DA-15-CG Application for Initial or Continued Qualification of St

Attachment A (Page 1 of 2)
Approved OMB No. 0581-0093
U.S. DEPARTMENT OF AGRICULTURE
AGRICULTURAL MARKETING SERVICE
DAIRY PROGRAMS

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 0581-0093. The time required to complete this information collection is estimated to
average 3 hours 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 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).

APPLICATION FOR INITIAL OR CONTINUED QUALIFICATION OF
STATE OR REGIONAL DAIRY PRODUCT PROMOTION,
RESEARCH,
OR NUTRITION EDUCATION PROGRAM
(Under Dairy Production Stabilization Act of 1983)

To file a complaint of discrimination, write USDA, Director, Office of Civil Rights, 1400 Independence Avenue, SW,
Washington, DC 20250-9410 or call (800)795-3272 (voice) or (202) 720-6382 (TDD). USDA is an equal opportunity
provider and employer.

Information is collected in order to determine initial or continued
qualification of dairy product promotion, research or nutrition education
pprograms (7 CFR 1150.153). Application is voluntary but qualification is
nnecessary to receive a benefit. Information from organizations is held
cconfidential in the manner set forth in 7 CFR 1150.173, except for any
rrelease required under the Freedom of Information Act.

USDA, AMS, DAIRY PROGRAMS
PROMOTION AND RESEARCH BRANCH
STOP 0233, ROOM 2958-S
1400 INDEPENDENCE AVENUE, SW
WASHINGTON, D.C. 20250-0233

The Dairy Promotion and Research Order (7 CFR 1150.101 et seq.) provides in §1150.153 that any organization that conducts a State or
regional dairy product promotion, research, or nutrition education program may request qualification of its program from the Secretary of
Agriculture. Producers contributing to a qualified program (QP) may receive credit for contributions to such program pursuant to
§1150.152(c) of the Order. To be eligible for initial or continued qualification, the program must:
a. Be engaged in dairy product promotion, research, or nutrition education that are intended to increase consumption of milk and dairy products
generally.
b. Except for programs operated under the laws of the United States or any State, have been active and ongoing before November 29, 1983.
c. Be financed primarily by producers, either individually or through cooperative associations.
d. Not use a brand or trade name in its advertising and promotion of dairy products unless approved by the National Dairy Promotion and Research
Board and the Secretary.
e. Certify to the Secretary that any requests from producers for refunds under its programs will be honored by forwarding to the Board or to the
qualified State or regional program designated by the producer that portion of the refund equal to the amount of the credit given to the producer
because of his/her participation in the program. The amount of such credit may not exceed 10 cents per hundredweight.
f. Not use program funds for the purpose of influencing governmental policy or action.

If additional space is required, provide an additional attachment identified by item number.
The following information is to be submitted by each organization requesting initial or continued qualification of its State or regional
dairy product promotion, research, or nutrition education program(s).
1.

CURRENT NAME AND ADDRESS OF ORGANIZATION (Complete Mailing Address)

Name: ________________________________________________________

Telephone No.: __________________________________________

Add1: ________________________________________________________

Fax Number: ___________________________________________

Add2: ________________________________________________________

Email Address: _________________________________________

City:

2.

____________________________ State: ________ Zip: __________

DOES YOUR ORGANIZATION CONDUCT OR FUND A DAIRY PRODUCT: (Answer All That Apply)
A. Promotion Program?

3.

B. Research Program?

IS YOUR ORGANIZATION PRIMARILY FINANCED (50% OR MORE) DIRECTLY BY
PRODUCERS AND/OR COOPERATIVE ASSOCIATIONS?
Yes

5.

ARE CONTRIBUTIONS BY PRODUCERS
REFUNDABLE TO SUCH PRODUCERS?
Yes

No

DOES YOUR PROGRAM UTILIZE A BRAND OR TRADE NAME IN ITS ADVERTISING AND PROMOTION OF DAIRY PRODUCTS?
No

DOES YOUR ORGANIZATION USE PROGRAM FUNDS FOR THE PURPOSE OF INFLUENCING GOVERNMENTAL POLICY OR ACTION?
Yes

7.

