No Form number So. TX Onions Certification for Handling Onions for Proc

OMB 0581-0178

CERTIFICATION FOR HANDLING ONIONS FOR PROCESSING
(CANNERS AND/OR FREEZERS)
20XX-20XX SEASON
Two copies of this Certification are enclosed. If you plan to purchase onions which do not
meet the South Texas Onion Rules and Regulations for CANNING OR FREEZING, you
must complete this Certification and return one copy to the South Texas Onion Committee,
retaining the other copy for your files.
I, THE UNDERSIGNED, HEREBY CERTIFY TO THE SECRETARY OF AGRICULTURE
AND TO THE SOUTH TEXAS ONION COMMITTEE THAT I HAVE READ, FULLY
UNDERSTAND, AND WILL COMPLY WITH THE FOREGOING RULES WHICH GOVERN
THE HANDLING OF ONIONS WHICH FAIL TO MEET THE SOUTH TEXAS ONION
RULES AND REGULATIONS, I FURTHER UNDERSTAND THAT NON COMPLIANCE IS
A VIOLATION OF THE AGRICULTURAL MARKETING AGREEMENT ACT AND
SUBJECT TO A FINE OF UP TO $1,100 FOR EACH VIOLATION.
BY:
(Print Name)

(Signature)

(Date)

TITLE:

FIRM:

MAILING ADDRESS:
(Street or Box No., City, State, and Zip Code)

PHYSICAL ADDRESS:
(If different than mailing address)

PHONE: (

)

FAX: (

)

Person in Charge of SPECIAL PURPOSE FORMS:
No shipments of special purpose onions may be made unless this form is completed and
returned to this committee office (7 CFR 959.126).

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Note: The following statements are made in accordance with the Privacy Act of 1974 (5 U.S.C. 552a) and the Paperwork Reduction Act of 1995. The
authority for requesting this information to be supplied on this form is the Agricultural Marketing Agreement Act of 1937, Sees. 1-19,48 Stat. 31, as
amended, (7 U.S.C. 601-674). Furnishing the requested information is necessary for the administration of the marketing order program.
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
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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 indMduaJ'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 CMI 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.