FV-210-1 915-Avocados Certificate of Exemption

REPRODUCE LOCALLY. Include form number and date on all reproductions. OMB No. 0581-0189

UNITED STATES DEPARTMENT OF AGRICULTURE

AGRICULTURAL MARKETING SERVICE

FRUIT AND VEGETABLE PROGRAM

AVOCADO ADMINISTRATIVE COMMITTEE

CERTIFICATE OF EXEMPTION

Pursuant to the Marketing Order regulating the handling of avocados grown in South Florida, and upon the basis of the evidence submitted to, and the determination made by, the Avocado Administrative Committee (Committee), as provided in said Marketing Order, there is hereby granted to _______________________________, a producer of avocados, an exemption from the regulation issued pursuant to said authority regulating maturity which will permit said producer to ship or handle the avocados herein specified:

Variety			Size			Weight
Quantity			Not to be shipped before
Location of Grove

This Certificate of Exemption may be transferred by said producer to any purchaser of said fruit, and the benefits of this Exemption shall be applicable to such purchases, provided that such purchaser gives notice to the Committee of such transfer, including number and sizes of packages involved, prior to the time that the fruit covered herein is shipped, and provided further that this Certificate has been properly completed by the producer and signed before a commissioned notary public. This Certificate shall be surrendered to the Federal State Inspection Program for cancellation upon completion of inspection of the subject avocados.

Issued on ____________________ 20____ upon the direction of the Committee.

____________________________________ ______________________

Committee Administrator Date

All avocados offered pursuant to this Certificate of Exemption conform to the above specifications and were produced in the location shown above. This exemption is hereby transferred to ________________________________________________ (Name of Handler), whose address is __________________________________________________________________________________.

_____________________________________________

Signature of Avocado Grower

State of Florida; County of ____________________________

Before me, the undersigned authority, personally appeared ___________________________________, who, being duly sworn, states that he(she) is ____________________________________ (Name of Handler) of _________________________________ (Name of Firm or Corporation), and that the statements herein contained are correct to the best of his(her) knowledge and belief.

SEAL

__________________________________

Notary Public

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 0581-0189. 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.

FV-210-1 (Rev. 9/13. Destroy previous editions.)