WMB 8 Rept. of Interhandler Transfers

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OMB NO. 0581-0178
WMBForm #8

Walnut Marketing Board
1540 Rlvef Park Drive,Suite 203
Sacramento CA 95815-4609
Ph (916) 922-5888 Fax (916) 923-2548

REPORT OF INTERHANDLER TRANSFERS OF WALNUTS
This report of walnuts transferred between handlers Is submitted In compliance withthe requirements of the Federal Marketing Order
No. 984', as amended. In executing this form. the handler respectively certifies to the Walnut Marke~ng Board and to the U.S.
Department of Agriculture as to the correctness and completeness of their statement

Instructions:

1. Report date of transfer and If DFA certified. ..
2. Report Inshell and shelled Interhandler transfers (In pounds).
3. Sender sends two copies of the form to the receiving handler.
4. Mall a signed original to the Walnut Marketing Board (WMB) office following each transfer or receipt
of walnuts. within 10 working days.

Date of Transfer

INTER-HANDLER TRANSFERS (In pounds)
.. .,
Inshell/Shelled
DFA Certified

Ves
Ves
Ves
Ves
Ves
Ves

I
I
I
I
I
I

Net Weight In Ibs

No
No
No
No
No
No

TOTAL
To be completed by Transferring Handlef

To be completed by Receiving. Handlef
The above walnuts were received

~20
(Name of Handler)
By'
(Name of Handler)
By'
The making of any false statements or representations In any matter withinthe Jurisdiction of any agency of the United
States, knowing Itto be false, Is a violation ofTitle18, Section 1001,UnitedState. Code, which provides for a penalty of a
fine of $250,000for Individual. and $500,000for organizations or Imprl80nmentof not more than five ~ars. or both.
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 0581-0178. The time required to complete this information collection is estimated to average 10
minutes 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, age, disability, and where applicable, sex, marital status, familial status, parental status, religion, sexual
orientation, genetic information, political beliefs, reprisal, or because all or part ofan individual's income is derived from any
public assistance program (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 TOD). 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 call (800) 795-3272 (voice) or (202) 720-6382 (TDD).
USDA is an equal opportunity provider and employer.