PMC 4.1 CA Dried Prunes Reserve Prunes Held--Handler

OMB No. 0581-0178

RESERVE PRUNES HELD BY HANDLER

TO: Prune Marketing Committee Date: ___________________________

3840 Rosin Court, Suite 170

Sacramento, CA 95834

HANDLER: __________________________________________________________________________

ADDRESS: __________________________________________________________________________

We certify we are holding as of __________________, 20___, at ________________________________ (plant location) the following reserve pool prunes:

Variety	Grade	Size Bracket	Aver. Size Count	Pounds		Variety	Grade	Size Bracket	Aver. Size Count	Pounds

Handler: _________________________ ______ Signature: ______________________________

Title: __________________________________

INSTRUCTIONS: Use as many forms as needed to list your inventory. Please keep different plant inventory on a single form.

IMPORTANT NOTICE: The issuance of a false certificate knowing it to be false is a violation of title 18, section 1001 of the United States Code, which provides a penalty of a fine or imprisonment, or both.

AUTHORITY: § 993.73 of Marketing Order No. 993, as amended, and § 993.172(e) of the Administrative Rules and Regulations established pursuant thereto.

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 10 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.

PMC 4.1 (Rev. 01/2014. Destroy previous editions.)