Handler's Report of Producer Payroll

Handler Name

Producer Price Diff. =
Butterfat Price =

Enter Payroll Mo. and Yr.

Protein Price =

Nov. 2003

W.A. Cheese Price =

OMB No. 0581-0032

United States Department of Agriculture
Agricultural Marketing Service

Prod. Premium Rate =

Dairy Programs

Market Service Rate =

Mideast Marketing Area

Adv. & Promo. Rate =

Other Solids Price

Federal Order No. 33

HANDLER'S REPORT OF PRODUCER PAYROLL
Producer Name
Producer Number

1

F. C. (Y or N)
Coop Cd.

Prod. Lbs.
Diff.

BF. %
BF. Lbs.

Prot. %
Prot. Lbs

O.S. %
O.S. Lbs.

S.C. Ct.
S.C. Adj.

BF. Value
SC. Value

Prot. Value
O.S. Value

P.P.D. Value
Min. F.O. Value

Prod. Prem.
Other Prem.

Prem. Value
Gross Value

Total Stops
Stop Charge

Haul. Rate
Haul. Value

Supply Ded.
Hosp. Ins.

Mkt. Serv.
A&P

P.P.A.
Assn Ded.

Adv. Ded
Misc. Adj.

Partial Pay
Total Ded.

Net Value
Check No.

Totals

This report is required by the order in accordance with 7 U.S.C. 608c and d. Failure to report can, upon
conviction, result in a fine of up to $5000 per day (7 U.S.C. 608c (14)).
1

Signed___________________________________

Date__________________________

The field F.C. (Y or N) designates if the entry on the report is for forward contract milk that has been priced under provisions of the Dairy Forward Pricing Program, which was implemented in accordance with the Food, Conservation and Energy Act of 2008 and is exempt from requirements of the Paperwork Reduction Act.

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 0581-0032. The time required to complete this information collection is estimated to average 1.5 hour(s) 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, sex, religion, age, disability, political beliefs, sexual orientation, or marital or family status. (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 USDA, Director, Office of Civil Rights, Room 326-W, Whitten Building, 14th and Independence Avenue, SW, Washington, DC 20250-9410, or call 202-720-5964 (voice and TDD). USDA is an equal opportunity provider and employer.