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["AUTO-CALCULATING WISCONSIN COMMERCIAL FEED TONNAGE & INSPECTION FEE REPORT",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"FORM INSTRUCTIONS"]
[]
[null,"Page 1 of 2",null,null,null,null,null,null,null,null,null,null,null,"ARM-ACM-349 (Rev. 8/21)"]
[]
[null,null,null,null,null,"Wisconsin Department of Agriculture, Trade and Consumer Protection"]
[null,null,null,null,null,"Division of Agricultural Resource Management",null,null,null,null,"For DATCP Use Only"]
[null,null,null,null,null,"Bureau of Agrichemical Management",null,null,null,null,"25900 700SE 1150073000 4600000 72100"]
[null,null,null,null,null,"Phone: (608) 224-4537",null,null,null,null,"10000 13400 1150014300 4600000 72100"]
[null,null,null,null,null,"http://www.datcp.wi.gov",null,null,null,null,"25900 700SE 1150073000 5900000 72100"]
[null,null,null,null,null,"datcpfeedlicense@wisconsin.gov"]
[null,null,null,null,null,null,null,null,null,null,"License # 31 -",null,null,null,null,null,"1. Enter the primary license number."]
[null,"Commercial Feed Tonnage & Inspection Fee Report for January 2021 - December 2021 [Wis. Stat. §94.72(6)]"]
[null,"LEGAL BUSINESS ADDRESS",null,null,null,null,null,null,null,"MAILING ADDRESS"]
[null,"LEGAL BUSINESS NAME",null,null,null,null,null,null,null,"C/O",null,null,null,null,null,null,"2. Enter the primary licensee company name, address, etc."]
[]
[null,"STREET ADDRESS",null,null,null,null,null,null,null,"ADDRESS/PO BOX"]
[]
[null,"CITY",null,null,null,null,"STATE",null,"ZIP","CITY",null,null,"STATE",null,"ZIP"]
[]
[null,"DOING BUSINESS AS (DBA) NAME"]
[]
[]
[null,"SCHEDULE A - Notice: This is a two page form. Please complete both pages."]
[null,"Product  Code",null,null,"Product Type",null,null,null,"Total Tons Distributed","Product Code","Product Type",null,null,"Total Tons \nDistributed",null,null,"3. Complete the table with the total tonnage distributed for each applicable category."]
[]
[null,11,null,null,"Broiler Complete",null,null,null,null,34,"Alfalfa Ingredients"]
[null,12,null,null,"Broiler Premix",null,null,null,null,35,"Animal-based Ingredients"]
[null,13,null,null,"Turkey Complete",null,null,null,null,36,"Barley Ingredients"]
[null,14,null,null,"Turkey Premix",null,null,null,null,37,"Brewery Ingredients"]
[null,15,null,null,"Layer Starter-Grower Complete",null,null,null,null,38,"Citrus Ingredients"]
[null,16,null,null,"Layer Starter-Grower Premix",null,null,null,null,39,"Corn Ingredients"]
[null,17,null,null,"Layer Breeder Complete",null,null,null,null,40,"Cottonseed Ingredients"]
[null,18,null,null,"Layer Breeder Premix",null,null,null,null,41,"Distillers Ingredients"]
[null,19,null,null,"Beef Complete",null,null,null,null,42,"Fat & Oil Ingredients"]
[null,20,null,null,"Beef Premix",null,null,null,null,43,"Grain Sorghum Ingredients"]
[null,21,null,null,"Dairy Premix",null,null,null,null,44,"Linseed & Flax Ingredients"]
[null,22,null,null,"Dairy Complete",null,null,null,null,45,"Marine Ingredients"]
[null,23,null,null,"Swine Premix",null,null,null,null,46,"Milk Ingredients"]
[null,24,null,null,"Swine Complete",null,null,null,null,47,"Mineral Ingredients"]
[null,25,null,null,"Sheep Premix",null,null,null,null,48,"Molasses Ingredients"]
[null,26,null,null,"Sheep Complete",null,null,null,null,49,"Oat Ingredients"]
[null,27,null,null,"Mineral Feed",null,null,null,null,50,"Rye Ingredients"]
[null,28,null,null,"Vitamin Feed",null,null,null,null,51,"Soybean Ingredients"]
