RAC-510 CA Raisins--Non-California Raisins

OMB No. 0581-0178

RAISIN ADMINISTRATIVE COMMITTEE Deliver or mail to:

2445 Capitol Street, Suite 200 Raisin Administrative Committee

Fresno, California 93721 and

Phone: (559) 225-0520 USDA Processed Products Inspection Service

NON-CALIFORNIA RAISINS

1.

Producer name

2.

Mailing address

3.

E-mail address

4.

Location and address of production unit, including Section, Township, and Range

5.

Acreage of production unit

acres

County of production unit

6.

Raisin net fruit weight

pounds

Variety

7.

Documents required and attached

a.

For USA raisins produced outside of California:

Commission processing order

Bill of lading or equivalent, with State of California stamp and date obtained at border crossing

Weight tags

b.

For raisins produced outside of USA:

US Customs entry form

I hereby agree to comply with all the regulations established for non-California raisins and certify that the raisins produced from grapes on the production unit identified herein are true and correct.

The making of any false statement or representations in any matter within the jurisdiction of any agency of the United States, knowing it to be false, is a violation of title 18, section 1001 of the United States Code, which provides for a penalty of a fine or imprisonment of not more than five years, or both.

Handler _____________________________________ Date ____________________________

By _________________________________________ Title ___________________________

INSTRUCTIONS FOR COMPLETING FORM RAC-510

This report is supplemental to the RAC-500 and the information herein is required pursuant to section 989.173(b)(7) of Federal Marketing Order No. 989, as amended.

1. Insert the name of producer, tenderer or equity holder as applicable (Individual, Partnership or Corporation name).

2. Show mailing address and phone number.

3. Show the location and address of the production unit, including the Section, Township and Range.

4. Show acreage of production unit, and County where produced.

5. Show raisin net fruit weight in pounds and variety.

6. All documents listed below are REQUIRED to be attached to this form and submitted to the Raisin Administrative Committee and the USDA Processed Products Inspection Service.

1. For USA raisins produced outside of California:

The Commission Processing Order from the State where produced, the bill of lading or equivalent with the State of California stamp and date obtained at the border crossing, and weight tag(s).

2. For raisins produced outside the U.S.A.:

The US Customs import entry form.

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 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.

RAC-510 (Rev. 10/2010) Destroy previous editions.