OMB No. 0581-0178
FAR WEST SPEARMINT OIL ADMINISTRATIVE COMMITTEE
100 N. Fruitland, Suite B
Kennewick, WA 99336
Phone: (509) 585-5460
Grower No.: ______________________________
APPLICATION FOR CLASS 3 (NATIVE) ANNUAL ALLOTMENT
I request that an Annual Allotment Certificate be issued in the name of
for the 20___ - 20___ marketing year for CLASS 3 Spearmint Oil.
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Please: 1) Line through fields you have taken out.
2) Add NEW fields and descriptions below.
3) Indicate how many years, including this year, each field has been in production.
New Acres |
Old Acres |
Years in Production |
Location Description |
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0 |
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Total New |
Total Old |
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Signed: ___________________________________
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 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.
Form I-3 (Rev. 01/2014. Destroy previous editions.)
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | AHatch |
| File Modified | 0000-00-00 |
| File Created | 2021-01-23 |