[null,29,null,null,"Horse Feed",null,null,null,null,52,"Vitamin Ingredients"]
[null,30,null,null,"Pet & Specialty Pet Food",null,null,null,null,53,"Wheat Ingredients"]
[null,31,null,null,"Pre-mixes (not specie specific)",null,null,null,null,55,"Poultry Concentrate"]
[null,32,null,null,"Miscellaneous",null,null,null,null,57,"Swine Concentrate"]
[null,68,null,null,"Veal Feed/Calf Feed",null,null,null,null,58,"Cattle Concentrate"]
[null,69,null,null,"Milk Replacers",null,null,null,null,60,"Human Food By-products",null,null,null,null,null,"3. Ignore the red text \"TOTALS DO NOT MATCH\" until after you complete Schedule B of the form by scrolling down within this worksheet. "]
[null,null,null,null,"Total Mixed Feed Distributed",null,null,null,{"$f":"SUM(I26:I49)","v":0},"Total Ingredients Distributed",null,null,null,{"$f":"SUM(N26:O49)","v":0}]
[null,"Combined Total of Commercial Feed Distributed",null,null,null,null,null,null,null,{"$f":"IF((SUM(M58:N67))=(SUM(I26:I49,N26:O49)),(SUM(I26:I49,N26:O49)),\"TOTALS DO NOT MATCH\")","v":0},null,null,"(Must equal Line 11 on Page 1)"]
[]
[null,"Page 2 of 2",null,null,null,null,null,null,null,null,"License # 31 -",{"$f":"L11","v":0}]
[]
[null,"SCHEDULE B: Last 6 digits of License # & Location of EACH WI Location"]
[null,"Inspection Fee Payment Calculation:",null,null,null,null,null,null,null,null,null,null,"Tons Distributed\n(Round quantities of 0.01 lb. - 2,000 lb. up to 1 ton)"]
[null,"Return both pages of this report and the payment to the address below by February 28, 2022."]
[null,"1.","Total Distributions into Wisconsin from out of state facilities (if n/a or zero, skip to line 2)",null,null,null,null,null,null,null,null,null,null,null,"tons",null,"6. Enter the total distributions into Wisconsin from OUT OF STATE facilities. If your firm does no thave a location out of state, skip this line."]
[null,"2.",null,null,null,null,null,null,null,null,null,null,null,null,"tons"]
[null,"3.",null,null,null,null,null,null,null,null,null,null,null,null,"tons"]
[null,"4.",null,null,null,null,null,null,null,null,null,null,null,null,"tons",null,"7. For rows 2 through 10, use one entry per Wisconsin in-state location. Enter the last six digits of the Wisconsin location license in the first column, the address and city of the Wisconsin location in the second column, and the total distributions from the location in the third column. Example:"]
[null,"5.",null,null,null,null,null,null,null,null,null,null,null,null,"tons"]
[null,"6.",null,null,null,null,null,null,null,null,null,null,null,null,"tons"]
[null,"7.",null,null,null,null,null,null,null,null,null,null,null,null,"tons"]
[null,"8.",null,null,null,null,null,null,null,null,null,null,null,null,"tons"]
[null,"9.",null,null,null,null,null,null,null,null,null,null,null,null,"tons"]
[null,"10.",null,null,null,null,null,null,null,null,null,null,null,null,"tons",null,"2.",-123456,"1234 Main St, Madison",null,500,"tons"]
[null,"11.","Total Tons of Commercial Feed Distributed (Sum of lines 1 through 10; must equal Combined Total on Schedule A)",null,null,null,null,null,null,null,null,null,{"$f":"IF(SUM(M58:N67)=0,\"\",SUM(M58:N67))","v":""},null,"tons"]
[null,"12.","INSPECTION FEES ($0.25/ton or $50.00, whichever is greater)",null,null,null,null,null,null,null,null,null,{"$f":"IF(SUM(M58:N67)=0,\"\",IF(SUM(I26:I49,N26:O49)<>SUM(M58:N67),\"TOTALS DO NOT MATCH\",IF(M68<200,50,(M68*0.25))))","v":""},null,null,null,"8. Red text (\"TOTALS DO NOT MATCH\") means that the total from Schedule B does not match the total from Schedule A."]
