F/H Form C(3) Hazelnuts Acknowledgement of Bonding Requirement

OMB NO. 0581-0178

HAZELNUT MARKETING BOARD

21595-A Dolores Way NE

Aurora, OR 97002-9738

Tel: (503) 678-6823

Fax: (503) 678-6825

ACKNOWLEDGE OF BONDING REQUIREMENT

Number __________________

Issued to:

This will acknowledge receipt of the “Hazelnut Marketing Board Bonding Undertaking,” F/H Form C, together with the “Hazelnut Marketing Board Bond,” F/H Form C(1) and/or F/H Form C(2), and finding no evidence to the contrary, handler stated above, to become effective:

_____________________________________

and to terminate on

____________________________________

Your limit of outstanding liability at any one time will be __________________ pounds.

HAZELNUT MARKETING BOARD

By ____________________________________

authorized agent

Date of issue ______________ 20_____.

F/H Form C(3) (Rev. 01/2014) Destroy previous editions.