FV-210 915-Avocados Producer Exemption

Generic OMB Fruit Crops, Marketing Order Administration Branch

FV-210 Avocado (915) App.for Producers Exemption Certificate (09-10)

Generic Fruit Crops (Mandatory)

OMB: 0581-0189

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REPRODUCE LOCALLY. Include form number and date on all reproductions. OMB No. 0581-0189

U.S. DEPARTMENT OF AGRICULTURE

AGRICULTURAL MARKETING SERVICE

FRUIT AND VEGETABLE PROGRAMS

APPLICATION TO THE AVOCADO ADMINISTRATIVE COMMITTEE FOR PRODUCERS EXEMPTION CERTIFICATE

Avocado Administrative Committee

P.O Box 900188

Homestead, FL 33090-0848

Tel: (305) 247-0848

DATE


NUMBER OF FRUIT IN SAMPLE

PRODUCERS NAME


TELEPHONE NUMBER (include area code)

MAILING ADDRESS (City, County, State, and Zip Code)


LOCATION OF GROVE (from established landmarks)


VARIETY FOR WHICH EXEMPTION IS REQUESTED

Details □ Current Regulation □ Requested Exemption

SHIPPING DATE


WEIGHT

SIZE

NAME OF HANDLER


PRODUCER’S REASON FOR REQUESTING THIS EXEMPTION (If additional space is required, use back)


ESTIMATED QUANTITY OF AVOCADOS FOR WHICH EXEMPTION IS REQUESTED


CERTIFICATION OF STATEMENT: I (we) hereby agree to comply with all of the requirements of the Marketing Order regulating the handling of avocados grown in the Florida production area and with all the rules and regulations issued thereunder.

SIGNATURE OF APPLICANT


DATE

DO NOT WRITE BELOW THIS LINE

COMMITTEE ACTION

MATURITY SUBCOMMITTEE

YES

NO

AVOCADO ADMINISTRATIVE COMMITTEE

YES

NO


















































NOTE: According 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 display s a valid OMB control number. The valid OMB control number for this information collection is 0581-0189. The time required to complete this information collection is estimated to average 10 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, gender, religion, age, disability, political beliefs, sexual orientation, and marital or family status. (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.

FV-210 (Rev. 7/10. Destroy previous editions.)

File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorWZeng
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File Created2021-01-31

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