No Form number ID/E.OR Onions--Assessment Credit Rept

OMB No. 0581-0178

IDAHO-EASTERN OREGON ONION COMMITTEE

PO Box 909, PARMA, ID 83660

PHONE: 208-722-5111 FAX: 208-722-6582

ASSESSMENT CREDIT REPORT

This form is for a handler to receive a credit for assessments on onions that have been levied in accordance with §§ 958.42 and 958.240 and are subsequently regraded, resorted, repacked within the production area, or shipped in accordance with a special purpose shipment §958.328(e). In the case of special purpose shipment, please only complete the first four columns of the table. Please attach copies of the applicable page(s) from the inspection certificate(s) with each lot referenced below marked with a highlighter. This form must be completed and returned to the Idaho-Eastern Oregon Onion Committee within 72 hours of handling the onions for (check one): □ Regrading □ Repacking

□ Resorting □ Planting □ Livestock Feed □ Charity □ Dehydration □ Canning □ Freezing □ Extraction □ Pickling

□Disposal

Original Inspection Certificate No.

Original Bag Count

Original Container

Original Grade

New Inspection Certificate No.

New Bag Count

New Container

New Grade

I, the undersigned, hereby certify to USDA and to the Idaho-Eastern Oregon Onion Committee that this report represents all onions that have been regraded, repacked, resorted, or handled for special purpose by our firm. Falsification of information on this government document may result in a fine, or imprisonment of not more than five (5) years, or both (18 U.S.C. 1001).

Signature

Name

Title

Firm

Phone

Date

Address

City

State

Zip Code

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 8 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. 10/2010. Destroy previous editions.