927-Processed Pear Assessment Report

OMB No. 0581-0189

Remit to: WASHINGTON STATE FRUIT COMMISSION

105 S. 18^th Street, Suite 205

Yakima, WA 98901-2149

Phone: (509) 453-4837

Fax: (509) 453-4880 PROCESSED PEAR ASSESSMENT REPORT

Firm ___________________________________ Prepared by ________________________________________________

Address ___________________________________ Signature ________________________________________________

City ___________________________________ Date ________________________________________________

State ____________ Zip Code ____________ Crop Year ________________________________________________

Name of Processors or Firms to whom fruit was sold	Tons Culls Sold for $ or Loss	Tons Culls	Tons Graded	Assessment Owing Summer/Fall Canned Pears $_________ per ton (Refer to Rate Sheet for Per Ton Assessment
Total Tons Reported				Total Paid: $

TERMS: § 927.123. Payments received more than 45 days after the date on which they are due shall be considered delinquent and subject to a late payment charge of $25.00 or 2 percent of the total due, whichever is greater. Payments received more than 60 days after the date on which they are due shall be subject to 1 ½ percent interest charge per month, until final payment is made, and interest shall be applied to the total unpaid balance, including the late payment charge and any accumulated interest.

Enclosed Check No. ________________________

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 45 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, audio tape, 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, SW, Washington, DC 20250-9410, or call (800) 795-3272 (voice) or (202) 720-6382 (TDD). USDA is an equal opportunity provider and employer.

Rev. 9/13. Destroy previous editions.