4.

No

Yes
6.

C. Nutrition Education Program?

No

IF YOUR PROGRAM OPERATES UNDER STATE LAW, WHAT IS THE MANDATORY ASSESSMENT RATE PER HUNDREDWEIGHT UNDER THAT
PROGRAM? PLEASE LIST THE AMOUNT OF THE STATE ASSESSMENT OR N/A (NOT APPLICABLE).

CENTS PER HUNDREDWEIGHT

FORM DA-15-CG (6/07)

(REPLACES Form DA-15-R (02/02) which is obsolete.)(Destroy all previous editions)

Attachment A (Page 2 of 2)
8. PROVIDE THE FOLLOWING INFORMATION ON ANNUAL INCOME AND EXPENDITURES FOR THE CALENDAR YEAR ENDING
(SEE ACCOMPANYING ADDITIONAL INSTRUCTIONS FOR FORM DA-15-CG.)

SOURCES OF TOTAL ANNUAL INCOME:
Carryover from Previous Year (This should be the same as last year's reported "Total Funds
Available for Future Year Programs.") ...............................................................................................
Current Year Income 1/
Producer Remittances ..........................................................................................................................
Add: Payments Received from Other QPs...........................................................................................
Add: Payments Received from Unified Marketing Plan Equalization Fund........................................
Less: Payments Transferred to Other QPs ...........................................................................................
Less: Payments Transferred to Unified Marketing Plan Equalization Fund ........................................
Other Income Sources2/ .......................................................................................................................
TOTAL ADJUSTED ANNUAL INCOME3/ ...............................................................................................
EXPENDITURES:4/ (Provide total expenditures spent directly by your organization for each line item)
Advertising, Promotion, and Sales (AP&S)
Fluid Milk .............................................................................
Cheese...................................................................................
Butter ....................................................................................
Frozen Dairy Products ..........................................................
Other AP&S Expenditures5/ .................................................
Subtotal for AP&S .............................................................................................................
Nutrition Education .........................................................................................................................................
Nutrition Research...........................................................................................................................................
Dairy Product Research ...................................................................................................................................
Market and Economic Research ......................................................................................................................
Public and Industry Communications..............................................................................................................
Unified Marketing Plan6/ ................................................................................................................................
Administrative7/ ..............................................................................................................................................
Other Expenditures8/ .......................................................................................................................................
TOTAL ANNUAL EXPENDITURES .........................................................................................................
UDIA DUES9/ ................................................................................................................................................
TOTAL ANNUAL EXPENDITURES AND UDIA DUES .........................................................................
TOTAL FUNDS AVAILABLE FOR FUTURE YEAR PROGRAMS10/ ..................................................

_________
(YEAR)

$

+
+
(-)
(-)

$

1/

Please provide a schedule of income for all sources of current year income. List each separate source and amount of income by name of remitter. DO NOT list individual
producers. List funds received from and/or transferred to each QP and for the Unified Marketing Plan Equalization Fund separately.

2/

Examples of Other Income Sources include: total interest earned by your organization; income from processors, handlers, sales of supplies and materials; refunds from overpaid
expenditures; contributions from various organizations; gains on the sale of property and equipment; and miscellaneous items. These items should be listed separately on the
attached schedule of income.

3/

Total Adjusted Annual Income equals the total of all Sources of Income minus Payments Transferred to Other QPs and/or the Unified Marketing Plan Equalization Fund.

4/

For each line item expenditure, enclose a schedule of expenses by project or program area, including a project description(s) and related costs. If no funds were spent in a line
item, indicate zero (-0-).

5/

Examples of Other AP&S Expenditures include calcium, nonfat dry milk, "Real Seal," holiday, and multi-product advertising and promotion programs.

