F/H Form 2 Hazelnuts--Exchange of Merchantable Inshell Between Hand

OMB No. 0581-0178

HAZELNUT MARKETING BOARD

21595-A Dolores Way NE

Aurora, OR 97002-9738

Tel: (503) 678-6823

Fax: (503) 678-6825

EXCHANGE OF MERCHANTABLE INSHELL BETWEEN HANDLERS

The undersigned hereby certify that merchantable inshell hazelnuts have been exchanged between _____________________________________, the selling handler, and ___________________________________, the buying handler. It is also understood and agreed that ________________________________ (buying or selling handler) shall assume any diversion obligation required on the following lot(s):

Date of Inspection Certificate No. Weight (lbs) Size

SELLING HANDLER: BUYING HANDLER:

_________________________________________ __________________________________________

By ______________________________________ By ________________________________________

Title _____________________________________ Title ______________________________________

No sale of merchantable inshell hazelnuts between handlers can occur until a completed exchange form is received (7 U.S.C. 608(d), 7 CFR 982.56 and 7 CFR 982.456).

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 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.

F/H Form 2 (Rev. 10/2010) Destroy previous editions.