CIAB Form #3A Report of Export Sales Activity

Tart Cherries Grown in the States of MI, NY, PA, OR, UT, WA and WI

Form 3A Export Sales Info.wpd August 2006

Background/Acceptance Statement (Producer and Handler Member/Alternate)

OMB: 0581-0177

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OMB No. 0581-0177
CIAB
Form
#3A

REPORT of EXPORT SALES ACTIVITY
Cherry Industry Administrative Board

Crop Year

P.O. Box 388, DeWitt, MI 48820-0388
517/669-1070 Fax: 517/669-1260

Handler:
Address:
City, ST Zip:
Tel. No.:
PORTS of ENTRY*
(Report in units)

Hot Pack

IQF

5+1

Dried

Other

Total

EUROPE
Belgium
France
Germany
Netherlands
United Kingdom
Other (s) (specify)
ST Europe
PACIFIC RIM
Australia
Hong Kong
Japan
Korea
Singapore
Taiwan
Other (s) (specify)
ST Pacific Rim
NORTH AMERICA
Canada
Mexico
ST North America
SOUTH or CENTRAL AMERICA
Other (s) (specify)
ST
MID. EAST & AFRICA
Egypt
Israel
Saudia Arabia
Other (s) (specify)
ST Africa/ Mid. East
GRAND TOTAL
The undersigned hereby certifies to the Secretary of Agriculture and to the Cherry Industry Administrative Board that this is a true and correct statement of the
sales activity of this handler for the listed years.
* Ultimate Destination

By:
Title:
Date:

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 0581-0177. The time required to complete this information
collection is estimated to average 5 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 Typeapplication/pdf
File TitleS:\Program Operations\OMB - Paperwork Reduction Act\Other Submissions\0581-0177 930 Tart Cherries\Forms\Form 3A Export Sales I
AuthorVEmmer
File Modified2006-09-06
File Created2006-09-06

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