6/

Please enclose a copy of your unified marketing plan expenditure reports and supplemental documentation.

7/

Section 1150.151 (a) of the Order states that the administrative expenses incurred by the National Dairy Board shall not exceed 5 percent of the projected revenue of that fiscal
year. In this regard, we urge you to keep the administrative expenses of your organization to a minimum.

8/

Examples of Other Expenditures include capital expenses, contributions to universities and other organizations, etc. Provide a schedule of expenditures.

9/

Report only UDIA membership dues.

10/

Total Funds Available for Future Year Programs equals Total Annual Expenditures and UDIA dues subtracted from Total Adjusted Annual Income.

9.

PROVIDE YOUR ANNUAL AUDIT, INCLUDING THE AUDITOR'S LETTER OF COMMENTS THAT ADDRESSES THE FIVE CRITERIA (ITEMS A-E) FOUND ON PAGE 3
OF THE ACCOMPANYING ADDITIONAL INSTRUCTIONS FOR FORM DA-15-CG.

10.

PROVIDE A COPY OF YOUR MOST RECENT ANNUAL REPORT.

I hereby certify that the information provided above is true, complete, and correct to the best of my knowledge. If producers are eligible to receive a refund of their contributions, I also
certify that producers' refund requests will be handled in accordance with the Order. The Secretary of Agriculture may examine our books, records, files, and facilities to verify any of the
information submitted and may procure other information to verify this organization's eligibility for qualification.
I agree to notify the Dairy Programs, AMS, of any changes in our organizational structure, including merger or other types of consolidation; changes that may affect our
program's continued qualification (see items 2 through 6); or if our program is discontinued.

NAME

TITLE

SIGNATURE

DATE

FORM DA-15-CG (6/07) (Reverse)

ATTACHMENT B (3 pages)

Additional Instructions for Form DA-15-CG.
ITEMS 1-7
Items 1-7 must be completed as noted on form. For Item 7, if Qualified Program (QP) does not
operate under a State law, please respond with Not Applicable or N/A.
NOTE for ITEMS 8-10: If line items equal zero, use a - 0 - in the appropriate space. Use
numbers for all line items.
**All on-line attachments: Please identify name of your QP in file name. Abbreviations are
acceptable. On-line submissions should attach files or schedules as appropriate. The on-line
menu (document activities) provides one convenient location for all attachments.
ITEM 8
SOURCES OF TOTAL ANNUAL INCOME - Includes:
•

Carryover from Previous Year. The amount reported for the line item "Carryover from
Previous Year" should agree with the amount reported as last year's (20__) "TOTAL FUNDS
AVAILABLE FOR FUTURE YEAR PROGRAMS." This line item consists of unused,
available and/or uncommitted funds as a combined total. If this amount does not match
provide written explanation.

•

Current Year Income. List separately sources and amounts of income in an attached
Schedule of Income** by name of each remitter (responsible person) and include total
producer remittances. A list of individual producers is not requested. Funds received directly
from cooperative associations, other organizations, or producers should be listed separately.

•

Add: Payments Received from Other QPs. All funds received from other QPs should be
listed separately in an attached schedule.** This schedule should identify the QP and the
total funds received.

•

Add: Payments Received from Unified Marketing Plan Equalization Fund(UMPEF). All
funds received from the UMPEF should be listed separately in unified marketing plan receipts
and expenditures reports.

•

Less: Payments Transferred to Other QPs. All funding transferred to other QPs should be
listed separately in an attached Schedule.** This schedule should identify the QP and the
total funds transferred.

•

Add: Payments Transferred to UMPEF. All funding transferred to the UMPEF should be
listed separately in unified marketing plan receipts and expenditures reports.

