CDAC-4 CA Dates--Date Product Manufacturers Rept.

CDAC Fonn #4

Send one signed copy no later than October 10th to:

California Date Administrative Committee
P.O. Box 1736,lndio, CA 92202-1736
Facsimile:760.347.6374

DATE PRODUCTAfANUFACnJRER'S REPORT
(Section987.65_987.165) 8pptOvedfofO"'8I/OSI/1~1711
In accordance with our agreements with the California Date Administrative Committee, this report of our beginning and ending inventories of product dates,
the quantity received during the crop year, the quantity used, the type and quantity of product manufactured, and our year-end inventory of products from
the crop year ending September 30,

Halawy

Deglet Noor

Zahidi

Khadrawy

State Inlenns ofwhole delest.)

PRODUCT DATES
Beginning Inventory of Whole Dates October 1
Quantity received from Handlers' in crop year
Quantity manufactured into date products

o

Ending Inventory of Whole Dates September 30

o

o

o

TYPES OF DA TE PRODUCT MANUFACTURED
Quantity Manufactured
Actual Weight

Whole Date
Equivalent

DATE PRODUCT INVENTORY ON SEPTEMBER 30,

Actual Pounds of Product
Equivalent Whole Date Pounds of Products
I hereby ceI1ify 10 the U.S. DeplW1men' of A~oJI\n!

II1d the Calilomla

Date AdmlnlS1rallve Committee

1I181111eInfonnation con1alned In 1Iis repal

Is COf'I1)lete II1d care<:I.

Date Product Manufacturer.

By:
Title:
Date:

The maldng "'lalse stalement or representation on this form, knowing 110 be false, Is a vlalation of Tile 18, section 1000, Untted Slales code, which provides for lI1e penally '" a fine "'$10,000 or Imprisonment "'nell more lI1en
ye8I'S. or bdh. This report Is required by law (7 use 608(d), CFR 987.51 end 7 CFR 987.151). Failure to report can resu~ In a ftne "'nell less !hen $50 or morell1en $5,000 for each such vlalation end each day dUling which
such vldation conlinues shall ba deemed a separelelllalalion.
According to lI1e Paperwcrt< Reduction Act '" 1995, an Agency may nell conduct or sponsor, and a person Is nol required 10 respond to a callection '" information
unlen ~ clsplayo a valid OMS cawral number. The valid OMS contral number for II1lsinformation _Ion
I. 0581~178. The time rsqulred to COR¥>Ietell1ls Information collection Is estimated to average 30 minutes per response,
including lI1e time for reviewing in_,
searching existing data sources, gall1ering and maintaining lI1e data needed, and completing _
relllewing the coIection 01 information,

The U.S. Department of Agriculture (USDA) prohibits discrimination in all i1s programs and activities on !he basis '" race, color, national origin, age, disability, and where app~cable, sex, mantal
status, fam~iaI status, parental status, refigion, sexual orientation, genetic information, political beliefs, reprisa~ Of because all or part '" an individuars incane is derived from any public
assistance program (Not aD prohibilBd bases apply 10 al programs.) Petsons with cisabilities who require alternative means for canmunication '" program infonnalion (Braille, large print.
audiotape, etc.) should contact USDA's TARGET Center at (202) 720-2600 (voice and TOO).
To file a complaint 01discrimination, write 10 USDA, Director, Office '" Civil Rights, 1400 Independence
720-6382 (TOO). USDA is an equal opportunity provider and employer.

Avenue, SW., Washinglon, D.C. 20250-9410, or caK (800) 795-3272 (1IOice)or (202)