906-TX Citrus Application & Certification Citrus By-Prod

OMB No. 0581-0189

TEXAS VALLEY CITRUS COMMITTEE

901 Business Park Drive

Suite 500

Mission, Texas 78572

Telephone: (956) 581-2190

Fax: (956) 584-0300

APPLICATION & CERTIFICATION

CITRUS BY-PRODUCTS PURCHASE AGREEMENT

Firm: ___________________________________________________ Phone No.: ___________________________

Mailing Address: _______________________________________________________________________________

(Address, City, State, Zip Code)

Physical Address: _____________________________________________ Fax No.: _________________________

(If Different Than Mailing Address)

Our firm, which is engaged in the manufacture of citrus products, hereby requests that the Texas Valley Citrus Committee (the “Committee”) approve this application for eligibility under sections 906.34 and 906.40 of Marketing Order No. 906.

In submitting this application, the undersigned organization understands that all the Texas citrus our firm receives that is exempt from regulations must be used solely for the processing of juice products. We agree:

1. that citrus received for processing will under no circumstances enter into fresh fruit marketing channels;

2. not to sell or transfer for sale, directly or indirectly, any fruit from Texas for processing;

3. to maintain our PACA license during the period when buying fruit from Texas;

4. to undergo random inspection by the Committee or by a designated State/Federal Agency;

5. to not have facilities, equipment, or outlets to repack or sell fruit in its fresh form;

6. to report on the “Orange and Grapefruit Diversion Report” provided by the Handler from whom the fruit is purchased, the actual weight of the fruit, by attaching the scale ticket at the point of receiving to the proper copy of the Diversion Report. This shall be returned to the Committee within the week; and

7. that failure to comply with the terms of this Agreement, will cause removal of our name from the list of certified processors.

This Agreement, when signed by an authorized agent and returned to the Committee, will serve as certification of a receiver of Texas citrus for processing into juice products.

By: ___________________________________________ _____________________________

Signature of Processor Date

______________________________________________ _____________________________

Name (please print) Title

Person Responsible for Orange & Grapefruit Diversion Report: __________________________________________

NO SHIPMENTS OF SPECIAL PURPOSE ORANGES OR GRAPEFRUIT MAY BE MADE UNTIL THIS FORM HAS BEEN APPROVED BY THE COMMITTEE.

Approved by: ____________________________________________ ____________________

Texas Valley Citrus Committee Date

NOTE: 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 0581-0189. The time required to complete this information collection is estimated to average 20 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.

Rev. 7/10. Destroy previous editions.