RAC-28 Processor's Rept. of Acquisition of Off-Grade (rev.)

OMB No. 0581-0178

RAISIN ADMINISTRATIVE COMMITTEE

2445 Capitol Street, Suite 200

Fresno, California 93721

Phone: (559) 225-0520 PROCESSOR’S REPORT OF ACQUISITION OF OFF-GRADE

Report No. _________________

The undersigned certifies to the Raisin Administrative Committee (RAC) and the Secretary of Agriculture of the United States that the following quantities of off-grade raisins, or raisin material, were received for the purpose indicated during the month of _____________________, 20___.

Tendered by (1) Name and Address	Date Acquired (2)	Varietal Type (3)	Weight of Residuals (4)	Weight of Off-Grade (5)	Under Exemption (6)
		TOTALS (7)

The making of any false statement or representations in any matter within the jurisdiction of any agency of the United States, knowing it to be false, is a violation of title 18, section 1001 of the United States Code, which provides for a penalty of a fine or imprisonment of not more than five years, or both.

Processor _____________________________________________ Date _____________________________________

By _________________________________________________ Title ___________________________________________________

INSTRUCTIONS FOR COMPLETING FORM RAC-28

One copy of this report shall be submitted to the RAC not later than the seventh day of each month by 10:00 a.m. and shall contain all raisins or raisin material acquired during the preceding month. The reports shall be numbered consecutively beginning at the start of each crop year and shall be certified by a responsible official of the reporting handler. Disposition of the raisins reported herein will be shown on Form RAC-28A.

1. Insert the name and address of the producer, packer or dehydrator from whom the material was received.

2. Show date acquired or received.

3. Indicate varietal type.

4. Show weight of raisin residuals including stemmer waste, tailings, or mixed waste.

5. Show weight of off-grade other than residuals.

6. If off-grade raisins were acquired under exemption (§ 989.173(b)(6)), indicate such by marking an “X” in this column.

7. Insert totals of residuals and off-grade received. If more than one sheet is used, totals should be brought forward.

8. Consult RAC Field Representatives on any points not clear to you.

This report is required by law (7 U.S.C. 608d, 7 CFR 989.173(b)(6)). Failure to report can result in a fine of $1,100 for each such violation, and each day during which such violation continues shall be deemed a separate violation.

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 15 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.

RAC-28 (Rev. 10/2010) Destroy previous editions.