PMC 2.6 CA Dried Prunes - Statement of Proposed Disposition of S

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OMB 0581-0178
Form PMC

2.6

ION OF S

Date
TO:

Prune Marketing Committee
384~ No. Freeway Blvd., Suite ~20
Sacramento, CA. 95834
The undersigned

PMC Approval Number:

hereby certifies to the United State Department of

Agriculture and to the Prune Marketing Committee for himself/herself
for and on behalf of
has purchased

and

that the undersigned
(Handler)
pounds of substandard prunes on or about
, and that said prunes, subject to approval by the

:ommittee, will be shipped to and converted by
(Name and

into
(Usage)

~ddress of Converter

Firm or
Individual

Address

By
Title
DDi'ORTANT NO'l'I:CJI
rhe issuing of a false certificate,
knowing it to be false, is a violation of Title 18, Section 1001
)f the United States Code, which provides a penalty of a fine of not more than SlO,OOO or imprisonment
,f not more than 5 years or both.

this report is required by law (7 U.S.C. 608(d), 7CFR S993.50{e) and 7CFR §993.1S0(e) (1)(ii».
~AILURE TO REPORT can result in a fine of not less than SSO 00 or more than $5,000 for each such
fiolation and each day during which such violation continues s'ha 11 be deemed a separate violation.
~his information is required to obtain authority from the Commi
Ind it will be used for that purpose.
ttee to dispose of substandard prunes
According to dte Paperwork Reduction A.rI.of 1995, an agency may not conduct or sponsor, and a persoo is not required to respond to
a col1ection of information W1lessit displays a valid OMB control number. The valid OMB control number for this information
collection is 0581-0178. The time requind to complete this information collection is estimated to average 2 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) prcbibits disaimination in all its p-ograms and activities on the basis of race, color,
national origin. gender, religion, ago. disability, political betie&. sexual orientation, and marital or fiunily status. (Not aU prohibited
bases apply to aU programs.) Persons with disabilities who require altemative means for communication of program information
(Brail1o.1arge print. audiotape, etc.) should contact USDA's TARGET Center at (202) 720-2600 (voice and TOO).
To file a complaint of discrimination, write USDA. Director, Office of Civil Rights. Room 326-W. Whitten Building. 1400
Indepatdence Avenue., SW, Washington, OC 20250-9410 IX'call (202) 720-5964 (voice and TOO). USDA is an equal opportunity
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