[null,"13.","LATE FILING PENALTY FEE (10% of total inspection fees due or $10.00, whichever is greater)",null,null,null,null,null,null,null,null,null,{"$f":"IFERROR(IF(K71>44563,IF((M69*0.1)>10,(M69*0.1),10),\"\"),\"\")","v":""}]
[null,null,"Submissions postmarked by February 28, 2022 are not subject to late penalties. Postmark:"]
[null,"14.","TOTAL INSPECTION FEES DUE (inspection fees plus penalties)",null,null,null,null,null,null,null,null,null,{"$f":"SUM(M69:O71)","v":0},null,null,null,"9. Enter the postmark date into the yellow highlighted cell to the left to calculate late fees, if any. (Enter as MM/DD/20YY or MM-DD-20YY.)"]
[null,"OPTIONAL - Commercial Feed Fee Payment Calculation (License fee and tonnage inspection fees may be paid in 1 or 2 checks) - OPTIONAL"]
[null,"15.","OPTIONAL - Sum lines 12 and 13 above for total inspection fees and tonnage late fees due",null,null,null,null,null,null,null,null,null,{"$f":"SUM(M69:O71)","v":0}]
[null,"16.","OPTIONAL - Sum of all license fees ($25 each) and license late fees ($5 or 20%, whichever is greater) due"]
[null,"17.","OPTIONAL - Total inspection fees, tonnage late filing fees, license fees, license late filing fees due",null,null,null,null,null,null,null,null,null,{"$f":"SUM(M74:O75)","v":0}]
[null,"PLEASE PRINT AND SIGN THIS FORM AFTER BOTH PAGES HAVE BEEN COMPLETED; DO NOT E-MAIL THIS FORM"]
[null,"  I certify that all information on this form is true and correct."]
[null,"NAME (FIRST, MI, LAST)",null,null,null,null,null,null,null,"TITLE",null,null,null,null,null,null,"10. Enter the appropriate information for the primary licensee representative's information. Note - this person will be contacted with any questions or important tonnage information, please enter accurate information."]
[]
[null,"TELEPHONE NUMBER",null,null,null,null,null,null,null,"FAX NUMBER"]
[]
[null,"EMAIL ADDRESS",null,null,null,null,null,null,null,"COMPANY WEBSITE URL"]
[]
[null,"SIGNATURE ",null,null,null,null,null,null,null,"DATE",null,null,null,null,null,null,"11. Final steps:"]
[null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"ü  Print and sign a hard copy form"]
[null,"Print and sign form, then mail with check to: State of Wisconsin, DATCP, PO Box 93193, Milwaukee, WI 53293-0193",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"ü  Do not e-mail the form"]
[null,"Make check payable to: Wisconsin Department of Agriculture, Trade and Consumer Protection",null,null,null,null,null,null,null,null,null,null,null,null,null,null,null,"ü  Retain a copy for your files"]
[null,"Personal information you provide may be used for purposes other than that for which it was originally collected (Sec. 15.04(1) (m), Wis. Stats.)."]
[null,"Information provided to the department in this tonnage report for the Commercial Feed program is CONFIDENTIAL as provided under Wis. Stat. §94.72 (6)(am)”3”. "]
[]
[null,"Wisconsin Inspection Fee - Wis. Stat. § 94.72(6)"]
[null," - If more than one manufacturer or distributor is involved in the chain of distribution, the one who first sells or distributes"]
[null,"commercial feed in this state or to a person in this state for further sale is responsible for the payment of inspection fees for"]
[null,"the feed."]
[null,null,null," - In other words, the first person to distribute a commercial feed or feed ingredient in or into Wisconsin is responsible"]
[null,null,null,"    for reporting tonnage and remitting fees."]
[null," - If a licensee distributes zero tons of commercial feed in/into Wisconsin, the minimum fee of $50.00 is due."]
[null," - Report commercial feed tonnage on a calendar year period (January through December)."]
[null," - Retain the detailed, written documentation to support all totals and calculations used in filing the annual Commercial Feed"]
[null," Tonnage & Inspection Fee Report."]
[null," - Data provided in this form enables the Department to:"]
[null,null,null,"1)  ensure compliance with Wis. Stat. §94.72(6),"]
[null,null,null,"2)  calculate the proper payment of inspection fees (avoiding over- or under- payment), and"]
[null,null,null,"3)  hold licensees accountable for commercial feed and feed ingredients introduced to the public."]