2

•

Other Income Sources. Examples include total interest earned by your organization, sales of
supplies and materials, refunds from overpaid expenditures, contributions from various
organizations, gains on sale of property and equipment, and miscellaneous items. These items
should be listed separately in an attached Schedule of Other Income.**

$ Total Adjusted Annual Income. This line item equals the total of all Sources of Total
Annual Income minus Payments Transferred to Other QPs/UMPEF.
EXPENDITURES - For those QPs participating in the Unified Marketing Plan (UMP), all
UMP expenditures should be provided in the line entitled AUnified Marketing Plan.@ Local
expenditures Aoutside@ the UMP must be provided and listed accordingly. Expenditures should
also include any purchases of materials from other QPs. A separate Schedule of Expenditures**
by each project and corresponding project description(s) and their related costs should be
included. This item includes expenditures in the categories of:
•

Advertising, Promotion, and Sales (APS). List expenditures with appropriate schedules for
each subcategory (Fluid Milk, Cheese, Butter, Frozen Dairy Products, Other AP&S
Expenditures) on which your organization expended income. Schedules should provide, if
possible, a breakout of the type of media used. Include a description of each activity and
examples of locally produced items.** Please identify if you utilize advertisements or other
materials created by Dairy Management Inc. (DMI), or other promotion organizations.

•

Other AP&S Expenditures includes all other promotional expenses not categorized by
individual product categories and includes such things as calcium, nonfat dry milk, "Real
Seal," holiday, and multi-product advertising and promotion programs.

•

Nutrition Education, Nutrition Research, Dairy Product, Research Market and Economic
Research, Public and Industry Communications, and Administrative. List expenditures for
each category, along with their appropriate Schedule of Expenditures.** Include individual
project titles and descriptions for research expenditures.nified Marketing Plan. QPs
participating in the unified marketing plan may attach DMI unified marketing plan
expenditure reports and supplemental information.**

•

Other Expenditures. All other expenditure items not included in the specific expenditure
category line items should be placed in this category on the form and identified. This category
consists of capital expenses, purchase of miscellaneous materials, etc.**

•

Total Annual Expenditures. This line item is the sum of all expenditure categories and
subcategories.

•

United Dairy Industry Association (UDIA) Dues. List only UDIA membership dues. All
other monies paid to UDIA over the membership dues should be included in the appropriate
line item expenditures described above.

3

•

Total Annual Expenditures and UDIA Dues. This line item is the sum of "TOTAL
ANNUAL EXPENDITURES" and "UDIA DUES."

•

Total Funds Avaliable for Future Year Programs. This line item is obtained by subtracting
"TOTAL ANNUAL EXPENDITURES AND UDIA PAYMENTS" from "TOTAL
ADJUSTED ANNUAL INCOME." This calculation should be done on a calendar year
basis.

ITEMS 9 and 10
THE MOST RECENT ANNUAL AUDIT, COPIES OF FINANCIAL STATEMENTS, AND
AUDITOR'S LETTER OF COMMENTS. These items need to be done annually.
The audit and annual report may correspond to your organization's fiscal year (identify FY) and
does not need to be for calendar year 20__. If your program does not have an annual report,
indicate this in the submitted materials.**
The auditing firm needs to address the following items in their audit report:
a. Is the organization engaged in dairy product promotion, research, or nutrition education?
b. Are the organization's activities financed primarily (more than 50 percent) by dairy
producers, either individually or through cooperative associations?
c. Does the organization use a brand name or trade name in its advertising and promotion of
dairy products?
d. Does the organization use funds for the purpose of influencing governmental policy or
actions?
e. Does the organization have in place internal controls that provide reasonable assurance
that funds, property, and other assets are safeguarded against fraud, waste, and
unauthorized use?
The audit must be prepared according to either the generally accepted audit standards issued by
the American Institute of Certified Public Accountants OR the Government Auditing Standards
("Yellow Book") issued by the Comptroller General of the United States.

