920-Kiwifruit Shipment Report

OMS No: 0581-0189

SHIPMENT REPORT
CROP YEAR 20xx/20xx

Kiwifruit Administrative Committee (KAC)
California Kiwifruit Commission (CKC)
Mail to: P. O. Box 1233, Reedley, CA 93654
or Fax to: (559) 637-0045 or Email to: [email protected]
KACphone: (559) 638-5951; CKC phone: (559) 226-4780

COMPANY:
CONTACT:
PHONE #:

Reporting Month:
PLEASENOTE: The followingInformation
Is to be cu"ent

Check if this is your final report for the season.

as of the last day of the reporting month and med with the
Commission/Committee no later than the fifth (5th) day of the following month. This Information Is being required to assure accurate and
.....__ _.________
__________. _____
n__________________
__ ___________________fldentlal.

Trays

3-Layers

Bag Masters

Volume Fill

Bins

Other Pounds *

(# of Cartons)

(20#)
(# of Masters)

(9kg -19.8#)
(# of Containers)

(125#)
(# of Bins)

(# of Pounds)

Domestic
Canada
Taiwan
Japan
Hong Kong
Korea
Australia
Mexico
Singapore
Not listed:
note market
TOTALS

Note: Ifyou shipped a container type or size not listed above, contact the CKC or KACoffice for assistance.
*WEIGHTOF OTHERSHIPPED (complete only if OTHERcolumn used above)
# of Containers Shipped
(B)
Other Pounds Shipped
Container Weight (pounds)
(A)
(A x B)

I understand

that records from which this report

Title:

According to the PaperM)f1t Reduction Act of 1995. an agency may not cxmduct or sponsor, and a person Is not required to respond to a collection of information unless it displays a valid OMB control number. A valid
OMS control number for this Information collection is 0581'()189. The time required to complete this Information collection is estimated to average 30 minutes per response. including the time for reviewing instructions.
searching existing data sources, gathering and maintaining the data needed, and completing and reviEM'ingthe collection of Information. Under the Paperwork Reduction Act of 1995. no persons are required 10 respond
10 a collection of Information unless It displays a valid OMS control number.
The U.S. Department of Agriculture (USDA) prohibns disairninatlon In Its programs and activities on the basis of race, color, national origin, age, disability, and where applicable. sex, marital status, familial status, parenl
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 10 all progran
Persons with disabilities INho require alternative means for communication

of program Information (Braille, large print, audiotape,

etc.) should contact the USDA's TARGET Center at (202) 72()"2600 (voice and TOD). To

complaint of discrimination.write to USDA,Director, Office of CivilRights. 1400 Independence Avenue. S.W.. Washington, D.C. 20250-9410.
opportunity

provider and employer.

or call (800) 795-3272 (voice)or (202) 720-6382 (TDD). USDA