PMC 2.21 CA Dried Prunes Application for Permission to Dispose of

OMB No. 0581-0178

APPLICATION FOR PERMISSION TO DISPOSE OF

UNDERSIZED PRUNES FOR NON-HUMAN USAGE

TO: Prune Marketing Committee Date: _____________________

3840 Rosin Court, Suite 170

Sacramento, CA 95834

Fax: (916) 565-6237

HANDLER

ADDRESS

The undersigned hereby applies for permission to dispose of undersized prunes, to the person, and for the non-human usage shown below:

	NAME	ADDRESS
(1) Our Vendee (customer):
(2) Consignee (if other than Vendee or User):
(3) User, Manufacturer, or Converter (if other than above):
(4) Non-Human Usage (specify):	(5)Period of Shipment:	(6) Approximate Tons to be Shipped:

If a broker is not involved, it is the handler’s responsibility to inform the actual user about the paperwork (forms PMC 4.71A and 4.71B) involved in complying with the undersized regulation. Failure of the actual user to complete the paperwork involved can result in refusal to issue future undersized approvals.

Signature: __________________________________

Title: ______________________________________

AUTHORITY: This report is required by law (7 U.S.C. 608(d), 7CFR 993.49, 993.50(g), 993.108 and §993.150(g)(1)).

FAILURE TO REPORT can result in a fine for each such violation and each day during which such violation continues shall be deemed a separate violation.

DEFINITIONS: Vendee: The Actual Buyer (Broker or User)

Consignee: One who takes possession of the load, (ie., holding area warehouse, etc.) if other than the actual user.

User: The feeder or feed dealer if its ground or mixed with other feed stuff.

Note: Prior to making any shipment or in any way disposing of undersized prunes, handlers are required to file a written application on form PMC 2.21 with the Prune Marketing Committee (Committee) for permission to make such shipment or disposal and receive the Committee’s approval thereof on form PMC 2.31. Disposal of undersized prunes shall be only in non-human consumption outlets and during the crop year received.

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.

PMC 2.21 (Rev. 01/2014. Destroy previous editions.)