COC-27A Olives - Inventory Holdings of Canned Ripe Olives

Form COC-27a
04-01

INVENTORY REPORT OF CANNED RIPE OLIVES OMS #0581-0178
MONTH

20_

(1) TO:
California
Olive
Committee
1903 North Fine #102
Fresno CA 93727

(2) FROM:

(3) EIN#:
(4) REPORT OF PACKAGED OLIVES:

WHOLE

SIZE

D

6/1 0

D

PITTED

24/8

24/300

BROKEN PITTED

D

uffet

TOTAL

Small

Med ium
Larg e
Extra

Larg e

.'

Ex Large Sev. .

J umbo
Colossal
Sup Colossal
Green Ripe

-

TOTAL

,

'

(5) CERTIFICATION
ANDSIGNATURE:The undersigned on behalf of the reportinghandler certifies to the
California Olive Committee and the Secretary of Agricultureof the United States that this report repres~nts
a comp,leteand accurate record of the inventoryof all packaged olives of the styles reported held by the
handler or held in public warehouse for his account, in any and all locations, as of the date shown above.

Date

Authorized Official

Title

This information is used to verify the provisions of the order, 7 CFR 932.161.
.

Making any false

statements or ,representations in any matter within the jurisdiction of any .agency of the United States,
knowing it to be false, is a violation of Title18 Section 1001, United States Code,. which provides for
penalty of a fine of $10,000 or imprisonment ot not more than five years or both.

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Note: The followingstatements are made in accordance with the PrivacyAct of 1974 (5 U.S.C. 552a) and the Paperwork Reduction
Act of 1995. The authority for requesting this informationto be suppliedon this form is the Agricuhural 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
administrationof the marketing order program.
Accordingto the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to
a collectionof information unless it displaysa valid OMB control number. The valid OMB control number for this information
collectionis 0581-0178. The time required to complete this informationcollection is estimated to average45 minutes per response,
including the time for reviewing instructions, searching existingdata sources, gathering and maintaining the data needed, and
completingand reviewing the collection of information.
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