COC-29B CA Olives--Sales Report Limited Use

Form COC-29b
04-01

SALES REPORT OF LIMITED USE OLIVES

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OM8#0581-0178
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MONTH

20_

(1) TO:

(2) FROM:
California Olive Committee
1903 North Fine #102
Fresno CA 93727
(3) EIN#:

(4) REPORT OF PACKAGED LIMITED USE:

STYLE

6/1

0

24/300

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24/BUffet! 24/4.5 124/2.25

TOTAL

Segmented
Sliced
Chopped

TOTAL
(4) CERTIFICATION AND SIGNATURE: The undersigned on behalf of the reporting handler certifies to the
California Olive Committee and the Secretary of Agriculture of the United States that this report represents a
complete and accurate record of sales of all packaged limited use olives as compiled from sales invoices and
adjustment from credit memos for the month above stated.

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 Title 18 Section 1001, United States Code, which provides for penalty of a fine of
$10,000 or imprisonment of not more than five years or both.

u__u___._

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 AgriculturalMarketing Agreement Act of
1937, Sees. 1-19,48 Stat. 31, as amended, (7 U.S.C. 601-674). Furnishingthe requested information is necessaJYfor 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 informationunless it displaysa validOMB control number. The valid OMB control number for this information
collectionis 0581-0178. The time required to complete this informationcollectionis estimatedto average 30 minutes per response,
including the time for reviewing instructions,searching existingdata sources, gathering and maintainingthe data needed, and
completingand reviewing the collectionof information.
The u.S. Department of Agriculture (USDA) prohibits discrimination in aU 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 aUor part of an individual's income is derived from any public assistance
program (Not aUprohibited bases apply to aU programs.) Persons with disabilities who require a1temative means for communication of
program information (BnUlJe, 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 caD (800) 795-3272 (voice) or (202) 720-6382 (TDD). USDA is an equal opportunity provider
and employer.