cooperative, Processor or Distributor ______________________________________________________________
Mailing Address _____________________________________________________________________________________________
Street Address_________________________________________________________________________________________________
Kansas License Number_________________________________
For Month________________ Year________________
Total Pounds Milk Sold or
Producer Name
Producer Number
Number of Days Delivered
Delivered
TOTAL LBS
X $.00015 = $
TOTAL DUE
($0.015/100 LBS)
This report is due on or before the end of the month following the preceding calendar month. An additional charge will be assessed equal to 1%
of the required fee for each day after the date due. If the additional late fee charge is less than $5, then a minimum of $5 is due.
For and on behalf of the cooperative, processor or distributor, I, the undersigned, hereby authorize the secretary of the Kansas Department of
Agriculture or his authorized representative to examine all records of the cooperative, processor or distributor necessary for the purpose of verifying and
determining the fees due to the State of Kansas under the dairy law. (K.S.A. 65-781)
I declare that this report, including any accompanying schedule and statement, has been examined by me and to the best of my knowledge and belief is
a true, correct and complete report. I also certify that I am authorized to sign this report.
_______________________________________________________
__________________________________
Signature
Date
_______________________________________________________
Print Name
For Office Use Only
DT1 ____________________ Check # ____________________ Transaction # ____________________________ T1A Revised 01/19
Kansas Department of Agriculture
1320 Research Park Dr
Manhattan, KS 66502
Phone 785-564-6700
Fax 785-564-6776
KDA.Dairy@KS.GOV
Monthly Report of Kansas Grade A Milk Producer Sales or Deliveries
to Milk Producer’s Association Cooperative, Milk Processor or Milk Distributor
Name of Association Cooperative, Processor or Distributor ______________________________________________________________
Mailing Address _____________________________________________________________________________________________
Street Address_________________________________________________________________________________________________
Kansas License Number_________________________________
For Month________________ Year________________
Total Pounds Milk Sold or
Producer Name
Producer Number
Number of Days Delivered
Delivered
TOTAL LBS
X $.00015 = $
TOTAL DUE
($0.015/100 LBS)
This report is due on or before the end of the month following the preceding calendar month. An additional charge will be assessed equal to 1%
of the required fee for each day after the date due. If the additional late fee charge is less than $5, then a minimum of $5 is due.
For and on behalf of the cooperative, processor or distributor, I, the undersigned, hereby authorize the secretary of the Kansas Department of
Agriculture or his authorized representative to examine all records of the cooperative, processor or distributor necessary for the purpose of verifying and
determining the fees due to the State of Kansas under the dairy law. (K.S.A. 65-781)
I declare that this report, including any accompanying schedule and statement, has been examined by me and to the best of my knowledge and belief is
a true, correct and complete report. I also certify that I am authorized to sign this report.
_______________________________________________________
__________________________________
Signature
Date
_______________________________________________________
Print Name
For Office Use Only
DT1 ____________________ Check # ____________________ Transaction # ____________________________ T1A Revised 01/19