FTC-102 Application for Registration as tomato handler (FL Tomat

FLORIDA TOMATO COMMITTEE
Established Pursuant to Federal Marketing Agreement and Order No. 966, As Amended
Regulating the Handling of Tomatoes
800 Trafalgar Court, Suite 300
Maitland, Florida 32751
www.floridatomatoes.ora
Telephone (407) 660-1949
Fax (407) 660-1656

[Insert Date]

To:

All 20XX-20XX Registered Tomato Handlers

From:

Reggie Brown, Manager

Subject:

20XX-20XX Tomato Handler Registration

We are enclosing an application for registration as a Tomato Handler during the
20XX-20XX season, as required under Marketing Order No. 966. Each handler
who applies for inspection must be registered with the Committee, pursuant to
§966.7. Registered handlers are the first handlers of tomatoes and must pay
assessments as provided in §966.42. Application for this registration must be done
annually.
Upon receipt and approval of your application, a new Registered Handler
Certificate for the 20XX-20XX season will be mailed to you.

Enclosures
cc:

Mr. Robert C. Keeney
Mr. Chris Nissen
Ms. Shannon Shepp
Federal-State Inspection Supervisors
FTC Members and Alternates

FLORIDA TOMATO COMMITTEE
Established Pursuant to Federal Marketing Agreement and Order No. 966, As Amended
Regulating the Handling of Tomatoes
800 Trafalgar Court, Suite 300
Maitland, Florida 32751
www.floridatomatoes.ora
Telephone (407) 660-1949
Fax (407)660-1656

REMINDER
[Insert Date]

To:

A1I20XX-20XXRegistered Tomato Handlers Who Have Not Yet Registered for the
20XX-20XXSeason

From:

Reggie Brown, Manager

Subject:

20XX-20XXTomato Handler Registration

We are enclosing an application for registration as a Tomato Handler during the 20XX-20XX season,
as required under Marketing Order No. 966. Each handler who applies for inspection must be
registered with the Committee, pursuant to §966. 7. Registered handlers are the first handlers of
tomatoes and must pay assessments as provided in §966.42. Application for this registration must be
done annually.
Upon receipt and approval of your application, a new Registered Handler Certificate for the 20XX20XX season willbe mailed to you.
Enclosures
cc:

Mr. Robert C. Keeney
Mr. Chris Nissen
Ms. Shannon Shepp
Federal-State Inspection Supervisors
FTC Members and Alternates

OMB #0581-0178
20XX-20XX
APPLICATION FOR REGISTRATION AS TOMATO HANDLER
FLORIDA TOMATO COMMITTEE
800 Trafalgar Court, Suite 300
Maitland, FL 32751
Phone (407) 660-1949. Fax (407) 660-1656
Gentlemen:
I hereby make application for Registration as a Tomato Handler for the 20XX-20XX season.
1.

Physical address of alilocation( s) of grading and packing facilities in the production area:

2.

Type of business (Individual, Firm, Partnership, Corporation, Co-operative, Association or
other business unit):

3.

If other than individual, show below names and addresses of the officers, partners, or other
individuals having a financial interest in the business with the applicant.
Name

4.

Title

Address. City. State. Zip

How many years has applicant been engaged in the tomato business in Florida?
Business Name of Applicant:

Street Address:
City, State, Zip Code:

Mailing Address:
City, State, Zip Code:
Telephone Number:

FAX Number:

Email address:

By:
(Authorized Signature and Title)
FTC Form 102-75

Please Print Name

Note: The following statements 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. 1-19,48 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 0581-0178. The time required to complete this
information collection is estimated to average 5 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
of an individual's income is derived trom 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
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 call (800) 795-3272 (voice) or (202) 720-6382 (TDD). USDA
is an equal opportunity provider and employer.

CRITICAL INFORMATON
REQUEST
Please provide the infonnation below for each grower who you expect willbe shipping through your packing facilityfor the
20XX-20XXseason. This infonnation is needed to ensure that your growers are kept up-ta-date on Committee activities
and on subjects affecting the Florida Tomato Industry as a whole, such as: Medfly alerts; government regulations; labor
situations; market conditions; etc. Return this fonn withyour application for registration as a tomato handler.
GROWER NAME_
CONTACT NAME
ADDRESS
CITY, STATE, ZIP
TELEPHONE

GROWER NAME_
CONTACT NAME,
ADDRESS
CITY, STATE, ZIP
TELEPHONE

GROWER NAME_
CONTACT NAME,
ADDRESS
CITY, STATE, ZIP
TELEPHONE

GROWER NAME_
CONTACT NAME,
ADDRESS
CITY, STATE, ZIP
TELEPHONE

GROWER NAME_
CONTACT NAME,
ADDRESS,
CITY, STATE, ZIP
TELEPHONE

(Make additional copies or use other side to list additional growers if necessary.)

.

!

GROWER NAME_
CONTACT NAME,
ADDRESS
CITY, STATE, ZIP
TELEPHONE

GROWER NAME_
CONTACT NAME
ADDRESS
CITY, STATE, ZIP
TELEPHONE

GROWER NAME_
CONTACT NAME,
ADDRESS
CITY, STATE, ZIP
TELEPHONE

GROWER NAME.
CONTACT NAME
ADDRESS
CITY, STATE, ZIP
TELEPHONE

GROWER NAME_
CONTACT NAME
ADDRESS
CITY, STATE, ZIP
TELEPHONE

GROWER NAME_
CONTACT NAME
ADDRESS
CITY, STATE, ZIP

TELEPHONE