F/H Form 3 Hazelnuts - Request for Transfer of Free Tonnage

HAZELNUT MARKETING BOARD
21595 a Dolores Way NE
Aurora, OR 97002-9738

F/H Fonn 3
OMB CONTR. NO.
0581-0178

REQUEST FOR TRANSFER OF FREE TONNAGE*
Date
TO: Hazelnut Marketing Board
In accordance with the provisions of Section 982.52(d) of Marketing Order No. 982, as amended, it is requested that
pounds of free tonnage be transferred: NOTE: Total Free Tonnage that can be transferred
equals your credits divided by the ratio listed on line C. 2. on you monthly F/H Fonn 1.
FROM:

Handler
By
Title

TO:

Handler
By
Title

* MUST BE SIGNED BY BOTH HANDLERS

APPROVAL OF REQUEST
The foregoing request is hereby approved, and the Hazelnut Marketing Board records have been adjusted accordingly.
HAZELNUT MARKETING BOARD
By
Dated
(After approval, the Hazelnut Marketing Board will send a copy to each of the handlers involved.)
No approval may be given to hazelnut handlers wishing to transfer excess restricted credits unless a completed request
fonn is received and approved by the Board. (7 U.S.C. 608(d). 7 CFR 982.53 and 7 CFR 982.460).
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 pari of an 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 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 (IDD). USDA
is an equal opportunity provider and employer.