No Form Number Handler Application

OMB No. 0581-0189

TEXAS VALLEY CITRUS COMMITTEE
901 Business Park Drive, Suite 400
Mission, Texas 78572
Telephone: (956) 581-2190
Fax: (956) 584-3307
HANDLER APPLICATION
20___ - 20___ SEASON
In accordance with Marketing Order No. 906, a handler is considered to be any person (except a common
or contract carrier of fruit owned by another person) who handles fruit or causes fruit to be handled. If
you handle oranges or grapefruit in the South Texas Counties of Cameron, Hidalgo, or Willacy, you must
register as a handler with the Texas Valley Citrus Committee (the “Committee”), by completing this form
and returning it to the Committee at the address above.
□ Independent Handler

□ Co-Op Handler

Firm Name ____________________________________________
Tax Id No. _______________________

or

Date _____________________

Social Security No. _______________________

Mailing Address ______________________________________________________________________
(Address, City, State, Zip Code)

Physical Address _____________________________________________________________________
(Address, City, State, Zip Code)

Sales Phone No. ________________ Office Phone No. ________________ Fax No. ________________
Applicant Signature ___________________________________________________________________
Title

Sales Staff __________________________________________________________________________
List Brand Names or Labels: ____________________________________________________________
___________________________________________________________________________________
Will you be individually labeling your product? _____________________________________________

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 05810189. 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.

Rev. 7/12. Destroy previous editions.