F/H Form 5 Hazelnuts Rept to Marketing Board of Handler Carryover

Vegetable and Specialty Crops

FH Form 5 Rpt to Board of Handler Carryover (01-14)

Vegetable and Specialty Crops Mandatory

OMB: 0581-0178

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OMB No. 0581-0178

HAZELNUT MARKETING BOARD This report is due

21595-A Dolores Way NE in the Board office

Aurora, OR 97002-9738 on or before

Tel: (503) 678-6823 July 15, 20___.

Fax: (503) 678-6825


REPORT TO HAZELNUT MARKETING BOARD OF HANDLER CARRYOVER

ON __________________________


City and State _________________________


The undersigned certifies to the Hazelnut Marketing Board (Board) and to the Secretary of Agriculture that the following is a true and complete report, to the best of his knowledge and belief, of all unshelled hazelnuts that were being held on June 30, 20___.


MERCHANTABLE

Pounds

Size

Variety

Location (mark an X)

Obligation Status

(mark an X)

Within Production Area1

Outside Production Area2

Declared (2)

Undeclared





























1 Held in the name of the handler, whether or not sold. 2 Previously reported by the Board.


RESTRICTED

Pounds

Size

Variety

Classification (mark an X)

Merchantable

Ungraded

(Net Credited Wt.)






















In addition to the hazelnuts listed above, there were held on _________________, 20___, __________ pounds of ungraded hazelnuts that will be carried over undeclared. There were _________ pounds of shelled hazelnuts on hand, which have already been reported to the Board on F/H Form 1(c).


Firm or Individual ________________________________ By _________________________________

This report is required by law (7 U.S.C. 608(d), 7 CFR 982.66 and 7 CFR 982.466). Failure to report can result in a fine of not less than $50 or more than $5,000 for each such violation and each day during which 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 20 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.

F/H Form 5 (Rev. 01/2014) Destroy previous editions.

File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleHAZELNUT MARKETING BOARD
Authorpolly
File Modified0000-00-00
File Created2021-01-23

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