ACP-6 Inter-Handler Transfer

OMB No. 0581-0215

Administrative Committee for Pistachios

4938 East Yale Avenue, Suite 102

Fresno, CA 93727

Tel (559) 255-6480; Fax (559) 255-6485

Email: [email protected]

INTER-HANDLER TRANSFER REPORT

This form is submitted to the Administrative Committee for Pistachios (ACP) in order to track inter-handler transfers within the production area, in compliance with section 983.150 of the FMO. The transferring handler must complete this form, sign Part A, and send one copy to the ACP, and send the original and one copy to the receiving handler within 30 days. The receiving handler must sign part B, and send the original to ACP within 30 days. Handlers are responsible for keeping a copy of the completed forms for their records.

Date of transfer: _______________________________________________________________________

Transferring handler: _____________________ From Plant at: _________________________________

Receiving handler: _______________________ To Plant at: ___________________________________

Description of inventory transferred:

Lot description:______________________________________________________________________

Lot ID marks:_________________________ Weight: ____________Lbs. Lot inspected (yes/no): ___

Container size/description:_____________________________________________________________

Aflatoxin Certificate No.:__________________ Minimum Grade Certificate No.:_________________

Lot description:______________________________________________________________________

Lot ID marks:_________________________ Weight: ____________Lbs. Lot inspected (yes/no): ___

Container size/description:_____________________________________________________________

Aflatoxin Certificate No.:__________________ Minimum Grade Certificate No.:_________________

Lot description:______________________________________________________________________

Lot ID marks:_________________________ Weight: ____________Lbs. Lot inspected (yes/no): ___

Container size/description:_____________________________________________________________

Aflatoxin Certificate No.:__________________ Minimum Grade Certificate No.:_________________

Part A:

Transferring Handler Signature:__________________________________ Date: __________________

Name:______________________________________________________ Title: __________________

Part B:

Receiving Handler Signature: ___________________________________ Date: __________________

Name:______________________________________________________ Title: __________________

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 0581-0215. The time required to complete this information collection is estimated to average 12 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.

ACP-6 (Rev. 08/10. Destroy previous editions.)