No Form Number Information Data Sheet on Citrus Processors

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
INFORMATION DATA SHEET ON CITRUS PROCESSORS
Name of Manufacturer: _________________________________________________________________________
Address: _____________________________________________________________________________________
(include Street, City, State, and Zip Code)
1.

Products Manufactured: _________________________________________________________________

2.

Estimated Quantity of Citrus to be Processed: ________________________________________________

3.

Outlets for Products Manufactured (wholesale, retail, or direct to consumers): _______________________
_____________________________________________________________________________________
_____________________________________________________________________________________

4.

What type of packaging is used for distribution (bottles, cartons, sealed containers)? __________________
_____________________________________________________________________________________
_____________________________________________________________________________________

5.

Are facilities maintained for distribution of citrus in fresh form? __________________________________

6.

What method is used to extract juice? _______________________________________________________
_____________________________________________________________________________________

7.

How is juice treated upon extraction? _______________________________________________________
_____________________________________________________________________________________

REMARKS: __________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
___________________________________
Processor Signature

_____________________________
Date

___________________________________
Processor Name

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.