CMC Trf-20XX-20XX 929-Cranberries Acreage & Sales History Transfer (Buyer)

OMB No. 0581-0189

C RANBERRY MARKETING COMMITTEE

219A Main Street

Wareham, MA 02571

Phone: (508) 291-1510

Fax: (508) 291-1511

BUYER’S TRANSFER FORM

20___ CROP YEAR

BUYER INFORMATION Grower No. _________________

Name:

Business Name (or D/B/A):

Address:

Telephone No.:

SELLER INFORMATION Grower No. _________________

Name:

Business Name (or D/B/A):

Address:

Telephone No.:

1. Effective date of the transfer: ____________________________ (day/month/year)

2. □ If this if a TOTAL transfer of the Seller’s cranberry-producing acreage, ALL of the Seller’s cranberry-producing acreage and prior year’s cranberry production used in calculating sales history, will be automatically transferred to the Buyer. Sign, date, and return this form to the Cranberry Marketing Committee. In addition, legal documentation must accompany the Leased Acreage Form showing the transfer/sale of the cranberry acreage. Transfers will not be processed without attached legal documentation.

3. □ If this is a PARTIAL transfer of the Seller’s cranberry acreage, complete (1) and (2) below. NOTE: Whenever there is a partial transfer of cranberry-producing acreage, the Buyer and Seller must denote on their respective transfer forms: (1) the amount of cranberry-producing acreage being transferred; and (2) the amount, in barrels, of sales history attributable to the acreage being transferred for each of the crop years shown below. In addition, legal documentation must accompany the Leased Acreage Form showing the transfer/sale or the cranberry acreage. Transfers will not be processed without attached legal documentation.

   1. Amount of cranberry-producing acreage received through the transfer: ___________ acres

   2. Indicate below the amount of production, in barrels, attributable to the acreage received in (c)(1) for each of the crop years shown.¹

Crop Year	20___	20___	20___	20___	20___	20___
Barrels

I hereby certify to the best of my knowledge that the information contained herein is true and accurate.

Buyer’s signature ________________________________ Date __________________

¹ Buyer Note: Prior crop years’ sales history(production) must be transferred by the Seller.

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 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.

CMC Trf-20___/20___ (Rev. 7/10. Destroy previous editions.)