Form FV-34 Application to Make Special Purpose Shipments - Certific

OMB NO. 0581-0178

U.S. DEPARTMENT OF AGRICULTURE (USDA) Idaho-Eastern Oregon Onion Committee APPLICATION TO MAKE SPECIAL

AGRICULTURAL MARKETING SERVICE PO Box 909 PURPOSE SHIPMENTS –

FRUIT AND VEGETABLE PROGRAMS Parma, ID 83660 CERTIFICATE OF PRIVILEGE

208-722-5111 Fax: 208-722-6582

The Marketing Order for onions requires that handlers desiring to make shipments outside the production area to canners, dehydrators, extractors, freezers, and/or picklers, which do not meet the requirements for fresh shipments, shall prior to making such a shipment apply to the Committee for permission. A shipment may be made to a receiver without a COP Permit number, if the sale occurs after 5 pm, on a Holiday, or Weekend; provided, that both the handler and receiver have had prior approval and this Application is faxed to the Committee prior to shipment.

Receiver & Agent								Phone
Contact Person(s)
Address
City					State			Zip
Purpose of Shipment(s)				Canning Dehydration Extracting Freezing Pickling
Type of Sale		Spot Sale Contract Sale					Total cwt.
Shipment Date(s)
Container(s)	50 lb bags Totes Bins Bulk Other:

I, the undersigned, hereby certify to USDA and to the Idaho-Eastern Oregon Onion Committee, that I have read, fully understand, and agree to comply with 7 CFR §958.328 which governs the handling of onions, and further agree that none of these special purpose onions will be diverted to any fresh market outlet(s). To the best of my knowledge all statements in this Application are true and complete. In addition, I will prepare an Onion Diversion Report for each Application and submit it to the Committee. The Committee reserves the right to audit the receiver or their agent randomly to verify shipments. Falsification of information on this government document may result in a fine of not more than $10,000 or imprisonment of not more than five (5) years, or both (18 U.S.C. 1001).

Signature				Name
Title				Date
Firm						Phone:
Address
City		State				Zip

COMMITTEE ACTION

APPROVED NOT APPROVED Reason not approved: ______________________________________________

COP Permit No. _____________ Date Approved:___________ Manager: ______________________________

According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0581-0178. The time required to complete this information collection is estimated to average 8 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information.

The U.S. Department of Agriculture (USDA) prohibits discrimination in all its programs and activities on the basis of race, color, national origin, age, disability, and where applicable, sex, marital status, familial status, parental status, religion, sexual orientation, genetic information, political beliefs, reprisal, or because all or part of an individual’s income is derived from any public assistance program (Not all prohibited bases apply to all programs.) Persons with disabilities who require alternative means for communication of program information (Braille, large print, audiotape, etc.) should contact USDA’s TARGET Center at (202) 720-2600 (voice and TDD). To file a complaint of discrimination, write to USDA, Director, Office of Civil Rights, 1400 Independence Avenue, S.W., Washington, D.C. 20250-9410, or call (800) 795-3272 (voice) or (202) 720-6382 (TDD). USDA is an equal opportunity provider and employer.

FV-34 (06/06)