United States
Department of
Agriculture
Marketing and
Regulatory
Programs
Agricultural
Marketing
Service
1400 Independence Ave., SW., Stop 0225
Washington, DC
20250-0225

To Organizations That Conduct State or Regional
Dairy Product Promotion, Research, or Nutrition Education Programs
Enclosed is an Application for Initial or Continued Qualification of State or Regional Dairy
Product Promotion, Research, or Nutrition Education Program (Form DA-15-CG) for
submission of program information and financial data for calendar year 2006. Please complete
and return Form DA-15-CG (Attachment A), the Sur-COR-__ (Attachment C), and required
enclosures by (insert date)______, to:
USDA, AMS, DAIRY PROGRAMS
PROMOTION AND RESEARCH BRANCH
STOP 0233, ROOM 2958-S
1400 INDEPENDENCE AVENUE, SW.
WASHINGTON, D.C. 20250-0233
In order for your program to continue its qualified status under the Dairy Promotion and
Research Order, all pertinent information should be included when completing the application.
Form DA-15-CG is available for completion on-line from the Promotion and Research Branch
web page (www.ams.usda.gov/dairy/dairyrp.htm) or at the uniform resource locator on the
enclosed security letter. The Additional Instructions for Form DA-15-CG are enclosed and have
been slightly modified to include notes for on-line completion. There is no need to mail a hard
copy of completed Form DA-15-CG if submitted on-line. However, Sur-COR-06 and any
supporting documentation or schedules not attached during on-line submission (e.g., copy of
annual report or annual audit) must be submitted by mail.
The information you provide will be aggregated with information from other qualified programs
and included in USDA's "Annual Report to Congress on the National Dairy Promotion and
Research Program and the National Fluid Milk Processor Promotion Program." Information
from individual qualified programs will be kept confidential to the extent allowable under the
Freedom of Information Act.

2
It is the view of the Agricultural Marketing Service, which has the oversight responsibility for
all commodity research and promotion programs, that the administrative expenses for such
programs should be held to the lowest level necessary for the efficient and effective operation of
the program. Also, it is essential that your organization have in place internal controls which
assure that funds, property, and other assets are safeguarded against fraud, waste, and
unauthorized use.
Please note that the Form DA-15-CG continues to account for income and expenditures
associated with the Unified Marketing Plan (UMP) coordinated through Dairy Management Inc.
Only those qualified programs participating in the UMP need to include the requested
information as noted on the form and described in the additional instructions.
If you have any questions regarding the attachments or their completion, please contacting the
Dairy Promotion and Research Branch, at (202) 720-6909, by fax at (202) 720-0285.
Sincerely,

Deputy Administrator
Dairy Programs
Enclosures: Form DA-15-CG (Attachment A), Additional Instructions for Form DA-15-CG
(Attachment B), Sur-COR-__ (Attachment C), Instructions for Completing Sur-COR-__
(Attachment D), and Security Letter
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 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 (TDD). USDA is an equal opportunity provider
and employer.

ATTACHMENT C

State & Regional Promotion Program 20__ Expenditures on Dairy Products for the Annual
Report to Congress on The National Dairy Promotion and Research Program

Organization Name: __________________________________________

Please provide quarterly expenditures spent directly by your organization in the categories listed below to the fullest extent possible.
Indirect costs such as compensation costs, administrative expenses, and industry relations costs, and research costs should not be
included.
Advertising expenditures for television, print, and radio should be combined, and any production costs should be included.
Non-advertising demand enhancement expenditures mean non-media based strategies aimed at selling more dairy products, such as
public relations, retail and food service promotions, and nutritional education programs. Expenditures should be reported based on
when the events/activities occurred rather than when payment was made to reflect when consumers were exposed to the promotion
activity.
National Implementation Fund should reflect the annual amount of dollars forwarded to Dairy Management Inc. for their application
towards the Unified Marketing Plan (UMP). UMP dollars spent locally by your organization should be allocated to your
organization's quarterly expenditures

20__Expenditures ($1,000)
Quarter 1

Quarter 2

Quarter 3

Quarter 4

n.a.

n.a.

n.a.

n.a.

