FV-12 CA Raisins--Request for Courtesy Inspection

Vegetable and Specialty Crops

FV-12 Request for Courtesy Inspection (01-14)

Vegetable and Specialty Crops Mandatory

OMB: 0581-0178

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OMB No. 0581-0178

RAISIN ADMINISTRATIVE COMMITTEE

2445 Capitol Street, Suite 200

Fresno, California 93721

Phone: (559) 225-0520

REQUEST FOR COURTESY INSPECTION


Varietal Type: ___________________________________________ Date: _____________________


Producer Name: _________________________________ Sample Number: __________________


Address: _____________________________________________________________________________


Request is hereby made for a courtesy inspection of natural condition raisins for:


Moisture ________________________

________________________ ________________________



FOR USDA USE ONLY


Inspection by: ___________________

Analysis No. ___________________



_______________________________________

Handler Name


By: ___________________________________
























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, SW, Washington, D.C. 20250-9410 or call (800) 795-3272 (voice) or (202) 720-6382 (TDD). USDA is an equal opportunity provider and employer.

FV-12 (Rev. 01/2014) Destroy previous editions.

File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorMurphy Jones CPS/CAP
File Modified0000-00-00
File Created2021-01-23

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