CPR-4 Report of Billings To and/or Payments from Pool Handlers

Return

to: Federal M¡lk Order No. l-Northeast Marketing Area

CPR.4
Form Approved, OMB No. 0581-0032
This repon is requ¡red by the Order ¡n
accordanæ w¡th 7 U.S.C. 608c and d.
Fa¡lure to report cân fesult ¡n the
assessment of a c¡vil penalty of up to
31,000 per day (7 U.S.C. 608c (r4XB))
or, upon conv¡c1ion, ¡n a fine of up to

333 North Fairfax Street
Mailing Address: P.O. Box 25828
Alexandria, V A 22313-5828
Tel: (703) 549-7000
(703) 549-7003
-Fax
Email: [email protected]
Website: www.fmmone.com

$5,000 per day (7 U.S.C. 608c (14X4)).

REPORT OF BILLINGS TO AND/OR PAYMENTS FROM POOL HANDLERS*
NAME OF COOPERATIVE ASSOCIATION:

NAME OR PURCHASER

DATE:
DELIVERY
PERIOD

DATE
BILLED

*lnclude all amounts billed and/or received since previous
report.
Report is due on the 20th of each month.
and mainta¡ning the data needed, and completing and rev¡ew¡ng the collect¡on of ¡nformation.

377-8642 (English Federal-relay) or (800) 84&6136 (Spanish Federal-relay). USDA ¡s an equal opportunity prov¡der and emptoyer.

AMOUNT
BILLED

AMOUNT RECEIVED
AND DEPOSITED

DATE
RECEIVED