No Form Number 906- TX Citrus-Handler Application

OMB No. 0581-0189

TEXAS VALLEY CITRUS COMMITTEE

901 Business Park Drive, Suite 400

Mission, Texas 78572

Telephone: (956) 581-2190

Fax: (956) 584-3307

HANDLER APPLICATION

20___ - 20___ SEASON

In accordance with Marketing Order No. 906, a handler is considered to be any person (except a common or contract carrier of fruit owned by another person) who handles fruit or causes fruit to be handled. If you handle oranges or grapefruit in the South Texas Counties of Cameron, Hidalgo, or Willacy, you must register as a handler with the Texas Valley Citrus Committee (Committee), by completing this form and returning it to the Committee at the address above.

□ Independent Handler □ Co-Op Handler

Firm Name ____________________________________________ Date _____________________

Tax Id No. _______________________ or Social Security No. _______________________

Mailing Address

(Address, City, State, Zip Code)

Physical Address

(Address, City, State, Zip Code)

Sales Phone No. ________________ Office Phone No. ________________ Fax No. ________________

Applicant Signature

Title

Sales Staff

List Brand Names or Labels:

Will you be individually labeling your product?

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.

Rev. 9/13. Destroy previous editions.