PMC 4.12 CA Dried Prunes Reserve Prunes Held by Handler for Anima

OMB No. 0581-0178

RESERVE PRUNES HELD BY HANDLER

FOR ANIMAL FEED DISPOSITION

To: Prune Marketing Committee

3840 Rosin Court, Suite 170

Sacramento, CA 95834

HANDLER: __________________________________________________________________________

ADDRESS: __________________________________________________________________________

We report below the locations and tonnages of reserve pool prunes available for shipment to animal feed disposal during the month of ________________________, 20___. The Prune Marketing Committee may issue their Warehouse Releases to instruct shipment of all or any part of these prunes during the month noted above.

Plant Designation	Street & Number	City	Phone	Name of Contact	Tons

Handler: _______________________________

Signature: ______________________________

Title: __________________________________

IMPORTANT NOTICE: The issuance of a false certificate knowing it to be false is a violation of Title 18, section 1001 of the United States Code, which provides a penalty of a fine or imprisonment, or both.

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 0581-0178. 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, 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.

PMC 4.12 (Rev. 10/2010. Destroy previous editions.)