Total

Fluid Milk
-Advertising
-Non-advertising demand enhancing expenditures
A. Total Fluid Milk
Cheese
-Advertising
-Non-advertising demand enhancing expenditures
B. Total Cheese
Three-A-Day Program
-Advertising
-Non-advertising demand enhancing expenditures
C. Total
All Other Dairy Products
-Advertising
-Non-advertising demand enhancing expenditures
D. Total All Other Dairy Products
Total Expenditures (A+B+C+D)
E. National Implementation Fund

n.a. : Quarterly expenditures are not applicable. Please provide annual total.
Questions should be addressed to Dr. Harry M. Kaiser at 607-255-1598 or [email protected].
Completed forms should be returned to: USDA, AMS, Dairy Programs, Promotion and Research Branch, Stop 0233, Room 2958-S,
1400 Independence Avenue, SW., Washington, D.C. 20250-0233.

Sur-COR-05

Attachment D

Information and Instructions for Attachment C for State and Regional Promotion
Program 20__ Expenditures on Dairy Products For The Annual Report to Congress on
The National Dairy Promotion and Research Program
The Dairy Production Stabilization Act of 1983, which authorized the National Dairy
Promotion and Research Program and established the criteria for qualifying State and regional
programs to receive up to 10 cents of the 15-cent assessment, directs the Secretary of
Agriculture to provide to Congress annually an independent analysis of the effectiveness of the
program. Over the past few years, the Cornell Commodity Promotion and Research Program
conducted these annual independent analyses. Due to lack of historical data, most of the
previous work has focused primarily on the evaluation of the national dairy advertising
programs for fluid milk and cheese. Quarterly advertising expenditures at the national level
were used to reflect major marketing activities for the total dairy promotion program.
To better account for all demand-enhancing activities, we are requesting certain information
and expenditure data on both advertising and non-advertising promotion financed by the
producer promotion program.
The enclosed form Sur-COR-__ (Attachment C) asks for expenditure information from your
State or regional program directed to the promotion of dairy products. The attached form is
unchanged from previous years and is broken out by fluid milk, cheese, 3-A-Day, and all other
dairy product categories and requests quarterly expenditure data on advertising and nonadvertising promotion activities. Recognizing that the national “3-A-Day” campaign is a
major “multi-product promotion” program, we include a separate section of the survey form
for this activity. For other multi-product marketing, please put them in the “all other dairy
products” category.
Advertising expenditures for television, print, and radio should be combined, and any
production costs should be included. Non-advertising demand-enhancing expenditures mean
non-media based strategies aimed at selling more dairy products, such as public relations,
retail and food service promotions, and nutritional education programs. Expenditures should
be reported based on when the events/activities occurred rather than when payment was made
to reflect when consumers were exposed to the promotion activity.
Please fill out the form Sur-COR-__ to the fullest extent possible. If some lines are combined,
please indicate. From an analytical perspective, the more detail we can acquire—the better we
will be able to estimate the benefits of those activities.
The information that you provide will be kept confidential and will be incorporated with
national level data provided by Dairy Management Inc., for analytical purposes. Your State or
regional program is an important part of the total national effort and affects demand and price
levels both locally and nationally. Incorporating specific State and national level promotion
activities are important to evaluate the total benefits these programs have for the nation’s dairy
producers. Also, separating promotion into its advertising and non-advertising activities will
give program managers better information as to the value of those activities.

Example Security Letter

(Attachment E)

Full Name
Address
City, State XXXXX-XXXX
You have been given security to enter an Application for Initial or Continued Qualification of State
or Regional Dairy Product Promotion, Research, or Nutrition Education Program for the following
organization(s):
Name of Qualified Program
The URL for this system is: http://199.134.225.62/Dairy/Login.cfm
Your Login is: FNAME
Your password is: 55NAME99
Attach documents after submission of form. (Document Activities on the main menu)
Help Desk Phones and Hours:
Monday - Friday 8:00 AM - 4:00PM MST
970) 295-5174 (970) 295-5143 (970) 295-5168