In Re Syngenta AG MIR 162 Corn Litigation

Plaintiff Fact Sheet

1. Print the name of the person/entity that farms corn. If you farm as a sole proprietorship, write your
name. If you farm as an entity, write the entity name. If you do both, put your individual name and
the entity name.

2. Print your address:

3. Enter your name/entity name (including partners and members) and social security number or tax
identification number:
ENTITY/INDIVIDUAL NAME

SOCIAL SECURITY # OR TAX ID #

4. If you farm as an entity, what state is the company organized under:

5. Provide the following information regarding corn only for each farm year:
Year

Counties/States where you

grew corn

Total acres of
corn in all
counties

Varieties of corn
grown

Did you own the

land, lease the
land, or a
combination of
both?
ow
n
leas
e
both
own
and
lease

2011

___________________________________________________________________________________
ow
n
leas
e
both
own
and
lease

2012

____________________________________________________________________________________
ow
n
leas
e
both
own
and
lease

2013

____________________________________________________________________________________
ow
n
leas

e
both
own
and
lease
____________________________________________________________________________________

2014

ow
n
leas
e
both

2015

own
and
lease

6. From 2011 to the present, provide the contract date, number of bushels, how the bushels were
priced (seasonal pool, pricing pool, booking contract, basis contract, hedged to arrive contract,
cash sale, or other contract), date the corn was priced, the price per bushel, and the name and
location of the buyer. Instead of filling out this chart, you can send us your settlement sheets.
Read the Fact Sheet Instructions for more details.
Date

No. of
Bushels

How Priced

7. Are you currently storing any corn?

Date Priced

Yes

Price

Name & Location of

Buyer

No

a. If yes, what percentage of your corn crop are you storing?

8. Print the name of any crop or marketing consultant you have used to market any of your corn since
2011. If you havent used one, write N/A:

9. Have you raised any livestock since 2011?

Yes

No

a. If yes, how much of your corn have you used to feed the livestock each year?

10. Have you been a part of an ethanol co-op at any time since 2011?

Yes

No

a. If yes, on a yearly basis state whether you were or are required to supply a certain amount of
corn to the co-op?
11. From 2011 to the present, have you grown/sold any crop that was genetically modified other than
corn?
No
Yes

12. From 2011 to the present, have you tested your corn for the presence of Viptera or
Duracade?
Yes
No
13. What is your email address?
14. Do you use email in your farming operations?

Yes

No

15. Do you keep electronic records related to your farming operations?

16. Documents. Send us copies of the following documents:
a. All corn seed purchase records from 2011 present
b. All sales/settlement contracts for corn from 2011 present
c. Crop Insurance Declaration Page for 2013 2014 crop years

Yes

No