RAC-500 CA Raisins--Mnthly Rept of Receipt of Raisins Produced f

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INSTRUCTIONS FOR COMPLETING FORM RAC-500

1.

Reports covering applicable month shall be submitted not later than
the eighth day by 10:00 a.m. of the following month. IT IS
IMPORTANT THAT THE REPORTS COVER ALL RAISINS
PRODUCED FROM GRAPES GROWN OUTSIDE THE "AREA"
(STATE OF CALIFORNIA).

2.

All quantities on the report shall be in pounds.

3.

Reports shall be certified by a responsible official of the reporting
handler.

4.

Each report should be numbered consecutively, beginning with No.
1 for the first month of the crop year during which such raisins were
received.

5.

The total receipts of the raisins during the current month, as shown
on the report in the first two columns, shall be supported by a copy
of a door receipt or weight certificate covering each and every
receipt of raisins. These door receipts or weight certificates shall
clearly show the name of the tenderer from whom received, the
varietal type of raisins, the net fruit weight, the number and type of
containers in the lot and the date of delivery. Form RAC-510

should also be attached with required documentation for other
U.S. (non-California) and imported raisins.

6.

Consult RAC Field Representatives on any points not clear.

This 'eport is ,equiTed by law (7 u.s.c 608(d) and 7 CF.R. 989.173(b)(7). Faibue to 'eport can ,esult in a.fine of$1,100
fo, each such violation and each day during which such violation continues shall be deemed a separate violation.
Acco,ding to the Papenvo,k Reduction Act of 1995, an agency _1nJIY_
not conduct 0' sponso" and a penon is not ,equiTed to
,espond to a coUectton oj info,mation unIesS it displays a valid OMB control number. The valid OMB control nuinber fo,
thIS infot'llUltion coUectton IS 0581-0178. The time ,equiTed to cO!"Pletethis information coUection is estimated to average
4 minutes per ,esponse, including the timefo, ,eviewlng instructions, searching existing dota sources gathering and
maintaining the ilata needed, and completing and ,eviewing the colkction of iliJot'llUltion. The u.s. Departmelii of
Agriculture
(USDA)
J!,ohibits
disc,imination
in allstatus,
its p,ograms
and activities
on status,
the basis
of 'ace,
national'o,igin,
age, disabiJiiy,
antI'wnere
~plicable,
sex, marital
JllIJIilialstatus,
parental
,eligio_n,s
o,ientation,
genetic info,mation, R!lliticlil beliefs, ,eprisal, 0' because all 0' part of an individual's InCome is derived from any public
assistance
IIVot allJ!,ohwited
bases apJ!lyto
Penons
with disabilities
,equiTe
alternatWe
audiotape,
etc.) shouldwho
contact
USDA's
TARGET
means
fo, p,ogram
communication
olp,ogram info,million
(B'alf,IIJ:1f!ams.)
';' !'U.'t: ,int,
Center at '202 720-2600 (voICetiiul TDD). To ile a co IainI 0 ilisc,iminatio!l, Wl'iteto USDA, Directo" 0 ICe0 Civil
f.j
l!!J:..hts,1/00 'PndependenceAvenue, S.
was-f!inRton,"1f.c 20 50-94100' call (800) 795-3272 (voice) 0' (2~ 711-6382
(1vD). USDA is an equal opportunity p,ovider anil employer.

:::J

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MONTHLY REPORT OF RECEIPT OF RAISINS PRODUCED
FROM GRAPES GROWN OUTSIDE OF THE "AREA"
RAISINADMINISTRATIVECOMMITTEE
P.O.Box 5217
Fresno, CA 93755-5217

MOO
Reed 12/06

Office of Management and Budget
Control Number 0581-0178

Report No.
ThQdersignedcertifies to the Raisin Administrative Committee and the Secretary of Agriculture of the United States that as of the month
enq
,
, the following quantities of raisins produced from grapes grown outside the "area" were received at
(PI Location), California and that copies of substantiating weight certificates, door tags, receipts etc. attached are true and correct.

Current Month's ReceiDts
Varietal Type

Pounds

Area of Origin

Pounds

Cumulative Quantity from August 1
Area of Origin

TCLS

The making of any false statement or representations in any matter within the jurisdiction of any agency of the United States, knowing it to be false, is a
Ilation of Title 18, Section 1001, United States Code, which provides for a penalty of a fine of $10,000 or imprisonment of not more than five years, or both.
Haer

By

(See reverse side for instructions)

Title

Date