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pdfOMB NO. 0581-NEW
U.S. DEPARTMENT OF AGRICULTURE (USDA)
Agricultural Marketing Service
Fruit and Vegetable Programs
Idaho-Eastern Oregon Onion Committee
PO BOX 909
Parma, ID 83660
208-722-5111 Fax: 208-722-6582
Assessment Credit Report
This form is for a handler to receive a credit for assessments on onions that have been levied in accordance with §§958.42 and 958.240 and are
subsequently regraded, resorted, repacked within the production area, or shipped in accordance with a special purpose shipment §958.328(e). In the case
of special purpose shipment, please only complete the first four columns of the table. Please attach copies of the applicable page(s) from the inspection
certificate(s) with each lot referenced below marked with a highlighter. This form must be completed and returned to the Committee within 72 hours of
handling the onions for (check one):
Regrading
Repacking
Planting
Resorting
Livestock Feed
Charity
Dehydration
Original Inspection
Certificate No.
Original
Bag
Count Original Container
Canning
Original Grade
Freezing
New Inspection
Certificate No.
Extraction
New Bag
Count
Pickling
Disposal
New Container
New Grade
I, the undersigned, hereby certify to USDA and to the Idaho-Eastern Oregon Onion Committee that this report represents all onions that have been regraded, repacked,
resorted, or handled for special purpose by our firm. 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
Firm
Phone
Address
City
Date
State
Zip
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.
File Type | application/pdf |
File Title | Assessment Credit Report.xls |
Author | AHatch |
File Modified | 2006-07-17 |
File Created | 2006-07-17 |