H-2 Producer Payroll Report

UNITED STATES DEPARTMENT OF AGRICULTURE
AGRICULTURAL MARKETING SERVICE
DAIRY PROGRAMS

1930-220th St. SE, Ste. 102
Bothell, WA 98021-8471

Phoenix, 4285021-1664
Phone: (602) 547-2909

Phone: (425) 487-6009

FEDERAL MILK ORDERS I24

Fax: (425) 487-2775
E-mail; fmmaseattle@fmmaseattle.

10050 N 25th Ave., Ste. 302

&

13I

Fax: (602) 547-2906
E-mail: [email protected]

com

H-2
Producer Payroll Report

Note: This cover page is for information purposes only and does not need to be submitted to the market administrator's office.

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 0581-0032. The time required to complete this information collection is estimated to average 0.5 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, political beliefs genetic information, 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 TARGËT Center at (202) 7202600 (voice and TDD). To file a complaint of discrimination, write to USDA, Assistant Secretary for Civil Rights, Office of the
Assistant Secretary for Civil Rights, 1400 lndependence Avenue, S.W., Washington, D.C. 20250-9410, or call (866) 632-9992
(English) or (800) 877-8339 (TDD) or (866) 377-8642 (English Federal-relay) or (800) 845-6136 (Spanish Federal-relay). USDA is
an equal opportunity provider and employer.

UNITED STATBS DBP.A.RTMENT OF AGRICULTURE
Ä.GRICULTURAL MARKETING SERVICB
DAIRY PROGRAMS

Form H-2
1930-220th St. SE, Ste. 102

Form Approved, OMB No. 0581-0032

Phone: (602) 547-2909

Phone: (425) 487-6009

FEDERAL MILI( ORDERS I24

Fax: (425) 487-2775
E-mail: [email protected]

& I3I

Fax: (602) 547-2906
E-mail: [email protected]

PRODUCER PAYROLL REPORT
Month's Production Results

Handler

Tank No.

Producer No.

Total Pounds of Milk

Producer Name

Pounds of Butterfat

Address

Pounds of Protein 1/

City, State, Zip

Pounds of Other Solids 1/
Average Buttedat Test
Average Protein Test 1/
Average Other Solids Test 1/

Month & Year
Daily Weights

PPD 1/; Uniform Skim 2/
1

16

Producer Protein Price 1/

2

17

Other Solids Price 1l

.f

18

4

l9

5

20

6

21

7

22

8

23

I

24

10

25

11

26

12

27

13

28

14

29

15

30

Value of Milk Production

Gross Payment for Month

31

Totals

Average Tests
1st half

2nd half
Net Payment for Month

B.F.

Pro 1l

os

10050 N 25th Ave., Ste. 302
Phoenix, AZ85021-1664

Bothell, WA 98021-8471

1/

Less Partial Payment
Less A/P Advance

1l FO 124 handlers only.

Net Check

UNITED STATES DEPARTMENT OF AGRICULTURE
AGRICULTURAL MARKETING SERVICE
DAIRY PROGRAMS

1930-220th St. SE, Ste. 102
Bothell, WA 98021-8471

10050 N 25th Ave., Ste. 302
Phoenix, AZ85021-1664

Phone: (425) 487-6009

Phone: (602) 547-2909

Fax: (425) 487-2775
E-mail: [email protected]

FEDERAL MILK ORDERS I24

&

I31

Fax: (602) 547-2906
E-mail: [email protected]

PRODUCER PAYROLL REPORT
Handler
Producer

No.

Tank No.

Producer Name
Address
Citv, State, Zip

Pounds
1

2
3

4
5
6
7
8

I
10
11

12
13

't4
15
16
17
18

l9
20
21

22

23
24
25
26
27
28

29
30
31

Total

1/ Percent Test.
2l FO 124 handlers only.

Butterfat

1/

Prolein

11

2l

Other Solids 1/ 2/