WMB 24-10 (RY) CA Walnuts Application as Approved User of Substandard W

Walnut Marketing Board
1540 RIver Park DrIve. Suite 203
Sacramento CA 95815-4809'
.
Ph (918)922-5888 Fax (918) 923-2548

.

OMB NO. 0581.-0178

WMB Fonn 124-10
(Reserve Year)
.

~

.

APPLICATIONTO.BE AN ApPROVED USER OF .
SUBSTANDARD WALNUTS
this appllcatian to be an approved user otsubstandard walnuts Is submitted In ccmpllance with the requirements of the Federal
MarketIngOrder No. 984. as amended. .In executingthis bm, the SubslBndard User respectively certifiesto the Walnut MarketIng
Board and to ~ U.S. Department of AgrIculture..
to the conecInes8
and completeness
.
. .
oJ of their statement.
.

Instructions:

.

1. AlI.substBndardusers mustcompletethe applicationto be an approved user.
2. Maila signed originalto the WalnutMarketIngBoard(WMB)office.
3. The appRcatlonwIDbe reviewed by the WMB. If approved, your company wBlbe sent a
conflnnaUonand Ilsted.asan AgprovedSubstandardUser.

Application Is hereby made for designation as an approved user of substandard walnuts with the
privilege of .recelving substandard walnuts for such use, or uses, as designed below, as provided
In Se~on 984.464 of Marketing Order No. 984, as amended.
.
crush for walnut 011.
manufacture livestock feed
feeding direcUyto livestock
In consideration of the granting of this approval, the undersigned agrees to:
(1)
(2)
(3)

Use such substandard walnuts as received for no other purpose than as designated above.
Store and manufacture such substandard walnuts as received only at the location or locations
specified.
Permit inspection of such storage and manufacturing facilltfesand of substandard walnuts received
and held and examination of books and records covering the walnut transactions by the Walnut

MarketingBoard and the U.S. Departmentof Agriculture.

.

(4)

Keep written records of receipts which will.show the names and add~es
of persons from whom
walnuts we~ acquired and make such records available for examination by authorized
representatives of the Walnut Ma~ng Board and the U.S. Depa~ent ofAgricuitl..lreduring regular
,.
business hours, fot the period of two years after the end of the marketing year Inwhich the ~rtfed
.
-. . .transactions were completed.
.
(5r .. Agree'tOneifotiatewiththe'handler a fairprice fOrall 9ubstandanfiriaterialrecelVSci, butat "oUme
negotiate a price below 2 cents per pound (kemelwelght). Any reimbursement beyond 2 cents per

pound lTIustbe forwardeddirectlyto the handler.
(6)

.

As a guarantee of faithful performance of the provisions of the Agreement. deliver to the Walnut
Marketing Board a Surety Bond Inthe sum of $25,000 (Twenty-fivethousand and 00/100 dollars).

Manufacturing operations are conducted at

Prior to disposition, substandard waJnu1s~II be stored at

Our daily maximum manufacturing capacity of substandard walnuts is:

.

.

.

I herebycertifyto the U.S. DepartmentofAgricultureand to the Walnut MarketingBoard thatthe
infonna.tion suppUed herein

Is complete

and correctand that substandard walnuts received by

me will be used.only for the. use designatedabove 8J1d
wili not be disposedof in any otherfonn.
...

Date:

By:
Title:
Firm Name:

Address:

Phone No.
.

FaxNo.
.

Application Is hereby approved, subject to revocation for cause:.
WALNUT MARKETING BOARD

By:

Date:

.

Title:
The making at any false statBmenta or repnlS8lltatlona In any matI8r within. the Jurisdiction 01 anY agency oIthe United
Stat8ll, knowing IUD be falsa.18 a violation 01 TItle 18, SectIon 1001, United Stat8s Code. which provld_ for the penalty
at a fine 01 $250,000 for Individuals and $500,000 for organizations. or Imprisonment at not more than S years. or bath.
No walnut "andl., shall dispose 01 substandard walnuta until this application has been received and approved by the

Walnut MarketingBoard (7CFR984.84 and 7CFR984.484).

.

.

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 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.