No Form number Application for Registered Onion Handler (So. TX Onions)

SOUTHTEXASONIONCOMMITTEE

OMB NO. 0581-0178

APPLICATION
FORREGISTERED
ONIONHANDLER2Oxx-20xx
SEASON
IMPORTANT:
Ifyouplanto HANDLE
onionsGROWNinthefollowingSouthTexasCounties,
youneedtoregisterasa
Handler.
Aransas, Atascosa, Bee, Brooks,Calhoun,Cameron,DeWitt,Dlmmlt,Duval,Frio,Gollad,Hidalgo,Jim Wells,Jim
Hogg, Kames, Kenedy,Kinney,Kleberg,laSalle, Uve Oak, Maverick,McMullen,Medina,Nueces, Refugio,San
Patricio,Starr, Uvalde,ValVerde,Victoria, Webb, Willacy,Wilson,Zapata, Zavala
PLEASEFURNISH
THEINFORMATION
REQUESTED
BELOW,
ANDMAILASQUICKLY
ASPOSSIBLEI
TAX10NO.
or
S.S.NO.:

FIRMORINDIVIDUAL:
NAME- SIGNATURE:

PRINT:

MAILING
ADDRESS:
(Address,
City,State,Zip)
PHYSICAL
ADDRESS:
(Address,
City,State,Zip)
OFFICEPHONE:

SALES:

FAX:

SALESSTAFF:

AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA

LISTOFBRANDNAMESORLABELS:

TYPESOFCONTAINERS
SHIPPED
(CARTONS,
BAGS,ETC.ANDWEIGHT
OFEACHCONTAINER).

AAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAAA

WILLYOUBEINDIVIDUALLY
LABELING
YOURPRODUCT?

Note: The followingstatements are made in accordance with the Privacy Act of 1974 (5 U.S.C. 552a) and the Paperwork
Reduction Act of 1995. The authority for requesting this information to be supplied on this form is the Agricultural Marketing
Agreement Act of 1937, Sees. 1-19, 4B Stat. 31, as amended, (7 U.S.C. 601-674). Furnishing the requested information is
necessary for the administration of the marketing order program.
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 05B1-D17B. The time required to complete this information collection is estimated to average 5
minutes per response, includingthe 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, politicalbeliefs, reprisal, or because all or part of an individual'sincome is derivedfrom any pubfic
assistance program (Not all prohibited bases applyto all programs.) Persons with disabilities who require alternative means fur
communication of program information (Braille, large print, audiotape, etc.) should contact USDA'sTAR?ETCenter at (202) 720..
2600 (voice and TOO). To file a complaint of discrimination, write to USDA,Director, Officeof CivilRights, 1400 Independence
Avenue, S.W., Washington, D.C. 20250..9410, or call (BOO)795-3272 (voice) or (202) 720-63B2 (TOO). USDAis an equal
opportunity provider and employer.