FV-35 Diversion Report

Vegetable and Specialty Crops

FV-35 Diversion Report (rev.) 12-12-11

Vegetable and Specialty Crops Mandatory

OMB: 0581-0178

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OMB No. 0581-0178

IDAHO-EASTERN OREGON ONION COMMITTEE
PO BOX 909, PARMA, ID 83660
PHONE: 208-772-5111 FAX: 208-722-6582
IDAHO-EASTERN OREGON ONION DIVERSION REPORT
This form is to be completed for each Certificate of Privilege permit number. This form is due within 72 hours of
daily shipment(s) for spot sale onions and/or onions sold in 50 lb. bags; otherwise this form is due by 4 pm on the
Wednesday immediately following the shipping week of Monday through Sunday.
Date of
Shipment(s)

COP Permit No.
Receiver Name & Agent
Address
City
R.R. Car No. or Truck Licenses

State
Container & Label

Zip
Hundredweight
(cwt.) Shipped

TOTAL Hundredweight (cwt.) SHIPPED
I, the undersigned, hereby certify to USDA and to the Idaho-Eastern Oregon Onion Committee (Committee) that
this report represents all onions for this COP Permit Number that were diverted from fresh channels in accordance
with the regulations of the Committee (7 C.F.R. 958.328) for the stated date of shipment. Falsification of
information on this government document may result in a fine or imprisonment, or both (18 U.S.C. 1001).
Signature
Name
Title
Date
Firm
Phone
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 05810178. 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. 

FV-35 (Rev. 11/2011. Destroy previous editions.)


File Typeapplication/pdf
File TitleMicrosoft Word - Revised FV-35 Diversion Report
Authorahatch
File Modified2011-12-12
File Created2011-12-12

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