OMB No. 0581-0178
ALMOND BOARD OF CALIFORNIA
1150 9th Street, Suite 1500
Modesto, CA 95354
Tel: (209) 549-8262 Fax: (209) 550-5494
COMPLETION OF DISPOSITION OF RESERVE ALMONDS
PARTIAL SHIPMENT REPORT
Shipment No. ________________
Notice is hereby given of inspection, lot stamping, and shipment of reserve almonds to:
Name, address, and phone number of manufacturer, outlet, or other user:
Attached are □ invoice, if applicable, □ bill of lading, if applicable, □ inspection certificate, and □ Canadian certificate, if applicable. NO PHOTOCOPIES MAY BE USED
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_________________________ _____________________________________ _____________________
Handler Signature Date
MANUFACTURER CERTIFICATION
I hereby certify to the Almond Board of California (ABC) and the U.S. Secretary of Agriculture, that we did manufacture/use the almonds described and identified above in the quantity and on the date specified. I hereby agree that ABC employees and/or USDA representatives may enter our premises at any reasonable time to observe the storage or disposition of the almond material, and to examine and audit our records of almond transactions.
_________________________ _____________________________________ _____________________
Handler Signature Date
FEDERAL OR FEDERAL-STATE INSPECTION SERVICE CERTIFICATION
I hereby certify that the almonds described in form ABC-14 have been made into the produce described in form ABC-13.
_________________________ _____________________________________ _____________________
Manufacturer/User Signature Date
_________________________
Phone Number
INSTRUCTIONS: The handler must file the yellow copy with the ABC when the shipment is made. Attach a copy of the inspection certificate. Either the manufacturer of the product (if other than the handler) or the user of the reserve almonds must file the pink copy with the ABC after the Federal or Federal-State Inspection Certification is completed. The handler retains the gold copy for his files.
This report is required by law (7 U.S.C. 608(d), 7 C.F.R. 981.67, and 7 C.F.R. 981.467). Failure to report can result in a fine for each such violation, and each day that such violation continues shall be deemed a separate violation.
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 12 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 of 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, political beliefs, genetic information, 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 USDA, Director, Office of Civil Rights, Room 326-W, Whitten Building, 14th and Independence Avenue, SW, Washington, DC 20250-9410 or call (202) 720-5964 (voice and TDD). USDA is an equal opportunity provider and employer.
ABC-14 (Rev. 01/2014) Destroy previous editions.
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | snel |
File Modified | 0000-00-00 |
File Created | 2021-01-24 |